Clarification Wellness Cmpding Pharmacy Prescriptions

October 13, 2008

Dear Listmates: I need to clarify something in regard to a recent post by a

parent to my csb e-group concerned that Wellness had been creating their

compounded GSH (glutathione) in PCCA after learning it had wheat germ oil, soy,

and aluminum in it. I (Dr. JM) personally had requested a few pharmacies in the

past ato use ONLY emu oil in the prescription for LDN when I found out their

prescription with lipoderm had soy in it, without even knowing it had the wheat

germ oil and aluminum in it. And I have asked literally dozens of pharmacies

over the last several years to only give LDN with emu oil - almost all of them

are using Dr. Tyrus 's formulation so already knew that.

This is from Wellness in regard to the parent who posted to my csb group unhappy

with Wellness about the PCCA for their GSH:

" They were under the impression that we (Wellness) took it upon ourselves to

change their son's prescription from an emu oil base to a lipoderm base. We went

and found the original prescription and their DAN! physician Dr. XXXXXX

(well-known and well-respected DAN! doctor) had written it for glutathione in a

lipoderm base - as she does most all her patients. So, I informed them that we

filled and had been filling the prescription right (as their doctor had

prescribed) for two years now.

Wellness, like a lot of other compounders, obtain their bases for most of their

transdermls from PCCA. The lipoderm base is one of the most popular and the most

effective and researched as far as transporting medications through the skin. It

is used all over the autism community by many physicians. Emu oil is usually

used as a back up to the lipoderm if a child were to have a reaction. The

ingredient list - as obtained from PCCA - does contain triticum vulgare (wheat)

germ oil, magnesium aluminum silicate, and pro-lipo multi emulsion liposomic

system (among other things). We have spoken with PCCA in-depth about this base

and they have assured us that the amounts of aluminum, wheat and soy are very

minute and almost unmeasurable. The idea may be that there may be more of a

benefit using this vehicle to get the medication absorbed into the bloodstream

than the risk of being exposed topically to minute amounts of aluminum, soy...

It is a shame that she is mentioning only Wellness, as others are using the same

base. It's not that we specifically recommend this base, it's just that we are

following a doctor's prescription and filling the transdermal as it is written.

I hope that people do not think that we changed her prescription - because we

did not. We merely filled the prescription as it was written, and in this case

it called for a lipoderm base.

Now that this post is out there I want to make sure that patients know to inform

their pharmacy of choice (as well as their doctors) their personal concerns

about the bases used. Like I mentioned earlier, it's not just Wellness, its many

other compounders using the same bases offered by PCCA.

If you have any suggestions for us, we are listening! "

I (Dr. JM) want to take the opportunity to say that Wellness is in my opinion

one of the best compounding pharmacies I know of for the autism community. They

go out of their way to help parents as much as possible, and keep up on all the

new advances made, attending all the DAN! conferences and helping both the

doctors and the patients in every way they can. Of course I love Dr. Tyrus

, formerly at Coastal Compounding and currently not working as a

pharmacist, for creating at my request a cream with nothing allergenic for our

autism kids and coming up with the emu oil based LDN for my studies and for all

my patients afterwards who have taken and are taking LDN. Wellness was one of

the first pharmacies to embrace and promote this new formulation and always

worked well with Dr. and me in our formulation efforts. I myself knew

only about the soy in the Lipoderm, not the wheat germ oil or the aluminum. I

am now contacting all the pharmacies I

use and asking them to make all my autism patient prescriptions with emu oil.

I will also bring this up at the upcoming Clinician Think Tank at the San Diego

DAN! and advise my colleagues of this situation. If they have not had any

problems with the PPCA cream for their transdermals, they may want to continue

using it as they always have, or they may take this into consideration and

choose to specify which carrier they want as I am doing. I gather that if not

specified by the prescribing doctor, PCCA is the standard carrier used. Best

wishes, Dr. JM

October 15, 2008

Does anyone know what formulation Coastal Compounding uses for their

transdermals? We get our glutathione from them.

