Compounding

Bio-identical hormones have been used over 20 years to meet the needs of women (in pre menopause, menopause and post menopause) and men ( in andropause). Bio-identical hormone treatment helps both women and men to restore hormal imbalance and help reduce or treat symptoms caused due to this imbalance.

Symptoms of hormonal imbalance in women include: depression, mood alterations, sleep disturbances, hot flashes, hair loss, fatigue, weight problems, bone loss (osteoporosis), and decreased sex drive.

Symptoms of hormonal imbalance in men include: decreased energy, sleep disturbance, mood alterations, depression, muscle weakness, erectile dysfunction, and decrease sex drive.

Bio-identical hormones include Estrone (E1), Estradiol (E2), Estriol (E3), Progesterone, Testosterone, Dehydroepiandrosterone (DHEA), and Pregnenolone. Our pharmacists work together with patients and prescribers to provide customized bio-identical hormone replacement therapy that provides the needed hormones in the most appropriate strength and dosage form to meet each individuals' specific needs.

Hormone replacement therapy should be initiated carefully after an initial medical and family history has been reviewed. Every individual is unique and will respond to therapy in their own way. Close monitoring and medication adjustments are essential.

Before undergoing a hormone replacement therapy, it is important to test for a hormone imbalance. This is best achived using a saliva test. Saliva hormone testing is most useful for uncovering hormone imbalance. Saliva hormone level measures hormone at tissue (cells) level. Because saliva reflects what actually gets into tissue rather than what might eventually get into tissue, it better reflects tissue (bio-available) hormone levels. In contrast, a blood hormone level reflects hormone which has not yet been delivered to tissue.

Saliva Test kits are available for purchase at River Run Pharmacy.Tests available include:

• Female Panel
• Male Panel
• Adrenal Panel

Chlorhexidine 0.12% Oral Gel

Carbamide Peroxide 22% Potassium Nitrate 5% Sodium Fluoride 2% Dental Gel (Teeth Bleaching)

Doxycycline 20mg Capsules ( for Periostat)

Magic Mothwash (Diphenhydramine, Nystatin Susp, Tetracyline, Dexamethasone)

Metronidazole benzoate 3% Dental Gel

Nystatin 100,000u to 200,000u Oral Troches

Pilocarpine 10 mg/ml Oral Spray (Dry Mouth formulation)

Pilocarpine HCl 2 mg Base A Troche (Dry mouth formulation)

Saline/Glycerin Oral Suspension (Saliva Substitute)

Tetracyline 2.4% Periodental Gel

Hair Growth

Minoxidil 5% Topical Solution

Fungal Skin Infections

Clotrimazole 2% Ibuprofen 2% Tea Tree Oil 1% Topical Cream

Ketoconazole /Tea Tree Oil/ DMSO Antifungal Solution

Tea Tree Oil 5.4% Lavender Oil 1% Clotrimazole 1% Undecylenic Acid 5%

Urea 5% Topical Cream

Nail Fungus

Itraconazole 1%/Ibuprofen 2% in DMSO Nail Polish

Fluconazole 1%/DMSO Topical Solution

Resistant Staphylococcus aureus (MRSA) Infections

Clindamycin 3%/Doxycycline 1% Topical Ointment

Ketoconazole 2%/Ibuprofen 2% Topical Powder

Bleaching/ Skin Lightening

Hydroquinone 4% Tretinoin 0.05% Urea 10% in Hydrocortisone 2.5% Topical Cream

Hydroquinone 4% Ascorbic acid 2% Salicyclic Acid 5% in Bethamethasone 0.1% Cream

Hydroquinone 5% Tretinoin 0.1% Triamcinolone 0.1% Topical Gel or Cream

Hydroquinone 5% Kojic acid 5% Hydrocortisone 1% in Tretinoin Cr

Hydroquinone 7% Kojic acid 5% in Clobetasol Cream

Hydroquinone 8% Glycolic Acid 8% Tretinoin 0.05% in Hydrocortisone 0.5% Topical Cream

Hydroquinone 10% Tretinoin 0.05% Triamcinolone 0.1% Topical Cream

Skin Renewal (Applied 2 to 3 times per week for Skin Exfoliation)

