Commonly Requested Pediatric Compounding Ideas

Nausea & Vomiting

• Ondansetron 4 mg/0.1 mL Topical Lipoderm®
• Ginger Root 200 mg Sorbitol Lollipop Base™
• Promethazine HCI 50 mg/mL Topical Lipoderm® (Stabilized)
• Promethazine HCI 25 mg/mL Topical Lipoderm® Promethazine – reminder of Black Box Warning

Acne

Parents are often looking for alternatives for acne for their teenagers. Physicians often inquire about non-antibiotic treatments.

• Niacinamide 3%/Lipoic Acid 0.5% Topical Cream
• Niacinamide 4% Acne Gel
• Niacinamide 4%/Biotin 0.1%/Lipoic Acid 0.5% Topical Acne Gel, Alternate

Autism

PCCA Anhydrous Lipoderm® is soy-free. Various drugs that are not stable in water may be incorporated into this base.

• DMPS 20% Topical Anhydrous Lipoderm®
• DMSA 20%/Emu Oil 10% Topical Anhydrous Lipoderm®
• Topical Anhydrous Lipoderm® – General Formula
• Glutathione 20%/Emu Oil 10% Topical Anhydrous Lipoderm®
• Methylcellulose 1% Flavored Suspension Vehicle (PF) – This is sometimes referred to as the Autism Suspending Vehicle. It is often used for autistic patients.

Commonly Requested Suspensions

Ask the pharmacist about the Proprietary Bitter Drug Powder Base used to reduce bitterness in hard-to-flavor medications.

• Omeprazole 2 mg/mL Oral Suspension – A flavorless formulation is available for use in G-tubes.
• Lansoprazole 3 mg/mL Oral Suspension – A flavorless formulation is available for use in G-tubes.
• Sildenafil Citrate 1 mg/mL Oral Suspension – Sildenafil is not commercially available in a suspension.
• Ranitidine 150 mg/5 mL Oral Suspension – The distinct bitterness and mint flavor of commercially available forms of ranitidine often cannot be overcome with flavoring. Compounding with the pure powder may help with compliance and ease the minds of parents.
• Atomoxetine 6 mg/mL Oil Oral Suspension – Straterra® (atomoxetine) is not stable in aqueous environment.
• Oral Effervescent: General Formula – Drugs that are not stable in water or that taste bad may work well in the general effervescent formulation.
• Ferrous Sulfate Heptahydrate 165 mg Oral Effervescent – Iron in general does not taste very good. Parents often inquire about alternatives for iron liquid for their children.

Cough/Cold

Various liquid formulations have been removed from the market. See the Winter Season Compounding Ideas sheet to see if any of these formulation ideas may apply to the pediatric patient.

• Menthol 0.1%/Eucalyptus 0.275% Sorbitol Lollipop™ Base – This tastes similar to commercial cough drops except in the convenience of a lollipop dosage form. One advantage of a lollipop is that it can last a long time if it is sucked on for a while and the rest saved.

Diaper Rash

• Nystatin 0.758%/Karaya Gum 33% Topical Ointment
• Cholestyramine 5% Diaper Rash Ointment
• Happy Hiney
• Buttocks Ointment
• Zinc Oxide 5%/Benzoin Compound Topical Paste

Fever

• Ibuprofen Suppository Ibuprofen is not commercially available as a suppository although acetaminophen is.
• Ibuprofen 100 mg Sorbitol Lollipop™ Base
• Acetaminophen 240 mg Sorbitol Lollipop™ Base
• Ibuprofen 10% in Lipoderm Transdermal Gel

Lice

• Ivermectin 1% Topical Lotion
• Aromatic Head Lice Formula
• Lice Remedy, Essential Oils

Psoriasis / Eczema

• Cyanocobalamin 0.07% Topical Cream
• Cyanocobalamin 0.1% Topical Foam

Topical Anesthetics

All of these drugs have a quick onset of action. Prilocaine/lidocaine is often used in offices; however, the onset is longer so the patient must wait.

• Lidocaine HCI 4%/Tetracaine HCI 0.5%/Epinephrine HCI 0.05% Topical Gel
• Lidocaine HCI 1%/Tetracaine HCI 1% Topical Foam