Podiatric Compounding

Foot and Leg Issues Can Benefit from Compounding Pharmacy

Podiatrists and other healthcare professionals encounter numerous problems that may be helped with compounded medications:

  • Arthritis
  • Athlete’s Foot
  • Blisters
  • Calluses
  • Diabetic Neuropathy
  • Dry Skin
  • Edema/Swelling
  • Inflammation
  • Muscle Spasms
  • Nail Removal
  • Neuralgias/Neuropathic Pain
  • Neuritis (tingling pain)
  • Onychomycosis
  • Sprains
  • Tendonitis
  • Warts

When you have a problem that is difficult to treat, or if you are concerned about the side-effects of systemically administered medications, call our professional compounding pharmacists. We work together with prescribers and their patients to provide innovative solutions to challenging medical situations. We can create customized formulations that contain the most appropriate ingredients in the best vehicle to efficiently deliver the needed drug to the affected area.

Transdermal Therapy to Decrease Side Effects

Medications that relieve pain, reduce inflammation, and relax muscles have undesirable side effects, such drowsiness. However, when these medications are administered transdermally, the therapeutic benefit can be enhanced while significantly reducing the risk of adverse effects.

For example, research has shown that topically applied ketoprofen provides a high local concentration of drug below the side of application, but decreases systemic exposure and significantly reduces the risk of gastrointestinal upset or bleeding. When properly compounded into an appropriate base, tissue concentrations of ketoprofen were found to be 100-fold greater below the application site (knee) compared to systemic concentrations. Muscle relaxants can be added to transdermal bases to minimize the risk of drowsiness.

Anti-fungal Medications

Athlete’s foot and onychomycosis (fungal nail) are common problems. Research points to the practicality of using ibuprofen, alone or in combination with azoles in the treatment of candidosis, particularly when applied topically, taking advantage of the drug’s antifungal and anti-inflammatory properties.” Various synergistic combinations are used for antifungal therapy.

Nail Removal

Urea plasters have been shown to be effective for non-surgical removal of traumatized, dystrophic, or diseased nails, and may even be superior to surgical excision. The use of urea plasters can be much less costly, several nails can be treated in one session, and the procedure is essentially painless. Because there is a reduced risk of infection or hemorrhage, the procedure is ideal for treating diabetics and others with vascular insufficiency and peripheral neuropathy.

Skin and Wound Care

Traumatic wounds and pressure sores may heal more quickly if treated topically with phenytoin (which is used orally for anti-seizure therapy). Medications which improve capillary blood flow can be added to a compounded medication to enhance the circulation at the wound margins and promote healing of the injured area.

Dry skin and calluses can be treated with topical application of moisturizers such as silicone or urea. We utilize specialized equipment, such as an ointment mill, that allows us to compound formulations containing much higher concentrations of urea than can be prepared using traditional methods. Plantar fasciitis and warts are some other problems that can be helped with customized medications.

Pain Management/Trigger Point Application

Pain sensations follow a nervous pathway along an entire dermatome, from the trigger point to where the sensation is perceived. Trigger point applications may be useful when pain medications are administered transdermally, and is especially useful for treating neuropathic pain.

Combinations to Improve Therapy

Numerous compatible medications can be combined into a single dosage form for ease of administration. Also, a synergistic effect can be achieved when certain medications are used in combination. Penetrant enhancers can be added to improve the extent of absorption of topically applied medications.

Iontophoresis & Phonophoresis

Iontophoresis facilitates delivery of medications into the tissues beneath the skin by electronic transport of ionized drugs in solution. Acetic acid iontophoresis is effective in the treatment of heel pain. Iontophoresis of dexamethasone for plantar fasciitus should be considered when more immediate results are needed. Iontophoresis has been used to successfully treat plantar hyperhidrosis.

Phonophoresis is a technique that combines topical drug therapy with ultrasound to achieve therapeutic drug concentrations in muscle and other tissues beneath the skin. Ultrasound gels can be formulated to contain medications such as anti-inflammatories and/or anesthetics.