If you wish to have a compounding pharmacy make liquid medications for you (or make capsules in custom dosages), you will need a prescription from a physician. Any MD can write this prescription, it doesn't have to be a psychiatrist.
Make your request for a compounded prescription calmly, politely, firmly, and, if necessary, repeatedly.
Instruction for doctors: How to write a prescription for a compounded drug
Write the prescription following this format:
Generic Name of Active Ingredient(s) / Strength or Dose (i.e., mg or %)
Dosage Form (i.e., Suppository, Transdermal Gel, Troche)
Directions for Use
The doctors should be sure to write "Compounded Medication" at the top of the prescription form.
Typically, for a compounded liquid, the prescription may read something like "compounded liquid, 90mg Effexor in 90mL, concentration 1mg:1mL, take 3mg per day" (a 30 day supply).
With a 1mg to 1 mL concentration, for example, you can reduce from 10mg to 9mg by taking 9mL of the liquid.
Generally, for insurance coverage, the prescription should specify a daily dose that is not available in tablets or capsules, or your insurance will insist you use the tablets or capsules instead.
You may be able to find recipes for compounded liquids by using search at http://www.pharmacytimes.com
Cost of compounded drugs
Because of the additional labor by a pharmacist, compounded drugs are generally more expensive than ordinary prescriptions.
In the US, the retail cost of a compounded liquid drug can be around $70. But charges may vary widely; it may be productive to compare prices from various pharmacies.
Some health insurance plans cover compounded drugs and some do not. US Medicare does cover compounded drugs on the plan's formulary.
You will need to contact the compounding pharmacy for an estimate and your health insurance plan to find out coverage of a compounded drug. Some plans may require "medical necessity" paperwork from the doctor before they will pay for a compounded drug.
Get an oral syringe to take a compounded liquid
With a liquid, you use an oral syringe to measure your dosage. Ex: If your liquid contains 1mg in 1mL and you want to take .5mg, you would take .5mL of the liquid. You can adjust the amount you take as you continue your taper. See Using an oral syringe and other tapering techniques
Some compounding pharmacies in the UK
According to Dr. David Healy, these pharmacies in the UK can supply liquid formulations of many antidepressants and other drugs:
Rosemont Pharmaceuticals (Tel 0113 244 1999)
These prepare large batches (so may be cheaper) for:
Amitriptyline 10mg/5ml, 25mg/5ml, 50mg/5ml
Dosulepin 25mg/5ml, 75mg/5ml
Contact to find out if they compound your drug.
Cardinal Health, Martindale (Tel 0800 137 627)
This manufacturer will usually prepare what you ask for, so if the antidepressant isn't in the above list [for Rosemont] opt for this.
Large chain pharmacies like Boots or Rowlands may have their own external supplier who they may prefer to use as they have a contract with them.
See below for more information about compounding pharmacies in your area.
Edited by Altostrata, 16 October 2015 - 03:44 PM.