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Formulas

Diphenhydramine HCl 12.5 mg/Hydrocortisone 2 mg/Nystatin 11.3 mg/Tetracycline 125 mg Troches

FDA-approved generic
Dose form
Troches
Active ingredients
Diphenhydramine Hydrochloride
Hydrocortisone
Nystatin
Tetracycline Hydrochloride

This compounded formulation combines Diphenhydramine HCl 12.5 mg, Hydrocortisone 2 mg, Nystatin 11.3 mg, and Tetracycline 125 mg into square-shaped troches. These solid dosage forms are designed to dissolve slowly in the mouth, allowing the medication to be absorbed through the oral mucosa for targeted local or systemic effects.

This formulation is used to treat oral inflammatory conditions, fungal infections, and bacterial infections, providing relief from symptoms such as inflammation, itching, and infection in the oral cavity.

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For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription detailsOrder form
Controlled substance: e-prescribe (EPCS) from your EHR. Faxed and phoned prescriptions cannot be accepted for this preparation.
Send it from your EHR, or fax to (401) 284-4506. How to e-prescribe this formula
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
To prescribe, you must be a verified prescriber.
To prescribe, you must be in a state where we hold an active out-of-state pharmacy license.
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This medication requires a prescription from your doctor

Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.

For prescribersSign in for prescription details and order forms.
Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Diphenhydramine Hydrochloride
Hydrocortisone
Nystatin
Tetracycline Hydrochloride
Troches

Formula Information

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This formulation combines Diphenhydramine HCl 12.5 mg, Hydrocortisone 2 mg, Nystatin 11.3 mg, and Tetracycline 125 mg into square-shaped troches designed to dissolve slowly in the mouth. As the troche dissolves, medication is absorbed through the oral mucosa, providing targeted local treatment and systemic effects where applicable.

Diphenhydramine HCl is an antihistamine that helps reduce allergic reactions, alleviating symptoms such as itching, swelling, and discomfort in the oral cavity. Hydrocortisone, a corticosteroid, offers anti-inflammatory properties, reducing inflammation and pain. Tetracycline is a broad-spectrum antibiotic that combats bacterial infections, addressing susceptible organisms present in the mouth.

This combination is particularly beneficial for patients experiencing complex oral conditions involving inflammation, allergic reactions, fungal, and bacterial infections simultaneously. It may be used in managing conditions such as oral mucositis, aphthous ulcers, or mixed microbial infections, especially in immunocompromised individuals.

The troche dosage form allows for direct application of the medication to the affected areas in the mouth. The slow dissolution ensures prolonged contact with the oral mucosa, enhancing the therapeutic effects while minimizing systemic side effects.

Patients are advised to allow the troche to dissolve slowly in the mouth without chewing or swallowing it whole. Adhering to the prescribed dosing schedule is important for optimal results. Potential side effects may include mild irritation or a temporary alteration in taste sensation. Patients should report any severe or persistent adverse effects to their healthcare provider promptly.

Prescribers may consider this compounded formulation for patients who require a tailored approach to oral health issues not adequately addressed by standard treatments. Compounding allows for customization to meet specific patient needs, including dose adjustments and ingredient modifications.

If you have any questions, please reach out to us.

Drug Interactions

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When considering the use of Diphenhydramine HCl 12.5 mg/Hydrocortisone 2 mg/Nystatin 11.3 mg/Tetracycline 125 mg Troches, it is crucial to be aware of potential drug interactions that may affect the efficacy and safety of this formulation. Diphenhydramine, an antihistamine, can interact with other central nervous system depressants such as alcohol, benzodiazepines, opioids, and other sedatives, potentially leading to enhanced sedative effects and increased risk of drowsiness or impaired motor function. Patients should be advised to avoid or limit the use of such substances while taking this medication.

Hydrocortisone, a corticosteroid, may interact with medications that affect the immune system, such as immunosuppressants or vaccines. Concurrent use with immunosuppressants may increase the risk of infections, while live vaccines may be less effective or increase the risk of adverse effects. Patients should inform their healthcare provider of any recent or upcoming vaccinations. Additionally, hydrocortisone can interact with nonsteroidal anti-inflammatory drugs (NSAIDs), increasing the risk of gastrointestinal bleeding or ulceration.

Nystatin, an antifungal agent, is generally well-tolerated with minimal systemic absorption, thus having a low potential for drug interactions. However, it is important to consider that concurrent use with other antifungal agents may alter the effectiveness of treatment. Patients should inform their healthcare provider of any other antifungal medications they are taking to ensure optimal therapeutic outcomes.

Tetracycline, an antibiotic, can interact with antacids, calcium supplements, iron products, and laxatives containing magnesium, as these can reduce the absorption and effectiveness of tetracycline. Patients should be advised to take tetracycline at least 1-2 hours before or 4 hours after such products. Additionally, tetracycline may enhance the effects of anticoagulants, such as warfarin, increasing the risk of bleeding. Regular monitoring of blood coagulation parameters is recommended for patients on concurrent anticoagulant therapy.

It is important for both patients and prescribers to be aware of these potential interactions to ensure safe and appropriate use of this formulation. Patients should provide a complete list of all medications, including over-the-counter drugs and supplements, to their healthcare provider. Prescribers should carefully evaluate the patient's medication regimen and consider any necessary adjustments or monitoring. If you have any questions or concerns regarding drug interactions with this formulation, please reach out to us for further assistance.

How Does it Work

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This unique formulation combines Diphenhydramine HCl, Hydrocortisone, Nystatin, and Tetracycline into a square-shaped troche designed to dissolve slowly in the mouth. This delivery method allows the active ingredients to be absorbed through the oral mucosa, providing both local and systemic therapeutic effects. The troche form is particularly beneficial for patients who may have difficulty swallowing pills or require localized treatment in the oral cavity.