Thanks,

Sue

On Mon, Oct 13, 2008 at 8:26 PM, JAQUELYN MCCANDLESS <

JMcCandless@...> wrote:

> Dear Listmates: I need to clarify something in regard to a recent post

> by a parent to my csb e-group concerned that Wellness had been creating

> their compounded GSH (glutathione) in PCCA after learning it had wheat germ

> oil, soy, and aluminum in it. I (Dr. JM) personally had requested a few

> pharmacies in the past ato use ONLY emu oil in the prescription for LDN when

> I found out their prescription with lipoderm had soy in it, without even

> knowing it had the wheat germ oil and aluminum in it. And I have asked

> literally dozens of pharmacies over the last several years to only give LDN

> with emu oil - almost all of them are using Dr. Tyrus 's formulation so

> already knew that.

>

> This is from Wellness in regard to the parent who posted to my csb group

> unhappy with Wellness about the PCCA for their GSH:

>

> " They were under the impression that we (Wellness) took it upon ourselves

> to change their son's prescription from an emu oil base to a lipoderm base.

> We went and found the original prescription and their DAN! physician Dr.

> XXXXXX (well-known and well-respected DAN! doctor) had written it for

> glutathione in a lipoderm base - as she does most all her patients. So, I

> informed them that we filled and had been filling the prescription right (as

> their doctor had prescribed) for two years now.

>

> Wellness, like a lot of other compounders, obtain their bases for most of

> their transdermls from PCCA. The lipoderm base is one of the most popular

> and the most effective and researched as far as transporting medications

> through the skin. It is used all over the autism community by many

> physicians. Emu oil is usually used as a back up to the lipoderm if a child

> were to have a reaction. The ingredient list - as obtained from PCCA - does

> contain triticum vulgare (wheat) germ oil, magnesium aluminum silicate, and

> pro-lipo multi emulsion liposomic system (among other things). We have

> spoken with PCCA in-depth about this base and they have assured us that the

> amounts of aluminum, wheat and soy are very minute and almost unmeasurable.

> The idea may be that there may be more of a benefit using this vehicle to

> get the medication absorbed into the bloodstream than the risk of being

> exposed topically to minute amounts of aluminum, soy...

>

> It is a shame that she is mentioning only Wellness, as others are using the

> same base. It's not that we specifically recommend this base, it's just that

> we are following a doctor's prescription and filling the transdermal as it

> is written. I hope that people do not think that we changed her prescription

> - because we did not. We merely filled the prescription as it was written,

> and in this case it called for a lipoderm base.

>

> Now that this post is out there I want to make sure that patients know to

> inform their pharmacy of choice (as well as their doctors) their personal

> concerns about the bases used. Like I mentioned earlier, it's not just

> Wellness, its many other compounders using the same bases offered by PCCA.

>

> If you have any suggestions for us, we are listening! "

>

> I (Dr. JM) want to take the opportunity to say that Wellness is in my

> opinion one of the best compounding pharmacies I know of for the autism

> community. They go out of their way to help parents as much as possible, and

> keep up on all the new advances made, attending all the DAN! conferences and

> helping both the doctors and the patients in every way they can. Of course I

> love Dr. Tyrus , formerly at Coastal Compounding and currently not

> working as a pharmacist, for creating at my request a cream with nothing

> allergenic for our autism kids and coming up with the emu oil based LDN for

> my studies and for all my patients afterwards who have taken and are taking

> LDN. Wellness was one of the first pharmacies to embrace and promote this

> new formulation and always worked well with Dr. and me in our

> formulation efforts. I myself knew only about the soy in the Lipoderm, not

> the wheat germ oil or the aluminum. I am now contacting all the pharmacies I

> use and asking them to make all my autism patient prescriptions with emu

> oil. I will also bring this up at the upcoming Clinician Think Tank at the

> San Diego

> DAN! and advise my colleagues of this situation. If they have not had any

> problems with the PPCA cream for their transdermals, they may want to

> continue using it as they always have, or they may take this into

> consideration and choose to specify which carrier they want as I am doing. I

> gather that if not specified by the prescribing doctor, PCCA is the standard

> carrier used. Best wishes, Dr. JM

>

October 15, 2008

This from Coastal Staff:

Hello Dr. McCandless!

Thanks for the email. Whether you have specified in the past or not we always

put all of our LDN in the EMU/Pluronic base. Never Lipoderm. That goes for all

of our Autism transdermals; we never use the Lipoderm. In our pharmacy the only

thing we have and do use the Lipoderm for is our dermotology, orthopedic and

cosmetic compounds.

Thanks!

Coastal Compounding Staff