By Sheila Griffin Llanas
Today's Wisconsin Woman
August 2006

"My history is unique," says Monica Zatarski Registered Pharmacist. "My father is a pharmacist. I grew up in a pharmacy." She and her father now co-own MD Custom Rx, on North Port Washington Road, a rare compound -only pharmacy.

Zatarski, who graduated in May 2004, from the UW-Madison, defines compounding as, "The art and science of preparing customized medications. We use raw ingredients to make individual products. It allows us to be creative and to address needs that aren’t being met by commercial products."

The first pharmacist, she says, mixed and poured and prepared medicine by scratch. There were no drug companies. These days, however, it's not practical for companies to design a drug in every possible strength and form. Drugs are available in what Zatarski calls one size doesn't fit all. "I get calls every day about problems where nothing else has worked," Zatarski says.

WHO USES COMPOUND MEDICATIONS?

Basically, anyone who can't take a commercial drug in the form it comes in is a candidate for compound, or custom, medication. Compounding can manipulate, combine and change a drug's form to meet the needs of the individual.

Many patients are sensitive or allergic to dyes, sugars, fillers or even to pill-swallowing in general. Children have trouble swallowing pills and drinking bitter tastes. Drugs can be made lactose-free or strawberry-flavored. Zatarski serves many patients taking bio-identical hormone replacement. She tailors a lot of pain medications. “Pain is so individual,” she says.

People of every age, gender and body type can benefit from compounding. Oh, and cats. “I have a lot of cat patients,” Zatarski says “Cats are hard to medicate. They are sneaky animals.” She often makes gels that can be rubbed into a cat's inner ear.

WHAT FORM?

Many compounds can change a prescription drug's dosage. No more breaking pills in half. Other compounds change its form. A product only available in an oral or injectable form can be compounded into, for example, a cream that can be rubbed into the skin. We do a lot of transdermal formulations,” Zatarski says. Lotions are applied topically rather than digested through the stomach. The benefit is that common side effects such stomach discomfort, organ irritation, ect. can be avoided. For example, a pain pill may treat local pain just has effectively in lotion form, without the drowsiness.

COMPOUNDING IS REGULATED.

Compounding, which requires specialized training and equipment, such as sterile, clean-room facilities, is widely used in hospitals. Over the last decade there have been advances in technology, equipment and research regarding compound medicine. FDA regulations governing compounding, USP795 and USP797, protect the consumer and guarantee a quality product.

Compound medications are not necessarily more expensive. Often, the out-of-pocket cost is the equivalent of a typical co-pay.

Zatarski upholds the triad of pharmacist, physician and patient. “Everything I make is by prescription,” says Zatarski. She enjoys working closely with the patients and their physicians, and keeps patient records regarding allergies, ect. “Sometimes a physician will call and ask us, ‘What can you make?”’ Zatarski says, “and we say, ‘The ski is the limit.”’