Compounding Pharmacy in Pediatrics

Compounding pharmacy has always been a last resort for products in certain dosage forms or doses that aren’t traditionally FDA-approved, but it can be especially effective in increasing adherence in specific populations like pediatrics.

Children commonly are hesitant to take almost any form of medication, likely due to a past memory of a similar spoonful of red liquid tasting really bad and possibly making them feel a little nauseous. Or in the case that no liquid form is available, they were left with swallowing a large pill or having it mixed in with applesauce. Clearly pediatrics is one area of pharmacy where adherence needs to be closely monitored and tailored for. Compounding custom oral suspensions/solutions with flavors like bubble gum and sweet fruits will have a better impact and hopefully will improve adherence with the child.

Pediatric patients with sensory processing disorders like ADHD or autism can also greatly benefit from custom formulated medications. These conditions can cause adverse reactions to normal stimuli like taking a medication orally. Luckily for patients like this, compounding pharmacies can custom formulate the medication to either be more palatable by reducing the particle size or adding flavors, or even create a topical formulation of the medication for transdermal application.

Specific food or dye allergies can also be a reason to use a compounding pharmacy if no FDA approved option is available without the specific allergen. Whether it be an allergy to the gluten in the capsule or a binder/filler, there are many different formulations at the disposal of compounding pharmacists from oral liquids, tablets, capsules and more, where each ingredient can be controlled.

Compounding pharmacies are in a bit of a grey area with FDA approval. While they are supervised and inspected by the FDA, compounded preparations are technically not FDA approved since they can be slightly different from batch to batch, and it would be impossible to individually test each formulation from each compounding pharmacy across the country. This being said the FDA does recognize the importance of these specialty pharmacies but reserves recommending them only for when there isn’t an FDA approved equivalent on the market, or if there is a widespread drug shortage. This is where compounding fits into pediatrics, where FDA approved products fail or result in underwhelming adherence.

Since compounded products aren’t individually FDA approved, it is vital to only use well trusted compounding pharmacies with transparent operating procedures. There have been many examples in the past of poor quality control standards and even fraud at some compounding pharmacies. However, this negative press shouldn’t keep patients away from potentially necessary customized preparations.

Thank you for reading!