Family Practice

The range of medical issues you attend to is truly remarkable! And so is the variety of unique formulations we can compound to help you and your patients:

Nail Fungus –For this condition so difficult to treat, using DMSO as a carrier greatly enhances penetration. In this formulation, Ibuprofen potentiates the activity of the azole anti-fungal:

Clotrimazole 2%/Ibuprofen 2% in DMSO–paint affected area twice daily

Nausea – When oral medications won’t work, suppositories (not always a desirable option) are sometimes the only option, except for a compounded gel form of promethazine:

Promethazine 25 mg/ml Gel–apply ½ to 1 ml to wrists as needed

Mouth/Throat Irritations – Obtaining adequate contact time to the injured tissue is key to enhancing effectiveness. Several unique bases are available to do just that:

Mucosal Bandage – This is a powdered base which, when moistened, creates a barrier film to serve two purposes: protect the injured tissue and keep medications in contact with the tissue. Sample formulation:

Lidocaine 1%/Triamcinolone 0.5% Polyox Mucosal Bandage-puff two thin layers onto affected area every 4-6 hours

Poloxamer Gel – Also called “reverse thermal gel”, poloxamer is liquid when cold and gels when warmed to body temperature.  We can make various concentrations to control the thickness of the gel, depending on the surface on which is being used.  For esophagitis, for example, we use a loose, low concentration gel as carrier which will not restrict airflow, but will provide bio-adhesive properties.  Sample formulation:

Budesonide 2 mg/5 ml Poloxamer Suspension – take 1 teaspoonful by mouth 3 times daily-no food or drink for 30 minutes following

Nasal Sprays – The use of broader-spectrum antibiotics in nasal sprays provides local exposure without the GI-disturbing effects of oral antibiotics.  Sample formulations:

Mupirocin 0.2% Nasal Spray-use 2 sprays to each nostril 3 times daily
Gentamicin 0.2%/Triamcinolone 0.01% Nasal Spray-use 2 sprays to each nostril 3 times daily

Topical Pain/Anti-inflammatory Creams – We utilize Lipoderm, a PCCA base which contains a proprietary liposomal component to potentiate the permeation of actives into the tissue.  Penetration is further enhanced by DMSO or other agents.  A wide variety of anti-inflammatory and pain agents may be used in type of product to suit each individual’s needs.  Please call for additional information on active ingredients.  Sample formulations:

Ketoprofen 20%/Lidocaine 5% Topical Cream – rub into affected area for at least 2 minutes, three times daily
Ibuprofen 10%/Triamcinolone 0.01%/Guaifenesin 10% Topical Cream-rub into affected area for at least 2 minutes, three times daily

Hemorrhoids-Rectal Rockets will blast your patients’ hemorrhoid pain away! Specially shaped to allow contact time with internal as well as external hemorrhoids, these  frequently provide resolution with 2-3 applications.  Sample formulation:

Hydrocortisone 1%/Lidocaine 2% Rectal Rocket-insert 1 suppository rectally at bedtime for 2 to 3 nights

Lice-Many parents are reluctant to utilize permethrin-containing products, which we have been told are not always completely effective.  We have received excellent feedback on this all natural alternative:

Aromatic Head Lice Formula-soak scalp and all hair overnight, then wash out thoroughly

Excessive Perspiration-Many patients may be concerned with the use of high-concentration aluminum chloride anti-perspirants.  Glycopyrrolate is an anti-cholinergic which can provide effective relief and be formulated into a convenient stick or cream:

Glycopyrrolate 1% Stick-apply to affected area(s) every 4 hours as needed

Smoking Cessation-Alternatives in dosage may be very important when working with a patient interested in achieving cessation. Lollipops may be made at various concentrations and may assist in satisfying the oral fixation component of smoking withdrawal over a long period of time:

Nicotine 2 mg Lollipop-suck on lollipop up to every 3-4 hours as directed by your physician

Wound Care-Adherence of medication to the wound site is a challenge in speeding up healing time.  The mucosal bandage described above offers the ideal properties for use on wounds, whether infected or not.  Sample formulations:

Metronidazole 2%/Misoprostol 0.0024%/Phenytoin 5% Mucosal Bandage-apply 2 thin layers to wound site every 4-6 hours
Ketoprofen 2%/Lidocaine 2%/Phenytoin 5% Mucosal Bandage-apply 2 thin layers to wound site every 4-6 hours

Non Sedating Muscle Spasm Relief-Relief of muscle spasm to allow patients to pursue their normal work or daytime activities can be very difficult.  Use of a penetrating cream base may provide the relief needed without sedation.  Sample formulations:

Cyclobenzaprine 2%/Ketoprofen 20% Lipoderm Cream-rub into affected area for at least 2 minutes, three times daily
Guaifenesin 10%/Baclofen 2% Lipoderm Cream-rub into affected area for at least 2 minutes, three times daily

Eczema/Sensitive Skin-Through the development of our natural skincare products, we have learned about the effectiveness of various nutrients in treating skin irritations.  We use natural cream bases which we make here in the compounding lab, and if needed can combine them with special PCCA bases to enhance adherence, penetration, or scar-treatment properties.  One formulation which has been particularly effective:

Vitamin B-12 0.07%/Vitamin D 0.5%/Deglycyrrhizinated Licorice 0.5% in Shea Butter Base-apply to affected areas 2-3 times daily