Reviewed by Linda Pungpravat, Compounding Pharmacist, RPH, Mixwell Compounding Pharmacy, Chino, CA.
What Is Pediatric Compounding?
Pediatric compounding is the preparation of custom children's medications, made by a pharmacy to a prescriber's written order. It lets a provider set the exact strength, form, and flavor for one child when a commercial product does not fit.
Why Children Often Need a Custom Form
Many medications are made only as tablets or capsules sized for adults. That creates three common problems for kids:
- Swallowing. Young children often cannot swallow pills, so a liquid or another form may be needed.
- Dosing by weight. Children are dosed by weight, and the strength a child needs may not exist commercially.
- Taste. A bitter medicine is a medicine a child fights, and missed doses follow.
What Mixwell Can Compound for Children
Mixwell prepares these by prescription, in forms and strengths a provider selects:
- Flavored oral liquids in tastes children accept
- Custom strengths matched to a child's weight based dose
- Options for Dye free, sugar free, or allergen conscious versions
- Alternative forms such as troches or topicals when swallowing is difficult
- Alternatives when a needed medication is discontinued or unavailable
Dyes, Preservatives, and Other Inactive Ingredients
Inactive ingredients are not always harmless in children, which is one reason a provider may ask for a custom preparation. The American Academy of Pediatrics Committee on Drugs reviewed this in Pediatrics (1997) and noted that adverse reactions to pharmaceutical excipients continue to be reported, while ingredient labeling remains voluntary. Benzyl alcohol is the clearest example. It is linked to neonatal gasping syndrome and is avoided in infants, and both the FDA and the AAP recommend against preparations preserved with benzyl alcohol in infants. A prescriber can specify a formula without a specific dye, preservative, or allergen when there is a reason to.
Also to note, some formulas will have no options but to have a preservative in it. This is due to make sure to preserve active ingredients and ensure effectivity upon use.
Safety Comes First
Compounded medications for children are not FDA approved and are prepared only with a valid prescription. Dosing for a child belongs to the prescriber, who accounts for weight, age, and the whole medication list. Parents should never adjust a dose or crush or split a medication on their own, since that can change how a medicine works. Call your provider or pharmacist with questions before making any change.
Who Prescribes Pediatric Compounds
Providers who care for children order these preparations for their patients:
- Pediatrics and family medicine
- Pediatric specialists such as gastroenterology, neurology, endocrinology, and allergy
- Pediatric dentistry
- NPs and PAs in pediatric and primary care practices
Their patients include infants, children, and teens who need a strength, form, or flavor that is not sold commercially.
How Mixwell Prepares Your Child's Prescription
Mixwell compounds each preparation to the prescriber's exact order in a purpose built lab. We compound under USP 795 for nonsterile compounding and USP 800 for hazardous drugs, using HD negative pressure containment when a preparation calls for it. As a PCCA member pharmacy, we prepare each formula for one patient by prescription. Mixwell is a nonsterile pharmacy and does not make sterile products or injectables.
Mixwell Compounding Pharmacy is located at 13788 Roswell Ave, Ste 158, Chino, CA 91710. We serve Chino, Chino Hills, Ontario, Pomona, Diamond Bar, and Rancho Cucamonga, and we deliver across California.
A Note on Compounded Medicine
Compounded medications are not reviewed or approved by the FDA and are prepared only with a valid prescription. Information about compounded drugs must be truthful, accurate, and not misleading. Nothing here promises a specific result, and compounded preparations are not presented as superior to commercially available products. Talk with your child's health care professional about your child's specific situation before you start or change any medication.