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Compounding

Compounding medication involves creating customized prescriptions tailored to meet individual patient needs. This process can include adjusting dosages, combining multiple medications, or altering the form of a drug (such as turning tablet into a liquid). Compounded medications are often used when commercially available options do not meet specific requirements or patient preferences.

Hormone Replacment

Hormone Replacement Therapy

Bioidentical Hormones are similar in structure as what the body makes naturally.  They are derived from plant sources such as yams and soy. 

 

Women

  • Estradiol (E2) – hot flashes, vaginal dryness, burning, irritation, painful intercourse, prevent bone loss

  • Estriol (E3) – hot flashes, vaginal atrophy & dryness, urinary pressure & urgency, prevent bone loss, prevent urinary tract infections

  • Bi-Est = Combination of Estradiol (E2) and Estriol (E3).  These can be in various ratios. Typical ratios are 70/30, 40/50, 50/50, 80/20

  • Progesterone – hot flashes, mood, fatigue, helps reduce endometrial cancer, brain fog & memory, insomnia, libido, reduce weight gain, dry skin

  • DHEA – precursor to testosterone and estrogen

  • Testosterone – improves libido, energy, and general feeling of well-being


Non-Hormonal Option for Vaginal Dryness

  • HEA = Hyaluronic Acid with Vitamin E & Vitamin A   = Suppository or Cream

  • *Applying topically to urethral opening could help with urinary leakage


*See the supplements-herbals section for other options for Menopausal Symptoms

Men

  • Testosterone – for Low-T, libido, energy, and mood

    • Commercial injectable vials available for a competitive price

    • Compounded in various forms

  • Progesterone – balances Estrogen, reduces weight gain, anxiety, erectile dysfunction, prostate problems, mood, and sleep


Other Treatments for Men

  • Clomiphene – blocks Estrogen & increases Testosterone, infertility

  • Anastrozole – reduces Estrogen levels by blocking the conversion of Testosterone to Estrogen, reduces gynecomastia

  • Sildenafil – for erectile dysfunction

    • Commercial tablets available

    • Compounded in various forms

  • Tadalafil – for erectile dysfunction

    • Commercial tablets available

    • Compounded in various forms

  • Apomorphine – for erectile dysfunction

    • Can be compounded together with Sildenafil or Tadalafil


Compounded Dosage Forms

  • Topical Creams or Gels

  • Tablet Triturates (Trits) – Tiny round tablets that dissolve on the tongue

  • Troches – Waxy square lozenges that dissolve on the tongue or between cheek and gums.  Can be halved or quartered easily

  • Capsules

  • Vaginal Creams

  • Vaginal Suppositories

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Troches

Creams

Capsules

Weight Loss Options

 

  • Low-Dose Naltrexone – reduces appetite and cravings. Expected weight loss is 1-2 pounds per week. 

  • Bupropion (Wellbutrin) – reduces cravings and appetite

“This is a report of a systematic review of the safety and efficacy of naltrexone or naltrexone/bupropion on weight loss.”     https://pmc.ncbi.nlm.nih.gov/articles/PMC8314402/

  • Curaslim – Herbal appetite suppressor, boosts metabolism, helps support glucose levels, mood & energy lift

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  • Sublingual Semaglutide – We compound liquid sublingual semaglutide drops.   We do not compound the injection. 


About Sublingual Semaglutide

This is a dosage form is not FDA approved.
*In addition to this information, please consult the patient information for Rybelsus ® (Semaglutide) tablets.

Directions for Sublingual Route

Place the prescribed amount under your tongue every morning and hold in the mouth as long as possible before swallowing. Don’t eat or drink anything for 30 minutes to allow the medicine to absorb through the oral tissues.

Semaglutide

Semaglutide belongs to a class of medications known as GLP-1 receptor agonists, which mimic the action of a natural hormone involved in glucose regulation. Its efficacy in controlling blood glucose levels and promoting weight loss has positioned it as a game-changer in the treatment landscape of type 2 diabetes and obesity.
However, the traditional modes of administration, primarily through injections, have posed barriers to some patients, leading to the exploration of more patient-friendly alternatives.
The sublingual route offers a direct pathway into the bloodstream, bypassing the gastrointestinal tract, which can often impede the bioavailability of medications.

Understanding Semaglutide

Semaglutide has garnered significant attention in the medical community for its dual-action capabilities in both diabetes management and weight loss. As a glucagon-like peptide-1 (GLP-1) receptor agonist, Semaglutide works by emulating the actions of the GLP-1 hormone, which is integral to blood sugar regulation and appetite control.

The Mechanism of Action

Semaglutide stimulates insulin secretion while suppressing glucagon release in a glucose-dependent manner. This means that it helps increase insulin levels when blood sugar is high, but not when it's normal, thereby reducing the risk of hypoglycemia.

Weightloss

Semaglutide slows gastric emptying, which contributes to a feeling of fullness, thereby aiding in weight management by reducing appetite and caloric intake.

Traditional vs. Sublingual Routes

Swallowed oral medications often face the challenge of the first-pass effect, where a significant portion of the drug is metabolized in the liver before reaching systemic circulation.
Injectable medications, while bypassing the gastrointestinal tract, can cause discomfort, anxiety, and inconvenience for many patients
Sublingual administration offers a middle ground, providing a non-invasive route that allows the medication to directly enter the bloodstream through the mucous membranes under the tongue.  Since there is no first-pass metabolism (as with swallowed tablets), lower milligram doses are needed to achieve effective therapeutic effects.
 

