Personalization is a term that everybody sees – and experiences – in the daily life.
Whether receiving customized ads in social media, creating your own perfume in a store or adding a list of accessories in your brand-new car, those tailored experiences keep us engaged and create the feeling of being unique.
One of the fields that has been evolving more rapidly within this concept is the personalized medicine (which can also be called precision medicine and is also related to the terms individualized treatments, med tech treatments, patient-friendly medications, or patient-centered medications). The use of modern, technological, and precise solutions for the health care has undoubtedly create a big fuzz in the last years, both in doctors and nutritionist and also in the general public.
Although sometimes we fell that the personalized medicines can only be made after a genetic test to know your organism deeply, it is not necessary to look at a very distant horizon to see the possibilities of personalization and therapeutic individualization. In fact, the very concept of compounding pharmacy is already based on the foundation of personalization: unlike drugs found in drugstores and made by industries in unique dosages, compounded products are made exclusively for each patient, respecting their needs and preferences, in appropriate dosages, and produced with highly technological processes to ensure safety and efficacy.
In this sense, a new form of administration can lead to immediate benefits for the patient. A practical and well-known example: a considerable fraction of the population has limitations in swallowing pills or capsules (for example: Parkinson’s disease, cerebral palsy and other neurological disorders, thyroidectomy, radiotherapy in the head and neck region, psychiatric patients or resistant to treatment etc.). Thus, even if the treatment already exists (in the form of an industrialized drug), the patient could not follow the prescription, which invariably leads to a suboptimal or non-existent response. A more careful look from the prescriber must exist in these situations, and in this sense it is prudent to prescribe the drug into a new presentation, which is more friendly (that is, thought with the patient centrally to the healing process) such as, for example, orodispersible films, shots (flaconettes), transdermal patches or any other that increases the patient’s interest in the medication. In addition, the dose can be adjusted to the patient’s real need, unlike the standard dose of industrialized drugs, which are the same for the entire population (regardless of weight, height, sex, enzymatic and metabolic differences, etc.). This optimization of the medicine for each case is, as is to be expected, the core of the compounding pharmacy – and also of medicine/functional nutrition.
Examples of simple and effective solutions
There are facts that come to seem like challenges when trying to make a patient fully adhere to their prescription, which can generate frustration for both the prescriber and the patient. However, simple attitudes can make a big difference in this process, no matter how banal they seem at first glance. Effervescent tablets, for example, can be options for drugs in high doses, for adults and children. They are solid and compact before use (and therefore with great stability), but they generate a solution that is easy to swallow and has a pleasant taste when used. For children, it is still necessary to consider the involvement in the preparation of the medication, due to the effervescence generated and observed as bubbles (a psychological benefit that contributes favorably to the treatment). Once again: a very simple solution, but one that demonstrates the prescriber’s differentiated care with his patient.
Another presentation that has gained more space is the orodispersible film, or oral strip, as it is more commonly called. Strips are sheets (or films) of edible materials to be placed in the mouth (or under the tongue), where they disperse quickly, releasing the active ingredients. As it is a different medicine and with aesthetics similar to food products (with the taste of your choice), the patient is motivated to carry out the ingestion. Since dissolution takes place in a few seconds, there is no trauma or unpleasant mouthfeel. It also has the benefit of not needing water for swallowing, a convenient situation for patients who are traveling or with nausea and vomiting. Thus, strips combine the advantage of a solid dosage form in terms of stability and the advantage of a liquid dosage form in terms of bioavailability.
A third example is transdermal patches. Transdermal patches combine the benefits of traditional transdermal patches (non-aggression of the gastrointestinal tract; absorption at a controlled rate, which allows to maintain constant plasma levels of active principles with high potency; elimination of the hepatic first-pass effect; interruption of treatment in a manner immediate by the simple removal of the skin system if the patient starts to manifest adverse or toxic effects) with exclusive advantages: more sustained and regular release, with less variation caused by factors related to the application; free from the risk of contamination from third parties (eg children, partners) due to possible physical contact with the patient; more convenient application for the patient, as there is no need for friction during application; not promoting skin oils.
The advantages of compounded medicine
The above examples are just some of the solutions that can greatly benefit the patient. In addition to these specific examples, compounded medicines have a series of advantages that make them the ideal choice for numerous cases:
- Dose versatility: adjustment of doses or concentrations of the active pharmaceutical ingredient. Mainly important for patients with specific needs, such as pediatric patients (various medications are not available in the market in concentrations for these patients).
- Possibility of choosing the pharmaceutical form and excipients: through compounding, the prescriber can choose to use the pharmaceutical form that best suits the chosen route of administration or the specific conditions of the patient. It is also possible to choose certain ingredients that may be controversial or harmful for some patients. Products can then be sugar-free, lactose-free, preservative-free, dye-free, flavor-free, fragrance-free, oil-free etc.
- Feasibility of associations of active ingredients: possibility of associating several ingredients in a single formulation, for synergistic effect or for dosage simplification.
- Obstacle to self-medication: the compounded products are prepared according to the prescription of an authorized professional. In this way, abuses and inherent risks of self-medication are avoided.
