Custom pharmacy fills niche for humans, pets requiring medicines

tailored to special needs

By Mary Buckle
Staff Writer

GLENDALE -What works for many does not necessarily work for everyone.

That is where prescription Compounding pharmacists John Waclawski and his daughter, Monica Zatarski, come in.

Waclawski and Zatarski three months ago opened MD Custom Rx, a specialty pharmacy where they make up customized medications according to doctors' - or veterinarians'- prescriptions.

Waclawski also owns Ye Olde Pharmacy where he started his prescription compounding business as an adjunct to the more typical sales of mass- produced medicines. Zatarski's pharmacist husband, Dan, now is the managing pharmacist at Ye Olde Pharmacy.

"As an independent pharmacy, I have always focused on a professional niche," Waclawski said.

Ye Olde Pharmacy provides health care services and products in addition to medication. It serves more than 9,000 patients with diabetes.

"We have special orthopedic shoes, the shoes that diabetics need to have,” he said. "People find us because of what they need.”
Waclawski has been on North Port Washington Road in several locations for 27 years and is the only independent pharmacy left in-the city.

One size does not fit all

About 15 years ago, he started to delve into customized prescription compounding."

There was a need," he said. "Mass-marketed drugs are kind of a one size fits all."

There are many people – and even some animals - who cannot take a mass-produced drug.

They are allergic to fillers or dyes or they need a dose that is not mass produced," Waclawski said.

Sometimes patients cannot take a medication in the mass produced form. Sometimes doctors -or—veterinarians-want to use a specific type of medication they believe will be helpful to a patient. Sometimes patients cannot have the sweeteners found in some mass-produced medicines or they need a specific combination of ingredients not commonly used. There are many reasons why there is a need for prescription compounds.

Waclawski started to compound medicines doctors needed and prescribed. Zatarski completed her Pharmacy degree at the University of Wisconsin-Madison and joined the business in 2004, becoming responsible for the prescription compounding business. Soon they out grew the space at Ye Olde Pharmacy and moved the compounding business to a new space next door at 5322 N. Port Washington Road.

At MD Custom Rx, they can produce sterile medicines such as eye drops and injectables in addition to pills, salves, gels and other compounds.

Sterile work is done in a clean room facility, which is actually three rooms, a prep room where the pharmacists pick up masks and gowns, an anteroom where they scrub, and a clean room with hood, convection oven and incubators where they prepare the sterile medications.

They work with about 200 physicians – neurologists, pediatricians and obstetricians among them.

 “Doctors ask me, 'What do you make?" Zatarski said. "We say, ‘what do you need?'"

She has developed her own personal specialty, bio identical hormone therapy, for women with symptoms associated with menopause, perimenopause or premenstrual syndrome. The patient, physician and pharmacist work together to identify the medications that will help the patients, both in hormone therapy and for illness or injuries.  Mass-produced hormones are either synthetic or derived from the urine of horses.  Bioidentical hormones are derived from plants and can be composed to match a woman's missing hormones.

Alternatives to pills

With prescription compounding, a medication can be delivered in a variety of ways-gels, solvents, capsules, lozenges even lollipops.

Waclawski said patients recovering from rotator cuff surgery, for instance have great success with pain gels that can be applied to the skin, working directly on the affected area. Pain pills often have side effects, such as drowsiness, but the gels usually have none.

 “The skin is a wonderful way to give drugs,” Zatarski said.

Creams and gels are an attractive alternative for patient who have trouble swallowing pills or are nauseous.

“They don’t go through the gut, which degrades them, or through the liver, which changes them,” she said.

They make an ear gel for cats, easier to use on felines, and other medications for animals as well.

“We make a preparation for St. Joseph’s Hospital for high risk pregnancies,” Waclawski said.

They also produce a special ointment for nursing mothers that knocks out yeast infections.

The state started and accreditation process for compounding pharmacists last year, a welcome requirement for the father and daughter pharmacists.

“I am glad about it because it will help regulate quality,” Zatarski said.

Waclawski and Zatarski are members of the International Academy of Compounding Pharmacists and the Professional Compounding  Centers of America and are certified in aseptic compounding.