Lactic Acid 7% (W/V)/Glycolic Acid 5.6% (W/V) Topical Solution

Circulation Problems

Nifedipine 4% Topical Lipoderm®

Pentoxifylline (5%, 10% & 15%) Lipoderm® Transdermal

Diabetic Neuropathy

Ketamine 10%/Gabapentin 6%/Clonidine 0.2%/Nifedipine 2% Topical Lipoderm®

Amitriptyline HCl 2%/Baclofen 5%/Ketamine HCl 5%/Ketoprofen 10% Topical Lipoderm®

Amitriptyline HCl 2%/Baclofen 2% Topical Lipoderm®

Amitriptyline HCl 2%/Ketoprofen 2%/Carbamazepine 2% Topical

Diabetic Toes

Nifedipine 4% Topical Lipoderm®

Pentoxifylline (5%, 10% & 15%) Lipoderm® Transdermal

Ketamine 10%/Gabapentin 6%/Clonidine 0.2%/ Nifedipine 2% Topical Lipoderm

Rough/Dry Feet

Urea 25% Topical Cream or Foam

Urea 20%/Lactic Acid 5% Topical Cream

Discontinued & Other Oral Capsules:

Disulfiram 250mg Capsules (Alcohol Abuse)

Doxycycline 20mg Capsules ( for Periostat)

Meclizine HCl 25mg Capsules (Diziness)

Magnesium Glycinate 250mg or 600mg (Essential Mineral – a high absorbable form of Mg)

Potassium Iodide (KI) ( Radiation Emergencies)

Red Yeast Rice 300mg (Cholesterol Supplementation)

Thyroid Capsules (Various Strengths)

Testosterone Topical Gels or Creams (Various strengths)

Testosterone 5, 10 or 25 mg Base A Troche (Restoring Hormone Balance)

Progesterone 30 mg/mL Topical Cream (VersaBase)

Sildenafil 20 mg T.T. (200 mg mold) Polyglycol Troche™ Base (Erectile dysfunction)

Diltiazem 2 to 5 % Ointment (Anal fissures)

Diltiazem 5%, Lidocaine 5% Ointment (Anal Fissures)

Nifedipine 0.2% Ointment (Anal Fissures)

Nifedipine 0.2%, Lidocaine 1.5% Ointment (Anal Fissures)

Amputation Pain

Amitriptyline HCl 2% Clonidine 0.2% Ibuprofen 2% Guaifenesin 2% Ketamine 2% Ketoprofen 20% in Topical Lipoderm®

Amitriptyline HCl 2% Capsaicin 0.025% Guaifenesin 10% Ketoprofen 10% Lidocaine 2% in Topical Lipoderm®

Baclofen 5% Gabapentin 5% Ketoprofen 10% Lidocaine 5% in Topical Lipoderm®

Baclofen 2% Clonidine HCL 0.2% Gabapentin 10% Ketamine HCL 5% in Topical Lipoderm®

Cyclobenzaprine HCl 2% Ketoprofen 10% in Topical Lipoderm®

Rheumatoid Arthritis / Joint Pain

Ketoprofen 10% Topical Lipoderm®

Ketoprofen 20% in Lipoderm™ Transdermal Gel

Soft Tissue Inflammation

Ibuprofen 20% in Lipoderm® Transdermal Gel

Diclofenac Sodium 10% in Lipoderm® Transdermal Gel

Ibuprofen 20%/Piroxicam 1% Topical Lipoderm

General Pain

Ketoprofen 10%/Cyclobenzaprine HCl 2% Topical Lipoderm®

Ibuprofen 20%/Piroxicam 1%/Cyclobenzaprine HCl 1% Topical Lipoderm

Anesthetics before Laser Procedure

Lidocaine 6% Tetracaine 6% Benzocaine 4% Topical Gel

Lidocaine HCl 4% Tetracaine HCl 0.5% Epinephrine 0.05% Topical Gel

Multiple Sclerosis

Naltrexone HCl 0.5 mg Capsules Size #1

Neuropathic Pain

Amitriptyline HCl 2%/Baclofen 2% Topical Lipoderm®

Amitriptyline HCl 2% Baclofen 5% Ketamine HCl 5% Ketoprofen 10% in Topical Lipoderm®

Amitriptyline HCl 2% Clonidine 0.2% Ibuprofen 2% Guaifenesin 2% Ketamine 2% Ketoprofen 20% in Topical Lipoderm®

