cash formulation ideas and brainstorming - …€¢ “after using the compounded preparation, my...

Cash Formulation Ideas and Brainstorming

Erin Michael, MBA, CPhTAndrea Branvold, MS, RPhInternational Seminar

Houston, TXNovember 10‐12, 2016

© 2016. All Rights Reserved. 1

Why Compounding Options are Important

• Medication on backorder or unavailable• Side effects of therapy; compliance• Treatment failure with current therapy• Combination customized prescription can target the problem with multiple mechanisms of action


Why Compounding is Important

• Compounds offer a variety of clinical options with unique innovative bases and dosage forms

• Skyrocketing commercial drug prices!– Insurance rejections with many commercial drugs

– Unaffordable copays


Dermatology ‐Warts

• Warts – OTC products ‐ treatment failures

• 17% Salicylic acid gel• 15% and 40% patches

– Office procedures: burning, freezing, surgical removal‐painful, frequently not effective


Imiquimod Cost Variability Example


Dermatology ‐Warts• PCCA Formula #4299 ‐ Salicylic acid 20% / Fluorouracil 5% / DMSO Topical Solution

• PCCA Formula #9403 ‐ Fluorouracil 5% / Salicylic Acid 15% / Cimetidine 5% / Deoxy‐D‐Glucose 0.2% Topical Lipoderm®

• PCCA Formula #3873 ‐ Salicylic Acid 80% Topical Paste* Young S., Cohen GE‐Treatment of verruca plantaris with a combination of topical Fluorouracil

and Salicylic Acid. J AM Podiatric Med Assoc. 2005 July‐Aug 95(4):366‐9.


Dermatology ‐Warts• Testimonial from the Apothagram:

– PCCA Formula #5615 (Cimetidine 10% / Deoxy‐ D‐Glucose 0.29% / Ibuprofen 2% Topical Lipoderm®). “We have many patients with warts come to us with a prescription for this formula,” she says. “Oftentimes, they are skeptical because they have had the wart for a long period of time, and so far, no other treatment has worked.”

– “I love that it is not harmful to the healthy skin surrounding the affected area,” she says. “We have never had a patient come back to us saying that this formulation hasn’t worked!”


Dermatology ‐Molluscum• “My daughter presented molluscum on her entire neck when she was seven

years old. In addition to being really itchy and often painful, she was embarrassed with how it looked in such a visible area. We took her to the pediatrician who said that it could take 8‐18 months to completely heal.

• “After using the compounded preparation, my daughter’s lesions cleared within four weeks. My little patient called it ‘Annie’s Miracle Cream’ since PCCA Pharmacy Consultant Annie DeReese, PharmD, developed the formula, PCCA Formula #11684 (Cimetidine 10% / Tea Tree Oil 2% / EGCg 1% / Deoxy‐D‐Glucose 0.2% Topical Anhydrous Lipoderm®), that helped get those bumps off of her! Another example of compounding to the rescue.”

• PCCA Document #98294 ‐Molluscum Contagiosum by Andrea Branvold, MS, RPh (Consultant's Corner, 01‐10 Apothagram)


Facial Hair (Hirsutism) • Vaniqa®

– Cost to pharmacy 45g ~$150– Must continue use for effects

• PCCA Formula #11760 ‐ Spironolactone 5% Topical Cream (Clarifying™)* We have a female patient who is on testosterone replacement therapy. Her physician

also prescribed her oral spironolactone to help with her acne. She said she doesn't like the side effects from the spironolactone.

* I GOT A PRESCRIPION SPIRONOLACTONE 5%+NIACINAMIDE 4% CREAM APP TO FACE BID WHAT IS THE FORMULA THANKS

* HAVE PATIENT WITH PCOS. FACIAL ACNE IS SPIRONOLACTONE 5% TOPICAL CREAM THE ANSWER? ONCE OR TWICE A DAY? THANKS

* Dermatology spironolactone 5% for acne with women with menopause, can it be used for balding


Facial Hair (Hirsutism)

• PCCA Formula #12290 ‐ Finasteride 0.25% Facial Topical Cream (Clarifying™) Hirsutism

• Topical progesterone? Estriol?– Possibly progesterone 1% with azelaic acid 1%, applying 0.25‐0.5ml (amount used depends on size of area)


