Although various types of Biologically Identical Hormone Replacement Therapy (BHRT) have been established, the route of administration is one way to improve the benefits, decrease the risks and side effects, and improve compliance.
Individual variations in response to different dosage forms increase the importance of having a choice of dosage forms to optimize patient outcomes. We have the ability to compound any dosage form to meet the needs of patient and healthcare practitioner alike.
- Hormone Overview Packet (PDF Download)
Mimicking ovarian hormonal secretion should be the goal of HRT (hormone replacement therapy). With the possible exception of pellet implants, percutaneous gels may offer HRT closest to the natural mode. Studies show plasma values remain constant throughout the day and the adequacy of the dose can be checked with standard laboratory testing (blood serum or saliva). Whereas the matrix of transdermal patches acts as a reservoir for hormonal delivery, percutaneous gels might use the natural reservoir effect of the skin to deliver a continuous flow of hormones into the body between the ONCE DAILY applications.
ALL HRT needs to be individualized for optimal effect. Variances in individual levels due to differences in absorption can easily be corrected by simply adjusting the volume or strength of the gel used by the patient. The gel dries completely within 1-2 minutes of application, leaving no visible trace or smell. Two or more hormones may be combined into a single dose to increase ease of application and compliance.
There are seldom problems with skin irritation even in warm or humid climates as is sometimes the case with transdermal patches. Like ovarian secretion, percutaneous gels do not deliver HRT via the portal system, thereby avoiding the first pass effect of liver metabolism. Unlike oral routes, a more physiologic estrone/estradiol balance is preserved.
NOTE: There are major differences in gel formulations. Some gels are not designed for delivering a 24-hour effect, e.g. PLO gels. Other gel forms include types of alcohol and other ingredients that are not appropriate for daily use. Our gels are consistent with those commercially available in Europe and are extremely hypoallergenic.
A true sublingual tablet can offer many of the benefits of a non-oral route without the unpleasant effects of a troche. Dissolving the tablet under the tongue introduces the hormones directly into the blood stream while by passing the metabolism that may occur in the liver. By delivering hormones directly into the circulation, problems with bio-availability due to the digestive tract might also be avoided, and often a lower dose can be used effectively. Generally there may be a 5-7% increase in absorption when using a sublingual tablet. We can compound all of our hormones either singly or in combination, per your prescription order.
We can provide a wide range of release systems and excipients, including oil-filled capsules, to be used with individual hormones or hormone combinations. We can offer capsules with an extended release delivery system for those medications and conditions that require a more continuous release to achieve the desired effect. Also available is a large variety of fillers for those patients who have multiple allergies or are extremely chemically sensitive.
Creams & Ointments
Creams and ointments can be compounded with a variety of different hormones and with complete strength and dosage flexibility. The consistency can be changed depending on the absorption required and the site of application. Our formulas are hypo-allergenic and can be made preservative free to minimize patient allergies and sensitivities. Most creams, to be effectively used for HRT, must be applied at least twice a day.
Fused Pellet Implants
Pellets are small, sterile cylinders which are formed by compression from medicated powders. They are implanted subcutaneously and can be used whenever a prolonged continuous absorption of hormones is desired. Patients receiving the pellet implants enjoy the convenience of not having to worry about daily dosing normally associated with other delivery systems.
Estradiol, estriol, estrone, progesterone and testosterone, as well as boric acid, acidophilus and more, can be compounded in suppository form. We use individually sealed, disposable, plastic molds for patient convenience. Also available are suppositories made in metal molds for those with chemical sensitivities.
Troches, Nasal Sprays, Ophthalmics
College Pharmacy has available a wide variety of dosage forms not typically found in other pharmacies. For those patients who have a unique medical circumstance, we can provide an alternative to traditional therapies.
Ask a Pharmacist
Get the answers you need
from our trusted specialists.