Baclofen 5% Gabapentin 5% Ketoprofen 10% Lidocaine 5% in Topical Lipoderm®

Gabapentin 6% Clonidine HCl 0.2% Ketamine 10 % in Topical Anhydrous Lipoderm

Gabapentin 10%/Clonidine HCl 0.2%/Baclofen 1% in Topical Anhydrous Lipoderm

Inflammatory Pain from Injury

Piroxicam 2% Topical Anhydrous Lipoderm®

Piroxicam 5% in Lipoderm® Transdermal Gel

Diclofenac Sodium 10% in Lipoderm® Transdermal Gel

Ketoprofen 10% Topical Lipoderm® (Pentylene Glycol)

Ibuprofen 20% in Lipoderm® Transdermal Gel

Fibromyalgia

Guaifenesin 2% and 10% in Lipoderm Base

Atenolol 7.5mg/ml Oral Suspension

Amlodipine 1mg/ml Oral Suspension

Aldactazide 5mg/ml Oral suspension

Baclofen 5mg/ml Oral Suspension

Calcium Carbonate 200mg/ml Oral Suspension

Dexamethasone Phosphate 1mg/ml Oral Syrup

Domperidone 5mg/ml Oral Suspension

Gabapentin 100mg/ml Oral suspension

Ibuprofen Suppositories

Lansoprazole 3 mg/mL Suspension for oral or G-tube use

Metronidazole 15mg/ml Oral Suspension

Metoprolol 10mg/ml Oral Suspension

Mouth wash for pain – HSC (Lidocaine 2% Oral Rinse Flavored)

Nitrofurantoin 10mg/ml Oral suspension

Omeprazole 2 mg/mL Suspension for oral or G-tube use

Oseltamivir 15mg/ml Oral Suspension

Predinisone 5mg/ml Oral Suspension

Sodium Bicarbonate 8.4% Oral Solution (Na+ 1 mmol/ml)

Sipronolactone 5mg/ml Oral Suspension

Sildenafil Citrate 1 mg/mL Oral Suspension

Trimethoprim 10mg/ml Oral Suspension

Ursodiol 50mg/ml Oral Suspension

Aromatic Head Lice Formula

Diphenhydramine HCl 1% Calamine 8% Topical Cream (For Chicken Pox)

Zinc Oxide 40% in Hydrocortisone 1% Cream and Nystatin Cream (1:2) - Diaper Rash Bum Cream

Miconazole 2% in Mupirocin 2% Oint and Betahmethasone 0.1% Oint (1:1) – Nipple Cream for Mom

Nail Fungus

Itraconazole 1%/Ibuprofen 2% in DMSO Nail Polish

Fluconazole 1%/DMSO Topical Solution

Fungal Skin Infections

Clotrimazole 2%/Ibuprofen 2%/Tea Tree Oil 1% Topical Cream

Ketoconazole/Tea Tree Oil/DMSO Antifungal Solution

Circulation Problems

Nifedipine 4% Topical Lipoderm®

Pentoxifylline (5%, 10% & 15%) Lipoderm® Transdermal

Warts & Corns

Salicylic Acid 40% Ointment

Salicylic Acid 20% Lactic Acid 20% Trichloroacetic Acid in Flexible Collodion

Salicylic Acid 10% Podophyllum 10% Trichloroacetic Acid 10% Topical Solution

Salicylic Acid/Menthol Cream

Rough/Dry Feet

Urea 25% Topical Cream or Foam

Urea 20%/Lactic Acid 5% Topical Cream

Hyperhidrosis of the Feet (Sweaty Feet)

Glycopyrrolate 1% Topical Cream

Glycopyrrolate 0.5% Topical Solution (Roll – on Bottle)

Glycopyrrolate 1% Topical Lotion

Athlete’s Foot

Tea tree Oil 5,4% Lavender Oil 1% Clotrimazole 1% Undecylenic Acid 5%

Urea 5% Topical Cream

Excessive Perspiration

Glycopirrolate 0.5% Topical Solution

Methenamine 5% Deodorant Stick

Heel Spurs

Ketoprofen 10% Topical Lipoderm

Amitriptyline HCl 2% Baclofen 5% Ketamine HCl 5% Ketoprofen 10% Topical Lipoderm

Ibuprofen 20% in Lipoderm Transdermal Gel

Iontophoresis Solutions & Phonophoresis Gels (Ultrasound)