Commercial Topical Antifungal Nail Preparations

Name API Size Potential Cost to Patient

Jublia® Efinaconazole 10%(topical solution) 4 mL ~ $550

Umecta® Urea 40%(topical emulsion) 7 oz ~ $240‐300

Kerydin® Tavaborole 5%(topical solution) 10 mL ~ $1,300

Nail FungusSee PCCA Document #99251 ‐ The Rising Costs of Nail Fungus Prescriptions


Dermatology ‐ Nail Fungus• PCCA Document # 99278 ‐ Compounding Options for Nail Fungus‐ Consultant’s Corner by Bruce Biundo

• Jublia® (Efinaconazole 10% solution) – 4ml ($645) / 8ml ($1290)– 4 weeks post‐treatment was achieved in 17.8% and 15.2% of efinaconazole recipients compared to 3.3% and 5.5% of patients receiving the vehicle solution

– PO meds require monitoring of liver function enzymes and can have drug interactions


Nail Fungus• PCCA Formula #11839 ‐

Ketoconazole 2% / Urea 40% / DMSO Nail Suspension

• PCCA Formula #4337 ‐Itraconazole 1% / Ibuprofen 2% / DMSO Nail Solution

• PCCA Formula #7993 ‐Fluconazole 1% / Urea 20% Nail Lacquer

• PCCA Formula #5347 ‐Itraconazole 1% / Undecylenic Acid 17% (W/V) / Tea Tree Oil 16.7%/ DMSO Nail Solution


Nail Fungus (cont’d)

• PCCA Formula #4462 Tea Tree Oil 5.4%/ Lavender Oil 1%/ Clotrimazole 1%/ Undecylenic Acid 5%/ Urea 5% Topical Cream

• PCCA Formula #10643 Terbinafine HCl 1%/ Fluconazole 3%/ Ibuprofen 2%/ Itraconazole 1% Nail Suspension


Nail Fungus (cont’d)• PCCA Formula #11577 ‐

Ciclopirox 8% / Fluconazole 1% / Terbinafine HCl 1% Topical Gel

• PCCA Formula #12253 ‐Ciclopirox 8% / Urea 40% Nail Gel

• PCCA Formula #0729 ‐Ketoconazole 2% / DMSO Nail Solution

• PCCA Formula #11990 ‐Itraconazole 1% / Terbinafine HCl 3% / Tea Tree Oil 6.6% / Urea 10% / Biotin 0.6% / DMSO Nail Suspension


Dermatology ‐ Hair Loss• PCCA Formula #10632 ‐Minoxidil 8.5% / Finasteride 0.1% Scalp Solution

• PCCA Formula #10935 ‐Minoxidil 10% / Finasteride 0.1% / Tretinoin 0.025% / Fluocinolone Acetonide 0.025% Topical Solution

• PCCA Formula #11196 ‐Minoxidil 5% / Azelaic Acid 1.5% / Tretinoin 0.025% / Progesterone 0.25% / Finasteride 0.1% Topical Foam (VersaBase®)


Dermatology / Cosmetic / Med Spa• Melasma

– Tri‐Luma® often unavailable• 30 gram cost to pharmacy $100

– PCCA Formula #10826 ‐ Fluocinolone Acetonide 0.01% / Hydroquinone 4% / Tretinoin 0.05% Topical Gel (PracaSil™‐Plus) (BUD Study)

• Can use different strengths, bases* Torok HM, Jones T Hydroquinone 4% / Tretinoin 0.05% / Fluocinolone 0.01%: A safe and

efficacious 12 month treatment for melasma. CUTIS 2005. Jan 75(1)57‐62


Dermatology ‐ Anesthetics

• Commercial anesthetics often not strong enough– Lidocaine 5%

• Lidocaine 5% topical ointment (not cream) is very expensive (35gm $170, 50gm $190)

– PCCA Document #97181 ‐ Toxicities Associated with Topical Anesthetics (UPDATED December 2015)


Dermatology / Cosmetic• Topical anesthetics

– PCCA Formula #11652 ‐ Benzocaine 20% / Lidocaine 10% / Tetracaine 4% Topical Cream (VersaBase®)

– PCCA Formula #10117 ‐ Benzocaine 20% / Lidocaine 6% / Tetracaine 4% Topical Ointment (Plasticized™)

– PCCA Document #98634 ‐ Compounding Topical Anesthetics ‐ Formula Spotlight by Melissa Merrell, PharmD (09‐13 Apothagram)


Dermatology Eczema / Psoriasis

• PCCA Document #99133 ‐ How to Write a Compounded Prescription ‐ Dermatology –Eczema / Psoriasis / Xerosis (XemaTop™)


