For healthcare professionals, our pursuit towards successful treatment outcome is highly dependent on patients’ compliance to the prescribed medical treatment. Treating sick infants and young children can be a very challenging experience due to the lack of licensed drugs approved for paediatric use. Most drugs in the market are developed for adult patients and due to ethical issues, there are very few drug investigational studies performed on children population. Hence, the variety of drug formulations available for paediatric use remains limited.
However, if the benefits of treatment exceed the risks, the physician may still prescribe the drug (which is not licensed for paediatric use) in a smaller dose. In cases where the safest and most effective medicine is not commercially available in an appropriate pharmaceutical dosage strength and form, access to compounded dosage forms becomes an essential component in ensuring therapeutic success.
Pharmacy compounded formulations may also be useful in the following scenarios:-
A different dosage strength and form is required – Children with difficulty swallowing oral tablets may have their medication compounded into a flavoured liquid suspension. In situations where the patient is not able to ingest medication, the same active ingredient maybe formulated into other dosage forms to be administered into alternative routes such as rectal suppository, dissolvable lozenges, medicated lollipops, topical foam, cream, gel or ointment.
A discontinued or unavailable medicine is required – The pharmaceutical active ingredient may be customized into the desired dosage strength and form.
Patient is sensitive to a particular excipient or preservative contained in the proprietary product – A similar preparation maybe formulated with the active pharmaceutical ingredient, minus the allergy causing agent.
Poor compliance due to drug palatability – A wide array of interesting flavours such as marshmallow, blackcurrant, chocolate, butterscotch, peach apricot, root beer, tutti frutti, bubble gum, and raspberry (and many more!) may be added to the compounded formulation to mask the bitter taste of the drug. This is especially important in terminally ill children who refuse to take their medications.
Other examples of compounded medication for paediatric use include:-
- Skin conditions such as eczema, psoriasis, diaper rash and wounds.
- Health related conditions in children such as insomnia, vitamin deficiencies and drug compliance issues.
- Paediatric hypertension and epilepsy
- Paediatric pain management via topical analgesics