Extemporaneous Compounding of Pain and Symptom Control Medications

Abstract

This paper introduces a new series in the Journal on extemporaneously compounded dosage forms for symptom control. Some advantages and limitations of compounded medications are described and issues that clinicians should consider are mentioned. Topics that will be discussed in future papers in this series are described. Changes of compounding-related chapters of the United States Pharmacopeia from advisory statements to enforceable standards are discussed. As an example of important formulation considerations, some physical-chemical characteristics and route of administration characteristics of opioid analgesics are discussed.

Key Words:

• Extemporaneous
• compounding
• dosage forms
• standards
• opioids
• routes of administration
• pain
• palliative care
• symptom control
• FDAMA

Additional information

Notes on contributors

Kenneth S. Latta

Cherokee Layson-Wolf, PharmD, is Assistant Professor at the University of Maryland School of Pharmacy. At the time that this review was conducted, she was a Community Care Pharmacy Practice Resident at Virginia Commonwealth University.

Perry G. Fine, MD, is Professor of Anesthesiology, School of Medicine and Associate Medical Director, Pain Management Center at the University of Utah Health Sciences Center, Salt Lake City; and National Medical Director, VistaCare, based in Scottsdale, AZ. This commentary is based on an article in Dr. Fine's VistaCare Palliative Medicine Monitor.

Jonathan R. Gavrin, MD, is the Internet editor for the Journal. He is Associate Professor of Anesthesiology and Adjunct Associate Professor of Medicine at the University of Washington School of Medicine; Associate Member, Fred Hutchinson Cancer Research Center; and Associate Director for Clinical Anesthesia Services, Harborview Medical Center.

Perry G. Fine, MD, is Professor of Anesthesiology, School of Medicine and Associate Medical Director, Pain Management Center at the University of Utah Health Sciences Center, Salt Lake City; and National Medical Director, VistaCare, based in Scottsdale, AZ. This commentary is based on an article in Dr. Fine's VistaCare Palliative Medicine Monitor.

Philip J. Wiffen, is the Regional Pharmaceutical and Prescribing Adviser, Anglia & Oxford Region of the National Health Service Executive, a member of the Oxford Regional Pain Relief Unit and Coordinating Editor of the Cochrane Collaboration Pain Palliative and Supportive Care Collaborative Review Group.

Perry G. Fine, MD, is Professor of Anesthesiology, School of Medicine; Associate Medical Director, Pain Management Center at the University of Utah Health Sciences Center, Salt Lake City; and National Medical Director, VistaCare, based in Scottsdale, AZ. This commentary is based on an article in Dr. Fine's VistaCare Palliative Medicine Monitor.