Dermatology ‐ Psoriasis

• Calcipotriene ointment 100gm ($492) – Topical steroids $$$


Dermatology‐ Psoriasis / Eczema

• Psoriasis / eczema– PCCA Formula #11788 ‐ Zinc Pyrithione 0.2% / Clobetasol Propionate 0.05% / Cyanocobalamin 0.07% Topical Cream (XemaTop™)

– PCCA Document #99157 ‐ XemaTop™ in Psoriasis tissue

* Sadeghian G1, Ziaei H, Nilforoushzadeh MA. Treatment of localized psoriasis with a topical formulation of zinc pyrithione. Acta Dermatovenerol Alp Pannonica Adriat. 2011;20(4):187‐90.


Dermatology

• Acne– BenzaClin® (Clindamycin 1% / Benzoyl Peroxide 5% gel)‐ $300‐$400

– Benzamycin® (Erythromcyin 5% / Benzoyl Peroxide 5% gel) ‐ $150‐$450

* Reminder do not copy commercial products


Dermatology• Acne

– PCCA Formula #12065 ‐ Clindamycin 1% / Benzoyl Peroxide 5% / Niacinamide 5% Topical Cream (Clarifying™)

– PCCA Formula #11589 ‐ Benzoyl Peroxide 10% / Erythromycin 3% Topical Cream (Clarifying™)

– PCCA Formula #12064 ‐ Erythromycin 3% / Benzoyl Peroxide 5% / Biotin 0.1% Topical Cream (Clarifying™)


Acne Documents• PCCA Document #99132 ‐ How to Write a Compounded Prescription ‐ Dermatology ‐ Acne / Problem Skin (Clarifying™ Base)

• Rosacea ‐ PCCA Document #99184 Cash‐Friendly Options for Dermatological Compounding (Parts 1 & 2)

• Rosacea ‐ December Apothagram ‐ Consultant Corner by Nat Jones


Dermatology

• Rosacea– Metronidazole 1% gel 60 gm ($200‐$250)– Clarifying™ Base may help reduce the appearance of red blotchy skin often seen in patients with rosacea

– PCCA Formula #11709 ‐ Niacinamide 4% / Metronidazole 1% Topical Cream (Clarifying™)


Dermatology

• Rosacea– Azelaic Acid 15% cream 50gm ($250)– Azelaic Acid 20% cream 30 and 50 gm ($300 to $500)


Dermatology

• Rosacea– Compounded alternative for Azelaic Acid is Potassium Azelaoyl Diglycinate; use 1:1

• PCCA Formula #11635 ‐ Niacinamide 5% / Biotin 0.1% / Potassium Azelaoyl Diglycinate 6% Topical Cream (Clarifying™)

• PCCA Formula #11639 ‐ Potassium Azelaoyl Diglycinate 15% / Niacinamide 5% Topical Cream (Clarifying™)


Dermatology

• Soolantra® (Ivermectin 1% cream) 30 gm ($400)– Rejected by insurance– Clarifying™ Base and niacinamide may help appearance of red blotchy skin

• PCCA Formula #11991 ‐ Ivermectin 1% / Niacinamide 4% Topical Cream (Clarifying™)


Dermatology ‐ Vitiligo and Psoriasis

• Methoxsalen (Oxsoralen®) topical unavailable commercially– PCCA Formula #0819 ‐Methoxsalen 1% Topical Solution

– PCCA Formula #9336 ‐Methoxsalen 0.6% Topical Ointment

– Capsules #50 $2500 FYI


Dermatology• Inflammation / skin infections

– Alcortin A, Vytone™,Aloquin• Hydrocortisone 2% / Iodoquinol 1% cream (#24 x 2 gram packets‐$3500!!)

– PCCA Formula #0438 ‐ Iodoquinol 1% / Hydrocortisone 0.5% Topical Cream

– PCCA Formula #2415 ‐ Iodoquinol 3% / Hydrocortisone 1% / Coal Tar Topical Cream

– In formula development: Iodoquinol combinations


Dermatology ‐ Scars

• Scars – PracaSil™‐Plus– PCCA Document #98719 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Scars

– PCCA Document #98678 ‐ PracaSil™‐Plus Marketing & Repackaging / Labeling Guidelines


We Need Your Help to Collect More Case Studies!

