Compounding Basics

A plain glossary of the dosage forms and bases a compounding pharmacy prepares, from troches and rapid dissolve tablets to creams, oral rinses, nasal sprays and suppositories. Each entry says what the form is and what it contains, and links to the Bayview page that prepares it.

Topical and oral routes send the same drug down different paths, one through the liver and one into the tissue under the skin. Here is what changes, what does not, and what Bayview compounds either way.

Only the tacrolimus ointment, capsules, granules, and injection are FDA-approved, so otic solutions, rectal enemas, gels, creams, foams, and shampoos are compounded and off-label. This guide sets out the forms, strengths, published evidence by route, the current boxed warning, and what belongs on the prescription.

Bayview compounds sildenafil in two dissolvable forms: troches that dissolve between the cheek and gum, and rapid dissolve tablets placed under the tongue. This explainer covers the strengths prepared, the directions for each form, what FDA has not evaluated, and what the preparation costs.

Compounded pain creams combine two to four actives with different mechanisms in one topical base, at strengths no manufacturer offers. This provider guide covers the ingredient menu, the strength and base options, what the published literature reports, and what to put on the prescription.

Clomiphene citrate is a racemic mixture of two isomers, and enclomiphene is the trans-isomer on its own. Here is what that composition difference means, why enclomiphene is compounded, and how both compare to testosterone therapy.

Estriol is the weakest of the body's three estrogens and has no FDA-approved US product, while estradiol is the most potent and is sold in FDA-approved forms. Here is what each name means, how vaginal and skin creams differ, and where compounded Bi-Est fits.

Numbing cream sold without a prescription is limited to 4% lidocaine, and the FDA has warned consumers about high-strength products marketed for tattooing and laser work. This post describes what compounded BLT numbing cream contains, how prescribers write directions for it, and why it is dispensed only on a prescription.

The published seven-class topical corticosteroid potency chart, given twice: once by class and once sorted by molecule for lookup. Then what the vehicle changes, why a compounded strength has no class, and the triamcinolone and fluocinonide preparations Bayview compounds on a prescriber's order.

A compounding pharmacy prepares a medication from individual ingredients on a prescriber's written order, in the strength, dose form and ingredient list that prescriber specified, rather than dispensing a finished manufactured product. This explainer covers what compounding is, why a prescriber writes for it, what a compounding pharmacy is not allowed to do, and how a compounded prescription is ordered and paid for.

A prescriber-facing guide to low dose naltrexone: available strengths and forms, the titration ranges reported in the literature, perioperative and monitoring considerations, and how to write the order. It reproduces what the published trials found, including the negative ones.

A troche is a compounded, prescription lozenge that dissolves slowly in the mouth rather than being swallowed whole. This guide covers what troches are made of, buccal versus sublingual placement, how to take one, storage, and what compounded troches cost.

Tacrolimus ointment carries a high price because it launched as a brand, generic competition arrived late and stayed thin, the active ingredient is costly, and insurers tier it behind prior authorization. Compounded tacrolimus is not a cheaper copy of the ointment: it is prepared on a prescriber's order in ear, rectal, gel, foam, and scalp forms no manufacturer makes.

Compounded creams are built from three parts a prescriber specifies: the active ingredients, the base that carries them, and the strength of each. This guide covers the common bases, the actives that go into pain cream formulas, what the published literature reports, and how strengths compare with over-the-counter and FDA-approved products.

Naltrexone blocks opioid receptors, so opioid pain medicines, opioid-containing cough and antidiarrheal products, and any procedure that may need opioid analgesia all require a conversation with your prescriber. This explainer covers reported side effects at low doses, what the literature says about stopping, and how the compounded strengths compare to the FDA-approved 50 mg tablet.

503A compounding pharmacies prepare medications for individual patients on a prescription and answer to state boards of pharmacy; 503B outsourcing facilities register with the FDA and batch preparations for clinics without patient names. This explainer covers which one fills your prescription, how to verify a pharmacy's license, and what "not FDA-approved" means for each.

Searching for a compounding pharmacy near you turns up whoever is closest, which is not the same as whoever can make what you were prescribed. What to check before you choose one, what 503A and the USP chapters mean, and when a licensed mail-order compounder is the better answer.

Naltrexone is manufactured only as a 50 mg tablet, so the 1-9 mg doses prescribed as LDN are prepared by a compounding pharmacy against a prescription. Here are the strengths and forms Bayview compounds, what they cost, how to get a prescription sent, and where we can ship.

Topical minoxidil 2% and 5% are already sold as FDA-approved over-the-counter products, so compounding is reserved for strengths, vehicles and combinations no manufacturer sells. What a compounded minoxidil preparation is, and why dose and suitability are the prescriber's decisions.

What low-dose naltrexone is, the proposed mechanisms behind it, and what the small trials, open-label studies and case series do and do not show. Every use at these doses is off-label, and it is compounded against an individual prescription.

How nail fungus is diagnosed, what oral and topical antifungals achieve in trials, where compounded preparations fit, and realistic timelines.

Most TMJ disorders settle with conservative care first. What that care involves, where compounded topical preparations fit alongside it, and the red flags that mean the jaw is not the problem.

The five reasons a dermatologist orders a compounded preparation, what compounding cannot do, how vehicles change a drug's behavior, and the safety points that matter.

What low-dose atropine is used for in childhood myopia, what the trials have and have not settled, and why this is entirely an eye doctor's decision.

Topical creams, troches and low-dose naltrexone: what each preparation contains, and what compounding can and cannot do. None of it is a decision a pharmacy makes rather than a prescriber.

Read about hormone replacement therapy, and the treatment options available.

Clomiphene citrate is FDA-approved for ovulation induction in women, so a prescription written for a man with low serum testosterone is off-label. How it acts on the pituitary signal, and what a prescriber weighs before writing one.

What testosterone therapy in women is supported by evidence, what it is not, and how it is dosed, monitored, and regulated.

What TRT is, the forms it comes in, the risks and monitoring involved, and why a diagnosis based on repeat morning testosterone testing comes first.

Oxytocin is FDA-approved only as an injectable used in hospital obstetric care, so compounded troches and nasal sprays are off-label preparations. This page covers what the preparation is, what the published literature reports, and what remains unsettled.

Palliative care is specialized medical care for people living with a serious illness, directed at controlling symptoms rather than curing the disease. Where compounding enters, and the kinds of preparations a palliative or hospice prescriber may order.

A sublingual dose dissolves under the tongue and crosses the lining of the mouth into the bloodstream without passing through the stomach and liver first. What that route changes, and which compounded forms are prepared for it.

In this post, we'll discuss the difference between a compounding pharmacy and a retail pharmacy.