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Weight Loss

Transdermal Pain Creams

Patient Education

Use:
Topical pain creams are used to help relieve pain, inflammation, neuropathy, and muscle tightness.
 
Advantage:
The advantages of topical applications include avoiding stomach and gastrointestinal irritation caused by oral medications. Local relief without as much systemic absorption as oral formulations, and therefore less systemic side effects. There are a variety of options, strengths, and combinations.
 
How to Use:
Apply as stated by your physician. Measure out the prescribed amount and rub in to the affected area for 2-5 minutes. Wear gloves or wash hands after applying. Do not apply eyes, nose, mouth, or vagina. In general, do not apply to open wounds.
 
Side Effects:
Skin reactions, rash, itching, and redness if you are sensitive to one of the ingredients. Any side effect listed for the ingredients when taken as oral medications are a possibility. However, typically they would be much less likely or severe.
 
Medications:
 
Inflammation (Swelling):  Diclofenac, Dimethylsulfone, Flurbiprofen, Ibuprofen, Ketoprofen, Ketorolac, Meloxicam
 
Neuropathy (Nerve Pain): Amitriptyline, Clonidine, Dextromethorphan, Gabapentin, Imipramine, Ketamine, Topiramate
 
Muscle Relaxant: Baclofen, Cyclobenzaprine, Magnesium
 
Pain relief: Capsaicin, Menthol, Methyl Salicylate, Tramadol
 
Antiviral: Acyclovir
 
Increased Blood Flow: Nifedipine
 
 
*Compounded preparations are not FDA approved formulations. 

Transdermal Pain Creams

Ivermectin

 

Over-The-Counter

 

  • Tennessee is the only state that enacted a law to allow Ivermectin to be dispensed without a prescription as long as there is a protocol with standing orders in place with a collaborating physician. Crossroads Pharmacy’s collaborating physician is Dr. Denise Sibley https://www.denisesibleymd.com/ .  The protocol follows FLCCC Alliance’s protocols available at https://covid19criticalcare.com/ . 

 

  • A one-page screening form is required to ensure patients do not have a condition or medication that would contraindicate taking Ivermectin.

 

  • Patients can come from other states, but they must appear in person at the pharmacy.

 

  • Dosing is based on weight.

 

  • There are no limits on the quantity.  Typically, patients get either 5 or 30 compounded capsules in the range of 18mg-45mg (based on weight). 

 

  • Compounded capsules allow for 1 capsule per dose versus 9-15 tablets per dose of the commercial tablets.

 

 

Prescription

 

  • We accept prescriptions from individual providers as well.  

 

 

Nobel Prize  & Trials for COVID-19

 

  • “Conclusion - We believe that the evidence to date supports the worldwide extension of IVM treatments for COVID-19, complementary to immunizations. The indicated biological mechanism of IVM, competitive binding with SARS-CoV-2 spike protein, is likely non-epitope specific, as reviewed [8], possibly yielding full efficacy against emerging viral mutant strains. IVM has been safely used in 3.7 billion doses since 1987, well tolerated even at much greater than standard doses [34,35] and used without serious AEs in the three high-dose COVID-19 treatment studies noted above [34,36,37]. In the current international emergency of COVID-19, with mutant viral strains, vaccination refusals and potentially waning immunities over months presenting new challenges, IVM can be an effective component of the mix of therapeutics deployed against this pandemic.”      https://www.sciencedirect.com/science/article/pii/S2052297521000883

 

 

 

Historical Uses:

 

  • River Blindness, Elephantiasis, Lice, Scabies, Heartworms

  • National Library of Medicine   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740/

  • Onchocerciasis, also known as river blindness, is a parasitic disease that causes skin and eye problems

  • Lymphatic filariasis (LF), also known as elephantiasis, is a parasitic disease caused by microscopic worms that can lead to disability and disfigurement

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Screening Risk Assessment
Visit us and complete a Screening Risk Assessment to determine your eligibility for Ivermectin.

OTC Ivermectin
Vetinary Compounding

Veterinary Compounds

Examples (Many more medications and options are available):

Cats

  • Piroxicam Ear (Pinna) Gel

  • Methimazole Ear (Pinna) Gel or Cream

  • Prednisolone – Tiny Tablets (Trits) or Suspension

  • Metronidazole Suspension – Tuna Flavor or Triple Fish (Made from canned Tuna, Salmon, and Sardines)

  • Doxycycline Suspension - Tuna Flavor or Triple Fish (Made from canned Tuna, Salmon, and Sardines)

  • Ursodiol Suspension – Tuna, Chicken, Beef flavors

  • Gabapentin – Tiny Tablets (Trits), Capsules, or Suspension


Dogs

  • Pimobendan + Furosemide + Enalapril - Suspensions, Capsules – Various Flavors

  • Gabapentin – Chew Treats, Tiny Tablets (Trits), Capsules, or Suspension

  • Keppra – Commercial tabs or Compounded Caps, Suspension, Powder Packets, Chew Treats

  • Thyro-tabs (Levothyroxine) – Commercial Tabs, Compounded Caps, Suspension, Powder Packets

  • Robaxin (Methocarbamol) - Commercial Tabs, Compounded Caps, Suspension, Powder Packets

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