• PCCA Document #99237 ‐ Case Study / Reports Template, PCCA Science (WORD FILE ‐ EMAIL ONLY)

• Must use PCCA base• Questionnaire• Before / after pictures


Marketing Minute

• Group discussion– At your table, share one pearl / technique / formula that has worked for you in this specialty


Dental

• Oral ulcers– Apthasol® ‐ no longer on market

• Amlexanox accelerates the healing of aphthous ulcers through an unknown mechanism. Although pain associated with aphthous ulcers is reduced, Amlexanox possesses no direct analgesic properties.


MucoLox™ ‐*Note

• Perceived by pharmacists as too expensive• Quality of life is a huge factor at certain points• Most common call is that patient needs pain control to last longer


Mucositis• Commercial products:

– Caphosol®• 900mL is $200 cost to a pharmacy• PCCA Formula #5488 ‐ Calcium Chloride 0.052% Buffered Saliva Substitute

• PCCA Formula #11400 ‐ Supersaturated Calcium Phosphate Oral Rinse (MucoLox™)

– Recommended directions for use: 2‐3ml four times a day. Hold for 2 minutes and expectorate.

– Begin at onset of cancer treatment– May increase to up to 10 doses per day if pain from mucositis is experienced


Mucositis• Commercial products:

– MuGard™• 240mL is $550 cost to a pharmacy

– PCCA Document #98928 ‐MucoLox™ Technical Report: Assessment of Mucoadhesive Properties of MucoLox™ Using a 3D Model of the Human Oral Mucosa


Mucositis ‐MucoLox™ Formulas• Commonly Requested Formulas for Patients with Oral Mucositis

Pain from Chemotherapy / Radiation – PCCA Formula #11144 ‐ Stanford Modified Mouthwash (MucoLox™)

– PCCA Formula #11145 ‐ Stanford Mouthwash (MucoLox™) – PCCA Formula #11133 ‐Misoprostol 0.0024% / Diphenhydramine HCl 0.1% / Lidocaine HCl 1% Oral Rinse (MucoLox™)

– PCCA Formula #11128 ‐ Doxepin HCl 0.5% Mouthwash (MucoLox™) (FormulaPlus™ BUD Study)


Mucositis ‐MucoLox™ Formulas (cont’d)• Commonly Requested Formulas for Patients with Oral Mucositis

Pain from Chemotherapy / Radiation – PCCA Formula #11382 ‐ Lidocaine HCl 1% / Beta Glucan 0.5% /

Dexpanthenol 1% / Vitamin E Acetate 2% / Glutamine 2% Popsicle (MucoLox™)

– PCCA Formula #11134 ‐Misoprostol 0.0024% / Ketoconazole 1% Compound Oral Rinse (MucoLox™)

– PCCA Formula #11132 ‐ Lidocaine HCl 2% Oral Rinse (MucoLox™) – PCCA Formula #11120 ‐ Beta Glucan 0.5% / Dexpanthenol 1% /

Vitamin E Acetate 2% Oral Rinse (MucoLox™)


Mucositis

• Oral ulcers– Polyox 301 bandage– Can add Misoprostol 0.0024% / Lidocaine 2% / Triamcinolone 0.1%, and Stevia (sweetener)

* Ahluwalia A1, Baatar D1, Jones MK1, Tarnawski AS2. Novel mechanisms and signaling pathways of esophageal ulcer healing: the role of prostaglandin EP2 receptors, cAMP, and pCREB. Am J Physiol Gastrointest Liver Physiol. 2014 Sep 15;307(6):G602‐10. doi: 10.1152/ajpgi.00177.2014. Epub 2014 Jul 24.


Rectal Steroids

• Cortifoam® ‐ hydrocortisone 10% foam– 15 grams costs the pharmacy ~ $340– PCCA Formula #11956 ‐ Hydrocortisone 10% Vaginal / Rectal Gel (MucoLox™/ VersaBase ®)


Rectal Steroids• Anucort HC™, suppository ‐Hydrocortisone 25mg generic may have availability problems and price range is “unstable” between #12, #24, #100– Rectal rockets, PCCA Formula #3515 ‐Lidocaine 2% / Hydrocortisone 1% Base MBK™ / Wax Suppository (Rectal Rocket)

* Vail J1. The rectal rocket: a two‐day treatment for hemorrhoids. Int J Pharm Compd. 2007 May‐Jun;11(3):194‐9.


