How Topical Compounding Has Worked For My Patients
You may have noticed the increasing presentation of the subject of topical compounded medications at our podiatry meetings. The reason for this is that the science of topical pharmaceutical compounding has advanced significantly over recent years.
Topical compounding allows the local delivery of high doses of medication to an area of pathology. Examples include the treatment of Achilles tendinosis, plantar fasciitis or following an acute injury. This technique provides the delivery of medications locally at levels significantly higher than with the administration of the same medications given systemically, typically as orals. In addition, the utilization of topical compounded medications provides for lower systemic levels of the same medication administered orally, generally less than 5 percent of the serum levels when one administers the same medications systemically. Furthermore, given the low systemic levels of the medications when administered topically, drug interactions are far less likely to occur.
Topical compounded medications expand the ability of the podiatric physician to effectively treat a variety of problems commonly encountered in daily practice. Many podiatric physicians are reluctant to utilize systemic medications for fear of adverse sequella or drug interactions, as a result denying some patients optimal efforts at pain relief or the reduction of inflammation. In addition, topically compounded medications are frequently accepted by the “I am already taking too many medications” patient and the ‘needle-phobic’ patient.
A particular aspect of topical compounded medications is the fact that they are medication(s), allowing me to combine multiple agents with multiple mechanisms of action. As a result, my ability to provide a patient with pain relief is substantially greater.
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