compoundingHOTLINE

Mr. Erickson is director of professional affairs at Gallipot Inc.

I have several patients on multiple estrogen and progesterone therapies, and now I cannot obtain estriol. What is happening?

In January 2008, the FDA warned some pharmacies to stop compounding and dispensing preparations containing estriol USP. In March 2008, the FDA informed suppliers that they must not sell estriol USP, except to holders of approved Investigational New Drug Applications. USP31 <795> ?Pharmacy Compounding- Nonsterile Preparations? permits USP monograph bulk pharmaceutical ingredients for compounding. Estriol is an endogenous substance and has been administered in hormone therapy for many years. For now, estriol is unavailable; the pharmacist should consult with the patient and prescriber about alternative hormone therapies. Please see www.savemyBHRT.org for current information and related links about activities and responses from different pharmacy associations. Patients may be interested in the Web site, aswell.

Compounding Tips

• Densities vary among creams and ointments. Pumps, syringes, and other devices that deliver specific volume should not be calibrated for weight of the specific preparation to be dispensed for dosing uniformity?1 cc does not necessarily represent 1 g of preparation.
• Do you need a urethral mold in a hurry? Slice the hub from a tuberculin syringe or 1-mL syringe, firepolish the end, immerse in the melted vehicle, and pull up the plunger to desired volume. Dispense in the syringe for ease of insertion.

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