Rectal ‐ Anal Fissures

• Anal fissures– Rectiv® 0.4% ointment #30 ($465)– PCCA Formula #11952 ‐ Nifedipine 0.2% / Lidocaine2% Rectal (VersaBase® / MucoLox™)


Hospice

• Nausea– PCCA Formula #9776 ‐ Lorazepam 1 mg/mL / Diphenhydramine HCl 12.5 mg/mL / Haloperidol 2 mg/mL / Metoclopramide 20 mg/mL Topical Lipoderm® (BUD Study)

* Bleicher J1, Bhaskara A. Lorazepam, diphenhydramine, and haloperidol transdermal gel for rescue from chemotherapy‐induced nausea/vomiting: results of two pilot trials. J Support Oncol. 2008 Jan;6(1):27‐32


Hospice (Nausea)

• Nausea– PCCA Formula #11330 ‐ Chlorpromazine HCl 10% Topical Lipoderm®

– PCCA Formula #8986 ‐ Ondansetron 4mg/0.1ml Lipoderm® ActiveMax®

* Obata Y1, Ashitaka. A statistical approach to the development of a transdermal delivery system for ondansetron. Int J Pharm. 2010 Oct 31;399(1‐2):87‐93


Hospice (Nausea)

• Nausea– PCCA Formula #9491 ‐ Promethazine HCl 25mg/gm Topical Lipoderm® (BUD Study)

* Bassani AS, , Banov D Ms, Lehman PA Msc. Evaluation of the percutaneous absorption of promethazine hydrochloride, in vitro, using the human ex vivo skin model. Int J Pharm Compd. 2008 May‐Jun;12(3):270‐3.


Hospice

• PCCA Formula #97873 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Hospice


Oncology• Radiation burn

– PCCA Formula #11396 ‐ Ketoprofen 2% / Lidocaine 2% / Misoprostol 0.0024% / Phenytoin 2% / Aloe Vera 0.2% Topical Gel (PracaSil™‐Plus)

– PCCA Document #98741 ‐ PracaSil™‐Plus Case Study: Radiation Burn Skin

– PCCA Document #98870 ‐ PracaSil™‐Plus Case Study: Open Wound Burn after radiation


Oncology• PCCA Document #97874 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Oncology

• PCCA Document #99083 ‐ Hand‐Foot Syndrome ‐Consultant's Corner by Andy Glasnapp (11‐15 Apothagram)

• PCCA Document #99174 ‐ Nutritional Support for Cancer Therapy Patients ‐ Consultant's Corner by Nat Jones (08‐15 Apothagram)


Pain• Muscular pain

– PCCA Formula #10154 ‐Magnesium Sulfate Heptahydrate 10% Topical Lipoderm® ActiveMax™

• Inflammatory pain– PCCA Formula #9448 ‐ Ketoprofen 10% Topical Lipoderm® (BUD Study)

• Can add cyclobenzaprine, baclofen• Can add an anesthetic


Pain

• Neuropathic pain– PCCA Formula #10835 ‐ Ketamine HCl 5% / Gabapentin 10% / Clonidine HCl 0.2% Baclofen 2% Topical Lipoderm® (BUD Study)

* Tam E1, Fu. Transdermal lidocaine and ketamine for neuropathic pain: a study of effectiveness and tolerability. Open Neurol J. 2012;6:58‐64. Epub 2012 Jun 28.


Pain• Diabetic neuropathy

– PCCA Formula #8541 ‐ Ketamine 10% / Gabapentin 6% / Clonidine 0.2% / Nifedipine 2% Topical Lipoderm®

– PCCA Formula #11019 ‐ Ketamine HCl 10% / Gabapentin 6% / Tizanidine HCl 0.2% Nifedipine 2% Topical Lipoderm® ActiveMax™

* Semenchuk MR1, Sherman S. Effectiveness of tizanidine in neuropathic pain: an open‐label study. J Pain. 2000 Winter;1(4):285‐92.


Pain

• PCCA Document #98006 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Pain Management

• PCCA Document #97967 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Podiatry

• PCCA Document #98742 ‐ How to Write a Compounded Prescription ‐ Pain Management


Acyclovir

• PCCA Document #99136 ‐ Acyclovir ‐Marketplace Changes Create New Opportunities for Compounders

• PCCA Document #99134 ‐ How to Write a Compounded Prescription ‐ Acyclovir (Herpes)


General Compounding / Herpes Infection

• Genital herpes / fever blisters / shingles– Zovirax® 5% cream #5 gm ($650.00)– Zovirax® 5% ointment #30gm ($1200)– Acyclovir 5% ointment (generic) #30 gm ($400)


Formulas with Acyclovir

• Genital herpes– PCCA Formula #11986 ‐ Acyclovir 5% / Lidocaine 2% Topical Cream (VersaBase®)

