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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.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Trichloroacetic acid (TCA) is a caustic, protein-denaturing acid used by clinicians on skin and warts; compounding pharmacies prepare it as topical solutions for in-office use.
Trichloroacetic acid is a strong organic acid, a chlorinated relative of acetic acid. Applied to skin it denatures and coagulates proteins in the epidermis and upper dermis, producing a visible white "frost"; the treated tissue then peels away and new skin grows in. Depth depends on concentration (StatPearls). There is no FDA-approved trichloroacetic acid drug product. The only DailyMed listing is an unapproved liquid (Astral Diagnostics, 2020) whose NDC has been inactivated by FDA compliance action and whose listing states it "has not been found by FDA to be safe and effective." The CDC's 2021 STI Treatment Guidelines list provider-applied TCA or bichloroacetic acid among recommended regimens for external, vaginal, cervical and intra-anal warts. Because no manufactured product exists, prescribers order TCA compounded in the concentration their procedure calls for. Compounded preparations are not FDA-approved and require a prescription.
Trichloroacetic acid has no FDA label and therefore no boxed warning; its hazards come from its caustic nature. It is applied by a trained clinician, never self-applied, and only to the target lesion: the CDC notes its water-like thinness lets it spread and damage surrounding tissue, and that excess acid should be neutralized with baking soda, liquid soap or talc. Splashes into the eye are an emergency. Immediate reactions include swelling, burning and blistering; delayed problems include infection, acne, darkening or lightening of the skin, visible lines of demarcation, and incomplete response. People with darker skin, a history of raised scars, cold sores, recent isotretinoin use, active skin infection or a prior reaction to a peeling agent need extra caution. StatPearls lists pregnancy, breastfeeding and smoking as restrictions for medium and deep peels; the CDC wart guidance gives no TCA-specific pregnancy advice, and no lactation data were found. If a treated area becomes very painful, blisters widely or shows signs of infection, talk to your prescriber or pharmacist.
TCA is classed as a protein denaturant rather than a keratolytic; it induces coagulation and denaturation of epidermal and dermal proteins, with frosting intensity (patchy, homogeneous white, plaque-like) marking light, medium and deep injury. Pharmacokinetic data on topical TCA were not found in the sources read; the reviews treat it as a locally acting agent and reserve systemic toxicity warnings for other peeling agents such as phenol, resorcinol and salicylic acid. No labeled indications exist. Prescribers have ordered compounded TCA for anogenital warts, where the CDC 2021 guidelines list provider-administered TCA or BCA, repeatable weekly, as a recommended regimen for external, vaginal, cervical and intra-anal warts; and for chemical peels, where a 2010 review in the Journal of Clinical and Aesthetic Dermatology summarizes studies of TCA, alone or combined with Jessner's solution or tretinoin, for acne, acne scarring, photodamage, actinic keratoses and melasma, noting higher relapse in melasma than with glycolic acid. Concentration, application technique and repeat interval are per prescriber. Monitoring: frost endpoint during application, neutralization supplies at hand, wound care and sun avoidance after treatment, antiviral prophylaxis for patients with a herpes simplex history, and follow-up for pigment change, infection or scarring. Not a controlled substance.
Wash your hands. Apply the amount on your label to clean, dry skin and spread it in a thin layer. For a metered pump, your label states the number of presses. For a dosing syringe, push the plunger to the mark. Let the gel dry before covering with clothing. Wash your hands afterward and keep the site from touching other people until it has dried. Do not apply to broken skin unless told to.
A gel can have a nonaqueous or a water-based base, and USP <795> sets its default beyond-use date by water content, not by the word gel. A nonaqueous gel usually carries a beyond-use date of up to 180 days at room temperature or refrigerated. A water-based gel carries up to 35 days with a preservative, or 14 days refrigerated without one. Your label states which applies. Keep the container closed, away from heat and open flame if it contains alcohol, out of reach of children, and discard after the beyond-use date on your label.
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.
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.
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.
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.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
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.
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.
Apply topically to affected area(s)
