Common Sterile Compounded Prescriptions at Town & Country Compounding

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Examples of sterile compounded prescriptions made at Town & Country Compounding

Sterile eye medications

Town & Country Compounding are trusted by ophthalmologists to address several conditions of the eye. 

*Click examples below to expand/collapse

Sometimes a patient needs a compounded medication to be administered at the surgery center for a procedure. 
*These are compounded with a prescription for a specific patient

The procedure allows medication to be administered in the space behind the eye called the vitreous cavity.  The procedure takes place in the in a clinic, surgery center or hospital, and any compounded medications that may be needed are prepared by our pharmacy with a prescription for each specific patient. 

Intravitreal injections are used for several types of conditions.

  • Age-related macular degeneration (AMD)
  • Diabetic retinopathy
  • Retinal vein occlusion 
  • endophthalmitis infection
    • Intravitreal antibiotics are needed to try and prevent loss of vision

Classes of drugs that are often used in intravitreal injections

  • Steroids
  • Antibiotics
  • Antifungals

See More: Intravitreal Injections

More about Intravitreal Injections from Town & Country Compounding »

Related blog: Atropine Eye Drops for Children with Nearsightedness (Myopia) >>

The strength of eyedrops needed for children with myopia is not commercially available. A compounding pharmacist can use the higher-strength commercial product and dilute it for the pediatric patient. This is done only in a sterile compounding lab.

Sometimes a patient needs a compounded medication to be administered at the surgery center for a procedure. 
*These are compounded with a prescription for a specific patient

More about Atropine Eye Drops »
  • Autologous serum eyedrops are often requested when patients have not had success with various medications for chronic dry eyes. Their own serum is used to make their eyedrops.

    How Autologous Serums Work

    Conventional therapies for severe dry eyes fail to heal the epithelial cells, which are the cells on the top layer of the cornea. The dry epithelial cells sometimes fall off of the cornea easily. Autologous serum comes from the patient’s own blood serum and plasma (Source: clevelandclinic.org). 

    The fluid contains epithelium-promoting growth factors  and becomes a good replacement for tears. 

    Sjogren’s syndrome is an inflammatory condition in which the mucous membranes, especially in the nose and mouth become very dry. Sometimes you will see this in patients who have rheumatoid arthritis and lupus. 

    Autologous serum eyedrops (ASED) are thought to contain various growth factors and nutrients from the serum that benefit the surface of the eye and may help with corneal epithelial defects. Serum contains albumin, vitamin A, and nerve and epidermal growth factors that may promote healthy growth and healing of the ocular surface. These nutrients are not in over-the-counter artificial tears preparations. 

    They are sometimes used by doctors with patients with neuropathic eye pain, keratitis and may also be used before and after certain high-risk corneal transplants and SLET procedures, or for post-vitrectomy diabetics.

    Read More:

 

More About Autologous Serum Eye Drops (Step-by-step Guide) >>

Eyedrops are often needed at a higher strength than what is commercially available for certain conditions and therefore, must be prepared by a compounding pharmacy. Often, the alternative to fortified ophthalmic drops is hospitalization and Intravenous infusions. It is important to get these eyedrops to the patient very quickly when needed!

The conditions that may require fortified eyedrops:

  • Resistant microbial keratitis – This diagnosis is considered an emergency situation.The infection can progress rapidly and can progress quickly and can cause permanent damage that decreases vision.  Around 30,000 cases of microbial keratitis occur annually in the U.S.
  • Corneal ulcers
  • Bacterial infections on the ocular surface
 
More About Fortified Antibiotic Eyedrops >>
Sometimes a patient needs a compounded medication to be administered at the surgery center for a procedure.

*These are compounded with a prescription for a specific patient

The procedure allows medication to be administered in the space behind the eye called the vitreous cavity.  The procedure takes place in the in a clinic, surgery center or hospital, and any compounded medications that may be needed are prepared by our pharmacy with a prescription for each specific patient. 

More about Eye Surgery Center Compounds »

Other sterile medications

Prescribers: Tri-mix & Quad-mix Rx Order Form »

Injections that are commonly prescribed for male patients who have had prostate surgery or for males who have not had success with typical therapies for erectile dysfunction (ED).

*Town & Country has patient instructional videos for injections and devices pertaining to ED

 

Learn More About Tri-mix or Quad-mix Injections

Ketamine infusion clinics provide the infusion therapy to patients. Ketamine may be used as a part of program for managing psychiatric disorders such as major depressive disorder, treatment-resistant depression, post-traumatic stress disorder, anxiety and acute suicidal thinking and also chronic pain management. 

Read More:

We compound various medications for patients who have intrathecal pumps used for chronic pain or spasticity. We can fill orders for intrathecal medications for patients who get their intrathecal pumps refilled either at their doctor’s offices or at home through home care services. 

What to Expect: Targeted Drug Delivery >>

Common medications that go into an intrathecal pump for targeted drug delivery are:

  • Baclofen
  • Morphine
  • Clonidine
  • Bupivacaine
  • Hydromorphone
  • Prialt® (ziconotide)
  • Fentanyl

Video Resource: Targeted Drug Delivery with Medronic’s Synchro Med II pump

Targeted drug delivery utilizes an implanted, programmable pump to release specific doses of medication for pain or spasticity through a catheter directly into the spinal cord. 

“Intrathecal drug delivery offers patients a way to experience pain relief using a fraction of an oral medication dose, which can help to minimize the uncomfortable and sometimes intolerable side effects (e.g., drowsiness, dizziness, nausea, vomiting and constipation) that often accompany pain medication taken orally.”
Source: ABOUT THE THERAPY TARGETED DRUG DELIVERY

Targeted drug delivery also can provide pain relief in patients who cannot achieve adequate analgesia even with high doses of oral opioid medications.

