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Use of compounded therapies ‘worth the headache,’ speaker says

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NEW ORLEANS — A speaker here at Cornea Subspecialty Day said the advantages to using compounded medications still outweigh the drawbacks, even when considering contamination issues.

Bennie H. Jeng, MD, said these agents have been “a mainstay for many conditions in our field,” in glaucoma and cornea care, and in anti-VEGF and intravitreal injections.

Compounding allows physicians to customize dosages, provide allergen-free and preservative-free medications, and provide formulations not normally available, he said.

Antibiotics can be fortified, cyclosporine can be formulated in other percentages, and retinoic acid can be adapted for ophthalmic use, Jeng said.

Bennie H. Jeng

Sometimes the use of compounded agents is inconvenient for both the patient and practitioner, he noted. A compounding pharmacy must be located; it can be expensive and insurance does not always cover it.

The news of contamination issues in several compounding centers was prominent in both the peer-reviewed literature and the lay press, Jeng said.

“What’s interesting is that between 2002 and 2012 there were 11 total episodes of outbreaks with compounding pharmacies, three of which involved ophthalmic preparations,” Jeng said.

The U.S. Senate Committee on Health, Education, Labor and Pensions released legislation to help improve the safety of compounded drugs, he said.

“It’s still being debated,” Jeng said. “It’s worried that new regulations may cause problems with patient care.”

Jeng asked: Are compounded medications worth the headache?

“In reality, we’re taking these medications that would otherwise be unavailable commercially to take better care of our patients,” he said. “If you ask me is it worth the headache to work with compounded medications, I say it’s definitely a ‘yes,’ because it helps us take care of our patients.”

Disclosure: Jeng has no relevant financial disclosures.