– PCCA Formula #11413 ‐ Acyclovir 5% / Lidocaine HCl 5% / Deoxy‐D‐Glucose 2% Vaginal Gel (MucoLox™)


Side note: Commercial Product for Herpes Labialis

• Xerese®– Acyclovir 5% + hydrocortisone 1% cream– A patient requested a petrolatum‐free base– 5 grams ($1000.00)

• PCCA Formula #11989 ‐ Acyclovir 5% / Lidocaine 2% / Hydrocortisone 2.5% Topical Cream (VersaBase®)


Formulas with Acyclovir

• Fever blisters– PCCA Formula #0937 ‐ Acyclovir 5% / Lidocaine 1% Lip Balm

• Shingles– PCCA Formula #11398 ‐ Acyclovir 5% / Ketoprofen5% / Amitriptyline HCl 2% / Bupivicaine HCl 1% / Gabapentin 6% Topical Gel (PracaSil™‐Plus)


Marketing Minute

• Group discussion– At your table, share one pearl / technique / formula that has worked for you in any of these specialties


Vaginal Dryness ‐ Estrogen


Vaginal Dryness (cont’d)

• Non‐hormonal compounded alternatives– PCCA Formula #11118 ‐ Hyaluronic Acid 5 mg/Gm Compound Vaginal Gel (MucoLox™/VersaBase® Gel)

– PCCA Document #98289 ‐ Treatment Options for Vaginal Atrophy: What Do the New Studies Show? by Annie DeReese (Consultant's Corner, 01‐11 Apothagram)


Women’s Health PCCA Documents

• #99227 ‐ Estrogen Vaginal Preparations ‐Consultant's Corner by Andrea Branvold‐Herr (07‐16 Apothagram)

• #99204 ‐Women's Health and What You Need to Know by Sara Hover ‐ Consultant's Corner (05‐15 Apothagram)


Vulvodynia• Prolonged contact time with the mucosa (MucoLox™) and multi‐drug therapy may be beneficial to help with pain (another quality of life example)– PCCA Formula #11108 ‐ Amitriptyline HCl 2% / Baclofen 2% Vaginal Gel (MucoLox™)

– PCCA Formula #11109 ‐ Ketamine HCl 0.5% / Diazepam 1% / Baclofen 2% Vaginal Gel (MucoLox™ / VersaBase®)

– PCCA Formula #11110 ‐ Gabapentin 6% Vaginal Gel (MucoLox™ / VersaBase®)


Women’s Health PCCA Documents• PCCA Document #97886 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ BHRT

• PCCA Document #97920 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Female Sexual Dysfunction & Libido

• PCCA Document #98287 ‐ Compounding Ideas / Formulations Marketing Sheet ‐Women's Health


Vet ‐ Atopic Dermatitis and Complications

• Apoquel™ (oral) has been on short supply• Options:

– PCCA Formula #12314 ‐ Tranilast 1% Topical Gel (ZoSil™) (Vet)– PCCA Formula #12311 ‐ Pramoxine HCl 1% / Hydrocortisone 1%

Topical Gel (ZoSil™) (Vet)– PCCA Formula #12302 ‐ Diphenhydramine HCl 2% / Tranilast 1%

Topical Gel (ZoSil™) (Vet)– PCCA Formula #12080 ‐ Triamcinolone Acetonide 0.015% Topical

Gel (ZoSil™) (Vet)


• Apoquel™ (oral) has been on short supply• Options:

– PCCA Formula #12402 ‐ Pramoxine HCl 1% Topical Spray (RheoSpray™) (Vet)

– PCCA Formula #12403 ‐ Tranilast 1% Topical Spray (RheoSpray™) (Vet)

Vet ‐ Atopic Dermatitis and Complications


Veterinary• Antibiotic ear gels• PCCA Formula #10357 ‐ Enrofloxacin 2% / Ketoconazole 2% / Triamcinolone 0.5% Poloxamer Otic Gel

• PCCA Document #99094• PCCA VOD Overview ‐ #98537 Dog Ear Model


Veterinary• PCCA Document #98338 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Veterinary / Canine

• PCCA Document #98340 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Veterinary / Feline

• PCCA Document #98339 ‐ Compounding Ideas / Formulations Marketing Sheet ‐ Veterinary / Equine


Marketing Minute

• Group discussion– At your table, share one pearl / technique / formula that has worked for you in any of these specialties


Questions??

Thank [email protected]@pccarx.com