Diphenhydramine HCl is an antihistamine that works by blocking the action of histamine, a substance in the body that causes allergic symptoms. By inhibiting histamine receptors, Diphenhydramine helps reduce symptoms such as itching, swelling, and redness.

Hydrocortisone is a corticosteroid that reduces inflammation by suppressing the immune response. When absorbed through the oral mucosa, it helps alleviate inflammation and discomfort associated with various oral conditions. Its anti-inflammatory properties make it useful in managing symptoms of oral lesions, ulcers, and other inflammatory conditions.

Nystatin is an antifungal agent that targets fungal infections, particularly those caused by Candida species. It works by binding to the sterols in the fungal cell membrane, causing cell leakage and ultimately cell death.

Tetracycline is a broad-spectrum antibiotic that inhibits bacterial protein synthesis, effectively treating bacterial infections. By preventing the growth and multiplication of bacteria, Tetracycline helps manage bacterial infections in the oral cavity, such as those caused by susceptible strains of bacteria. This can be particularly beneficial for patients with oral infections that are resistant to other antibiotics.

The combination of these active ingredients in a troche form allows for a comprehensive approach to treating a variety of oral conditions, including allergic reactions, inflammation, fungal infections, and bacterial infections. The slow dissolution of the troche ensures prolonged contact with the oral mucosa, enhancing the absorption and effectiveness of the medication. This formulation is designed to provide targeted relief while minimizing systemic side effects, making it a versatile option for both local and systemic treatment needs.

If you have any questions about this formulation or its use, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to assist you with any inquiries or concerns you may have.

Other Uses

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This unique formulation of Diphenhydramine HCl, Hydrocortisone, Nystatin, and Tetracycline in troche form is primarily designed for targeted local or systemic effects through oral mucosa absorption. While it is commonly used for specific conditions, there are several other potential uses that may benefit patients and prescribers seeking alternative therapeutic options. The combination of these active ingredients can be particularly useful in managing complex oral conditions that require a multifaceted approach. For instance, the anti-inflammatory properties of Hydrocortisone can be beneficial in reducing inflammation and discomfort associated with oral lesions or ulcers, while Diphenhydramine HCl, an antihistamine, can help alleviate itching and irritation in the oral cavity.

Additionally, the antifungal properties of Nystatin make this formulation suitable for addressing oral fungal infections, such as oral thrush, especially in patients who may be immunocompromised or undergoing treatments that predispose them to such infections. This makes the troche formulation a valuable option for patients with mixed infections or those who have not responded to standard treatments.

Moreover, the troche form allows for prolonged contact with the oral mucosa, enhancing the local effect of the medication and potentially reducing systemic side effects. This can be particularly advantageous for patients who have difficulty swallowing pills or require localized treatment without systemic exposure. The slow dissolution of the troche ensures a steady release of medication, which can improve adherence and therapeutic outcomes. For prescribers, this formulation offers a versatile tool in managing complex oral health issues, providing a comprehensive approach to treatment that addresses multiple symptoms and underlying causes simultaneously.

As with any medication, it is important for both patients and prescribers to consider individual patient needs, potential interactions with other medications, and any underlying health conditions that may affect the use of this formulation. If you have any questions or need further information about this formulation, please reach out to us at Bayview Pharmacy. We are here to assist you in optimizing patient care and ensuring the safe and appropriate use of compounded medications.

Frequently Asked Questions

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What is the purpose of this compounded formulation?

This compounded formulation is designed to deliver a combination of medications through the oral mucosa for targeted local or systemic effects. It includes Diphenhydramine HCl for allergy relief, Hydrocortisone for anti-inflammatory effects, Nystatin for antifungal treatment, and Tetracycline for antibacterial action.

How should I use these troches?

Place the troche in your mouth and allow it to dissolve slowly. Do not chew or swallow it whole, as this will reduce its effectiveness. The medication is absorbed through the oral mucosa as the troche dissolves.

What conditions can this formulation treat?

This formulation can be used to treat conditions that require a combination of antihistamine, anti-inflammatory, antifungal, and antibacterial effects, such as oral infections, inflammation, and allergic reactions.

Are there any side effects associated with this formulation?

Possible side effects may include dry mouth, drowsiness, or gastrointestinal discomfort. If you experience severe side effects or an allergic reaction, contact your healthcare provider immediately.

Can I use this formulation if I am pregnant or breastfeeding?

If you are pregnant or breastfeeding, consult your healthcare provider before using this formulation to ensure it is safe for you and your baby.

How should I store these troches?

Store the troches in a cool, dry place away from direct sunlight and moisture. Keep them out of reach of children and pets.

Can I take other medications while using this formulation?

Before using this formulation with other medications, consult your healthcare provider to avoid potential interactions and ensure safe use.

How long does it take for the troche to dissolve?

The troche is designed to dissolve slowly in the mouth, typically taking several minutes. This allows for optimal absorption of the medication through the oral mucosa.

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.

Is this formulation suitable for children?

The suitability of this formulation for children depends on the specific medical condition and the child's age and weight. Consult a healthcare provider for guidance tailored to your child's needs.

About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

The conditions listed on this page are indications prescribers have ordered this preparation for. They are not FDA-approved indications, and listing them is not a statement that this preparation is effective for them.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.

Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Diphenhydramine HCl 12.5 mg/Hydrocortisone 2 mg/Nystatin 11.3 mg/Tetracycline 125 mg Troches
Troches
90 troches
controlled

Place 1 troche between cheek and gum and let slowly dissolve