A Bit of History

Until the 20th century, pharmacy was all compounding and involved the use of water and alcohol, for the extraction of substances from plants, animals, and minerals. Going back to the time of Hippocrates (4th century BC), the preparation of pills, ointments, oils, and inhalations was commonplace. Over the next two thousand years, pharmacists continued to apply the art and science of pharmacy to the preparation of medication

using the highest standards possible at the time.

In 1820, the U.S. Pharmacopeia was established to promote the standardization of formulas. While compounding was still the most prevalent way of formulating medications well into the 20th century, it became less common as the pharmaceutical industry began providing standard dosage forms.

During the 1980s and 1990s, the number of compounded prescriptions began increasing due to a resurgence of recognition of individual patient needs—something that mass produced drugs are unable to accomplish because many are available only in limited dosage forms and strengths. Today, the demand for prescription compounding makes it a rapidly growing component of pharmacy practice.

The Triad

With compounded hormone prescriptions, it is imperative that the communication lines remain open and free-flowing among the three key players shown in the graphic: the patient, the licensed practitioner, and the licensed pharmacist. All three of these individuals play a critical role in obtaining and maintaining the patient's optimal hormone balance.

The Patient

To achieve hormone balance, the patient needs to pay careful attention to symptoms and communicate this information to the practitioner. Using this information, the

practitioner can direct the pharmacist in developing an effective hormone therapy. It is important that patients have good communication with their practitioner and

pharmacist with regard to their hormone therapy, and feel comfortable asking questions and requesting information.

The Practitioner

The practitioner examines, evaluates, tests, diagnoses, and prescribes treatment. Once the appropriate hormone therapy is prescribed, the practitioner monitors the effects of the hormone therapy. Compounded bioidentical hormones can be adjusted in their dosing as well as their formulation, under the guidance of the practitioner, to achieve the goal of optimal hormone balance for each of their patients.

The Pharmacist

The pharmacist provides quality assurance for each and every prescription compounded. The compounding pharmacist is available to the practitioner and the patient to provide information and resources about hormone strengths/dosages, formulations, and effects