See PhysioTherapy Compounding Ideas

Athlete’s Foot

Tea tree Oil 5,4% Lavender Oil 1% Clotrimazole 1% Undecylenic Acid 5%

Urea 5% Topical Cream

Excessive Perspiration

Glycopirrolate 0.5% Topical Solution

Methenamine 5% Deodorant Stick

Heel Spurs

Ketoprofen 10% Topical Lipoderm

Amitriptyline HCl 2% Baclofen 5% Ketamine HCl 5% Ketoprofen 10% Topical Lipoderm

Ibuprofen 20% in Lipoderm Transdermal Gel

Iontophoresis Solutions & Phonophoresis Gels (Ultrasound)

See PhysioTherapy Compounding Ideas

Muscle Spasms/Leg Cramps

Guaifenesin (2% & 10%) in Lipoderm® Base

Magnesium Chloride USP 10% Topical Lipoderm

Nail Fungus

Itraconazole 1% Ibuprofen 2% in DMSO Nail Polish

Pain

Ketoprofen 20%/Ibuprofen 2%/Ketamine 2%/Clonidine 0.2%/Amitriptyline HCl 2%/Guaifenesin 2% Topical Lipoderm®

Ketoprofen 10%/Guaifenesin 10%/Capsaicin 0.025%/Lidocaine 2%/ Amitriptyline HCl 2% Topical Lipoderm®

Ketoprofen 10%/Cyclobenzaprine HCl 2% Topical Lipoderm®

Baclofen 5%/Ketoprofen 10%/Lidocaine 5%/Gabapentin 5% Topical Lipoderm®

Ketamine HCl 5%/Gabapentin 10%/Clonidine HCl 0.2%/Baclofen 2% Topical Lipoderm®

Ketoprofen 5%/Cyclobenzaprine HCl 0.5%/Lidocaine HCl 5% Topical Lipoderm®

Tired/Aching Feet

Essential Oil Foot Cream

Relaxing Foot Effervescent

Compounding allows veterinarians to broaden their prescribing abilities and to offer dosage forms that are patient-specific in strength and formulation. The compounding pharmacist can solve a lot of problems for both the doctor and the owner – certain medications maybe available only in human dosage forms or exist only as bulk chemicals; specific products may no longer be available; the dosage strength of commercially available product may be too big for the small animal or too little for the horse; the taste or flavour may be too disagreeable for the animal. Compounders also work on problems of many exotic animals.

Some of most popular veterinary formulas are:

Aluminium Hydroxide Oral Suspension

Amino Caproic Acid 16.7% Oral Syrup

Amitriptyline 10 mg/0.5ml Oral Suspension

Azithromycin 50 mg Chewable Treat

Calcitriol 4 nanograms/0.25 ml Oral Oil Solution

Calcium Glubionate Oral Syrup

Camphor Liniment for Veterinary Use

Captopril 5 mg/ml Oral Solution

Diethylstylbestrol Oral Capsule

DMSO Cream 50% and 70%

Furosemide 10 mg/0.1 ml Pluronic Lecitin Organogel

Genital Violet 0.5% Stain Solution

Hairball Remedy

Insect repellent Bath Oil

Itraconazole Suspension 100 mg/ml

Ivermectin/Pyrantel Capsules 65 mcg/57 mg

Kanamycin Compound Oral Antidiarrhea Mixture

Ketamine HCl 10 mg Base A Troche

Metronidazole Benzoate 125 mg/ml Oral Suspension in Oil

Omeprazole Flavoured Suspension

Potassium Bromide 250 mg/ml Oral Solution

Povidone-Iodine Shampoo for Vet Use

Phenobarbital 200 mg Chewable Treat

Tetracycline 100 mg/ml Oral Suspension

Triple Fish oral Suspension

Bio-identical Hormone Replacement

See BHRT Compounding Ideas

Libido

Sildenafil Citrate 1% Testosterone 0.1% Topical Cream (VersaBase®)

Sildenafil Citrate 2% Aminophylline 3%/Arginine HCl 6% Topical Cream (VersaBase®)

Sildenafil Citrate 1% Arginine HCl 11.7%

Sildenafil Citrate 1% Topical Cream

DHEA (Dehydroepiandrosterone) 15 mg/0.25 ml Topical Cream (VersaBase®)

Testosterone 1% Topical Cream

Vaginal Dryness

Estriol 0.05% Vaginal Cream

Vitamin E 200 u/mL Vaginal Cream

Vitamin E 200 IU Base MBK Vaginal Suppository