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WILKES-BARRE — When a cat wouldn’t allow his owner to give him some much-needed thyroid medicine, Bruce Lefkowitz came to the rescue. The pharmacist transformed the traditional pill form of medication into an ointment that the owner could rub into the ear of the cat instead.
Lefkowitz, owner of Harrold’s Pharmacy, works his magic in the compounding pharmacy of the Wilkes-Barre facility. He and five other pharmacists turn ordinary tablets, creams, capsules and ointments into the right formulas that are perfect for people and pets.
A cat needed Prozac medicine (evidently cats get depressed, too). In order to entice the feline into taking the prescription, Lefkowitz flavored it with tuna. Now, that’s enough to make anyone meow in delight.
Sometimes a prescription removes a certain offending item, or sometimes it is transformed from pill to ointment, depending upon the problem.
For the cat, suffering from thyroid disease, the transdermal compound proved to be just the trick.
For humans who find it difficult to swallow large pills, a liquid supplement may be just the right antidote.
Harrold’s is one of only 10 Pennsylvania pharmacies accredited for compounding. Many people in the community don’t know that there is an alternative to regular prescriptions.
But for the third-generation owner of Harrold’s, the practice has the pharmacy just going back to its roots.
Although the practice has grown more popular, some people are still not aware of the other available options, according to the pharmacists.
Pharmaceutical compounding is the creation of a particular product to fit the unique need of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools.
“Doctors like what we do because it gives them another option for the patient when traditional medicine fails,” Lefkowitz said.
The reasons are varied, according to the pharmacist.
Changing the form of the medication from a solid pill to a liquid may make it easier to swallow. Many hospice patients experience difficulty in swallowing their medicine so other forms of the medicine are beneficial.
A pharmacist may substitute an ingredient or may even leave out a non-essential ingredient, like gluten, that a patient is allergic to.
“So many people can’t take Motrin because it irritates their stomachs so we formulate pain creams instead that can just be rubbed into the affecting areas,” he said.
Lefkowitz said one of the more popular requests is to remove lactose fillers, dyes, silica or gluten for those people who are allergic to them.
“A lot of people have digestive issues,” he said.
It may also be done to make medicine more palatable, such as adding flavors or otherwise altering taste or texture.
Back in the 1940s, doctors prescribed medicine for patients that wasn’t commercially available and pharmacists custom-made them. These types of medicines are not mass-produced by the major pharmaceutical companies because it is not profitable for them, Lefkowitz said.
Sometimes a drug may be discontinued in manufacturing and a pharmacist may have to combine raw ingredients to custom blend a medicine.
Lefkowitz calls it custom-made prescriptions.
“The pharmacy has really come full circle since when my grandfather owned it,” he said.
Compounding is generally covered by most major insurance companies. Due to the intricate natures of the blending, the wait time may vary for each customer. Sometimes a full day is needed to prepare the compound.
The medical compounds come in a variety of forms: liquids, flavors, lollipops, topical creams, ointments, salves and gels, sprays and mouthwashes.
One of the unique requests the pharmacy gets is to customize pet medicine into easy-to-give dosage forms with tasty flavors like peanut butter, fish or beef to make it more palatable for the animals.