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

why does nobody talk about state board

Discussion Receipts ×8 Well Actually ×3 Long Haul ×1

Question in the title, detail here: why does nobody talk about state board.

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.

A beyond-use date derived from published stability data means something different from one assigned by default rule. Asking which is a fair question and the answer is usually available.

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.

Would rather be corrected in public than confident in private.

4,444 up / 136 down97% upvoted54 commentsid jgcvah16 Jun 2024

54 comments

18 in this archive, depth 4

best — the order this archive was captured in

u/ferran_mensah623 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/ilias_cabrera-2 points·2 years ago

ask which facility, then ask for their testing

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u/yusuf_kirchner434 points·2 years ago

Potency and sterility testing on the finished preparation are separate from any certificate covering the starting material. Ask which you are being shown.

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u/fatima_kowalski320 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/nadia_fonseca253 points·2 years ago

Small fix — 503B facilities register with the regulator; 503A pharmacies are licensed by the state board. Different mechanisms.

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u/hassan_chowdhury288 points·2 years ago

Salt form matters for mass: a preparation specified as one salt and dosed as the free base gives you a different amount of peptide for the same number on the label.

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u/julia_erdogan197 points·2 years ago

Who is the prescriber, and are they the same organisation as the pharmacy?

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u/gallbladder_gary47 points·2 years ago

salt forms are the recurring argument and the answer is boring

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u/liv_vukovic13 points·2 years ago

Nothing in this thread is medical advice, and the choice between arrangements is one for you and a prescriber who knows your history.

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u/honest_syringe14 points·2 years ago

the pharmacy and the prescriber are two separate questions

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u/lukas_vermeulen148 points·2 years ago

compounded is not generic, there is no equivalence claim

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u/fatima_kowalski119 points·2 years ago

ask what the beyond-use date is based on

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u/controversial_only26 points·2 years ago

do not assume the concentration matches the branded product

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u/maren_sorensen139 points·2 years ago

That is not what patient-specific means. It refers to the prescription, not to a customisation of the formula.

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u/amara_kuipers107 points·2 years ago

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

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u/yannick_barros35 points·2 years ago

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

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u/honest_syringe47 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/mateusz_adebayo72 points·2 years ago

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

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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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