Read More: Journals of Neurosurgery:Surgical treatment of spasticity: intrathecal baclofen pump implantation under subarachnoid block

Testing of intrathecal injections at an independent analytical lab 

The intrathecal stock solutions have been tested by an independent analytical laboratory to establish that they have maintained their indicated potency and sterility over a 180-day period along with a USP method suitability testing.

Then, once compounded into single dose vials, the intrathecal stock solutions are quarantined, and samples are sent to an independent testing laboratory for the following tests prior to being released from quarantine for dispensing:

  • Potency testing
  • Sterility testing (USP 71)
  • Endotoxin testing (USP 85)

*These are compounded with a prescription for a specific patient

Many times, there are commercially available injectable products that need to be mixed together into an IV infusion. We can prepare them for the individual patient (with a prescription) and send them to the clinic for infusion. 

  • Vitamin C (ascorbic acid) infusion
  • Myers Cocktail 
  • Glutathione
  • Amino acids

Commonly requested injectables that are commercial available and/or compounded

  • EDTA 250 mg/ml
  • Glycerin 50%
  • Glycerin 72%
  • Glutathione 200 mg/ml
  • Methylcobalamin 10,000 mcg/ml
  • Nicotinamide Adenine Dinucleotide (NAD+) 50 mg/ml
  • Pantothenic acid 250mg/ml
  • Pyridoxine 100 mg/ml
  • Selenium 40 mcg/ml
  • Vitamin C 
  • Vitamin D3 50,000 IU/ml
  • Zinc chloride 10mg/ml

Amino Acids:

  • Arginine 50 mg/ml
  • Carnitine 50 mg/ml
  • Glycine 50 mg/ml
  • Taurine 50 mg/ml

Drugs used for chemotherapy (chemo) are also referred to as oncology drugs, antineoplastic drugs or cytotoxic drugs. This class of drugs is used in cancer patients but can also be used to treat other things
such as multiple sclerosis (MS), arthritis and others.
Source: CDC

Chemo drugs or other drugs needed during therapy may be sterile or nonsterile, and our labs are prepared to do either type. For example, a customized sterile eye drop, eye ointment or infusion may be
needed. We also provide sterile and non-sterile chemotherapeutic antineoplastic drugs for clinical trials.

Please contact us if you have a specific need or if you are a company in need of a clinical trial.

Contact Us >>    More About Clinical Trials >>

An elastomeric pump is a disposable one-time use device for a continuous infusion, often used for medications such as:

  • Antibiotics
  • Chemotherapeutic agents
  • Anesthetics 
  • Analgesics

Uses of Elastomeric Pump & How Is It Used >>

Continuous Ambulatory Delivery Device– a CADD® pump is an infusion pump that you may see at the bedside at a hospital. 

It is a reusable medical device that can be programmed to deliver continuous infusion as well as bolus doses for pain management. The patient may be allowed to control when and how often they get a dose of their medication

This pump may be helpful in painful diseases such as pancreatitis, sickle cell anemia or may be used to help ease pain after surgery or ease suffering in end-of-life care (hospice).

Read More: Patient-Controlled Analgesia Pumps

Continuous Ambulatory Delivery Device (CADD®) pump is an infusion pump that you may see at the bedside at a hospital. 

It is a reusable medical device that can be programmed to deliver continuous infusion as well as bolus doses for pain management. The patient may be allowed to control when and how often they get a dose of their medication

This pump may be helpful in painful diseases such as pancreatitis, sickle cell anemia or may be used to help ease pain after surgery or ease suffering in end-of-life care (hospice).

Learn More About Patient-Controlled Analgesia Pumps >>

We have expanded and are now in our state-of-the-art compounding facility in Ramsey, NJ shipping to multiple states.

Town & Country Compounding has been inspected by the New Jersey State Board of Pharmacy and National Association of Boards of Pharmacy (NABP) in addition to accreditation inspections. We are also accredited by ACHC for sterile compounding, non-sterile compounding, nursing and home infusion.

Town & Country Compounding Is Compliant and goes beyond the requirements of USP 795, USP 797, and USP 800 Guidelines

Our profession has adopted new rules and regulations from the State Board of Pharmacy and the USP (United States Pharmacopeia). We are USP 800 compliant with all aspects as a sterile and non-sterile 503A compounding pharmacy.

Dr. Phillip S. Kim, MD

President, Pennsylvania Pain Society Center for Interventional Pain & Spine

Town & Country Compounding makes customized medication at the highest level.

Their high-tech labs, expertise, and rigorous compounding protocols give me confidence that my patients are getting the best quality compounds.

Sterile laboratories for clinical trials

Premium Standards in Sterile Preparations

We work with Pharma companies, Health systems, and universities and to create sterile and non-sterile medications for clinical trials and drug development.

For example, we work on the development of IND and NDA medications, as well as new delivery vehicles for existing drugs. We also have HD (hazardous drug) labs equipped to compound chemotherapy drugs and other drugs considered hazardous by NIOSH

Oversight of sterile compounding

Oversight for sterile compounding practice falls primarily to the states and is typically governed by the individual state’s board of pharmacy, however the Food and Drug Administration (FDA) also maintains authority to inspect pharmacies for insanitary conditions. 

In some states, the Board of Medicine (or similar entity) regulates sterile compounding that occurs in physician offices. Most pharmacies maintain active accreditation from an agency that performs rigorous inspections for compliance with state laws and internal policies. Majority of state laws and accreditation standards are based on the principles outlined in the U.S. Pharmacopeial Chapter <797> Pharmaceutical Compounding – Sterile Preparations.

Sterile Compounding Resource Center