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c/compounding·posted 2 years ago by u/bilal_osei

reading API source threads from 2024 and half of it aged badly

Regulatory Clean Column ×4 The Quiet One ×3

reading API source threads from 2024 and half of it aged badly. It is the sort of thing everyone half-believes and nobody writes down.

Kept the label from every vial. When the shortage status changed, having the paper trail made the conversation much shorter.

Asked for potency testing on the finished preparation. They had it. I had assumed they would not.

The five questions worth asking before you commit to any compounded arrangement.

Which facility, by name. Whether it is a 503A pharmacy or a 503B outsourcing facility. What concentration is on the label. What the beyond-use date is based on. Whether there is potency testing on the finished preparation rather than only on the starting material.

All five are answerable in one email and the pattern of what comes back is more informative than any of the individual answers. An organisation with a quality system finds these questions ordinary.

That is everything I have. The rest is opinion and I have tried to keep it out.

2,346 up / 356 down87% upvoted69 commentsid j6d9li4 Jul 2024

69 comments

30 in this archive, depth 3

best — the order this archive was captured in

u/stubborn_batchlist_pls311 points·2 years ago·edited

Agreed on potency testing of the finished preparation. That is a different question from the purity of the starting material.

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u/bilal_oseiOP112 points·2 years ago

the API source is the question nobody asks and everybody should

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u/ahmed_fonseca241 points·2 years ago

A 503A pharmacy compounds for an identified patient against a prescription. A 503B outsourcing facility registers with the regulator, may produce without patient-specific prescriptions, and is subject to current good manufacturing practice requirements. The two are governed differently and the difference is not cosmetic.

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u/medutest_mel65 points·2 years ago

Is the compound still on the shortage list where you are?

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u/helga_vermeulen187 points·2 years ago

The shortage list is the legal hinge: the permissions that allow certain compounding to happen at scale are tied to a drug’s shortage status, which changes.

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u/hydration_hank67 points·2 years ago

salt forms are the recurring argument and the answer is boring

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u/tove_ogunleye-22 points·2 years ago

Same view. If the intake asked you nothing, the intake was a formality and you should factor that in.

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u/jonas_eriksen1 point·2 years ago

a 503B has to register and report, so there is a paper trail to ask for

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u/usp_appendixMOD84 points·2 years ago

Left up. It describes an arrangement with specifics and it is honest about the jurisdiction.

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u/julia_erdogan26 points·2 years ago

potency testing on the finished preparation is the thing to ask for

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u/liver_enzyme_liz76 points·2 years ago

This. Compounded preparations carry no equivalence claim, and treating them as generics is a category error people make constantly.

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u/nadia_fonseca113 points·2 years ago

ask which facility, then ask for their testing

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u/elise_ramos37 points·2 years ago

compounded is not generic, there is no equivalence claim

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u/lipid_panel_larrybloodwork62 points·2 years ago

if a clinic will not name the facility, that is your answer

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u/mateusz_adebayo32 points·2 years ago

Yes — asking which facility, by name, is the single most useful question and most clinics will answer it.

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u/cold_chromatogram3148 points·2 years ago·edited

Not convinced. You are comparing a compounded concentration with a branded one and assuming they match.

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u/usp_appendixcompendial14 points·2 years ago

do not assume the concentration matches the branded product

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[deleted]6 points·2 years ago

[deleted]

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u/ffmi_watcher25 points·2 years ago

Compounded preparations are not approved products and carry no bioequivalence claim. That is a statement about regulatory category, not about quality.

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u/bilal_oseiOP19 points·2 years ago

the label on a compounded vial is a legal document, read it

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u/marit_mwangi15 points·2 years ago

Careful. Naming a clinic without describing what actually happened turns this into a different kind of thread.

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u/cold_chromatogram316 points·2 years ago

Why "compounded" is not "generic", written out because the confusion is constant.

A generic is an approved product demonstrated to be bioequivalent to a reference. A compounded preparation is made for a patient or, in the case of an outsourcing facility, under a different regulatory route entirely. It carries no equivalence claim and it is not required to demonstrate one.

That is not a quality judgement. Plenty of compounded preparations are made carefully in facilities with real testing programmes. It is a statement about what has and has not been established, and the difference matters when people assume the two are interchangeable.

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u/santiago_rasmussen24 points·2 years ago·edited

Push back: "compounded is fine because a pharmacy made it" skips every question this board exists to ask.

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u/ismael_pires15 points·2 years ago

Switched between two compounded preparations and the concentration on the label was different. Redid the arithmetic on paper before drawing anything.

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u/tobias_vukovic3 points·2 years ago

Concentration on the compounded vial was different from what I had been using and I nearly did the arithmetic on autopilot.

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u/rania_diallo16 points·2 years ago

That figure is the starting material purity, not the finished preparation potency. Two different tests.

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u/ireland_drugs_pay6 points·2 years ago

Cosigning the beyond-use date question. What it is based on tells you whether anybody has done stability work.

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u/rania_diallo15 points·2 years ago

503A is patient-specific, 503B is outsourcing facility, they are not the same thing

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u/ffmi_watcher5 points·2 years ago

a telehealth intake that asks nothing has told you what it is

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About c/compounding

Compounded GLP-1s as a supply route: the 503A/503B distinction, the shortage-list mechanics that made compounding legal and then didn't, state board rules, telehealth prescriber models, and what a compounding pharmacy will and will not tell you about its API source.

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