Children pose many challenges when it comes to medication, and by working together with your child’s pediatrician or physician, we are frequently able to leverage the timeless art and advanced technology of compounding to solve many of those problems. In general, they may resist having to take a medication, dislike the taste or texture, have difficulty swallowing solid dosage forms, and are fearful of injections. That’s where compounding can step in.
The limited pediatric market for most drugs is by many considered a leading cause of the pharmaceutical industry’s lack of investment in drug development. Most medications are not labeled for pediatric populations, and when a medication is not approved for use in infants or toddlers, it typically is not available in suitable pediatric dosages or forms.
Many medications needed by children are not available in liquid forms, and even fewer are available in forms children actually like. So the question becomes: what options do you have for delivering the right medication to your children when they need it — and making sure it is safe, effective, and stays in their system long enough to work as intended?
Fortunately, Davis Islands Pharmacy and Compounding Lab is able to help with these problems. Extemporaneous formulations, ways of creating the drug with your child’s unique needs and preferences in mind, plays an important role, especially in infants and young children who are unable to swallow tablets or capsules. With state-of-the-art technology, we compound oral medications into pleasantly flavored suspensions, solutions, concentrates, freezerpops, gummy bears, lozenges, or lollipops. Each of these forms can come in colors that appeal to children, making it easier to get them to take their meds.
A palatable formulation of your child’s medication is more likely to improve compliance and minimize spillage or waste during administration. Lollipops are an ideal alternative to “swish and swallow” medications that need to be retained in the mouth for a prolonged period of time. Most drugs can be compounded into transdermal gels that are easily applied to an appropriate site, such as a child’s wrist or back, for absorption of the medication through the skin.
The efficacy of any compounded medication is influenced by the technique and equipment ised in preparing the formulation, the purity and quality of the ingredients, the choice of vehicle or base, and proper use of additives such as penetration enhancers. As compounding pharmacists, we consider each active and inactive ingredient in order to prepare a customized medication with the desired taste, color, smell, viscosity, uniformity, texture and stability – all to ensure your child’s medication is safe, effective, and easier to consume.
Attention Deficit Disorder and Autism are two problems affecting an increasing number of American children. No two child’s problems are alike, and these are serious issues that affect the development, learning and growth of the next generation of the American population, so it’s important they are addressed early in order to limit the impact of these problems during the most vital development period of your child’s life.
Often parents are reluctant to turn to big pharma for “solutions”, and aren’t aware of compounding as a tailored alternative that can be customized to your child’s needs and created in ways that come with fewer side effects.
To back up this claim, the Autism Research Institute asked parents to rate the effectiveness of numerous biomedical treatments. As of 2008, over 26,000 parents had evaluated more than 80 treatments. Detoxification was considered helpful by 74% of parents. Other highly rated therapies and the percentage of children that “got better” included: gluten/casein-free diets, 66%; food allergy treatment, 64%; methylcobalamin, 56% (nasal) and 67% (subcutaneous); and essential fatty acid therapy, 56%.
The most interesting finding was that more parents reported their children “got worse” with conventional drug therapy than with biomedical/ non-drug treatment, nutritional supplements, or special diets. It is widely thought that the earlier treatment is started, the better the results.
Most children with autism have a need for increased amounts of vitamins, minerals, and certain amino acids. Some detoxification agents have shown to remove essential minerals, creating a need for those minerals to be supplemented in other ways.
With compounding, we work with physicians to customize supplemental therapies for the unique needs of specific children. Once the physician has determined the specific nutrients that are needed, numerous compatible supplements can be combined into patient-specific flavored suspensions or transdermal preparations to simplify administration.
Gluten is a protein found in wheat and other grains such as rye, oats, and barley. Casein is the main protein found in dairy products. Many commonly used medications contain gluten, and that can interfere with children who are gluten intolerant. Some probiotics contain casein. In our compounding lab, we regularly create compounded preparations of medications that are gluten and casein-free to solve problems for children with certain sensitivities.
It’s difficult to treat children suffering from nausea or vomiting, and medications aimed at helping those problems don’t work if they don’t stay in the child’s system long enough to be absorbed. Orally administered anti-emetics can be difficult for nauseated children to keep down, and rectal suppositories are often not well accepted by children. Along with other compounded preparations of nausea and vomiting drugs, transdermal anti-emetics, such as promethazine, can offer a safe and effective alternative.
Constipation is a common problem for children with certain diseases and gastrointestinal defects. Commercially available products offer limited choices when it comes to flavor – and oftentimes those options aren’t particularly appealing to children. Laxatives are difficult to reflavor, but compounding offers a solution. In our compounding lab, we concentrate preparations such as milk of magnesia, and flavor each prescription differently to please each patient.
Diaper rash is a pain to deal with and incredibly uncomfortable for babies and toddlers. Customized formulations containing protectants, absorbents, and bile acid sequestrant can provide relief for irritated skin. We can also compound medications such as cholestyramine ointment, to precent site irritation in ostomy patients.
Many children do not find success with over-the-counter acne medication, and oftentimes do not tolerate certain prescription drugs very well. The emergence of resistant pathogens emphasizes the need for alternatives to antimicrobial agents for acne therapy. We can compound cosmetically-appealing customized formulations that are safer and more effective for treating acne early on, preventing scaring later in life.
Topical anesthesia is needed for common pediatric procedures such as suturing, wound cleaning, and injection administration, as well as laser and cosmetic therapy. The ideal topical anesthetic for children would provide complete anesthesia following a simple pain-free application, not contain narcotic or controlled substances, and have an excellent safety profile.
The combination of topical anesthetics, lidocaine, and tetracaine and the vasoconstrictor epinephrine has been used successfully for anesthesia prior to suturing linear scalp and facial lacerations in children. Convenience of application without need for occlusion is an advantage of certain compounded anesthetics.
Foot problems are no fun for children: they can be pain to treat and often keep kids away from the activities that provide an outlet to release energy and play. Pediatric compounding for the feet, whether treated by a podiatrist or pediatrician, often solves problems parents and doctors frequently face.
Although surgical excision is the most popular method for removing nails, the use of concentrated urea plasters applied under occlusion may be a superior option, particularly for pediatric patients. The use of urea plasters has inherent advantages: they are relatively inexpensive, it allows for several nails to be treated in a single session, and the procedure is essentially painless.
Topical medications usually have a lower adverse drug-reaction profile than systemic medications. When combined with various synergistic combinations and topical medications including penetrant enhancers, compounded antifungal therapy can be a great treatment option for children.
Resistant warts and molluscum contagiosum have been treated successfully with compounded topical medications, avoiding discomfort associated with freezing, scraping, electrocautery and laser therapy. Children often find these compounded solutions to be more tolerable and just as effective in removing warts and molluscum.
Head lice and scabies can be a nightmare for parents and are two problems you want to avoid; but when your child contracts them, it’s important to get the safest and most effective solution to get rid of the problem. Concerns about emerging resistance and the potential harm of using permethrins have prompted a search for effective pediculicidal therapies that are not harmful to children with repeated use.
Compounding has a pediatric solution for head lice. An herbal formulation has been shown to be effective for head lice. Ivermectin can also be compounded for topical application or as an oral dose titrated for each patient for the treatment of head lice and scabies.
At Davis Islands Pharmacy and Compounding Lab, we are dedicated to meeting the specific needs of your children. As always, we welcome your questions and look forward to helping you solve your pediatric medication problems. We work together with prescribers, children, and their families to customize medications and meet specific needs that are often not mass produced due to the unique needs of unique children.