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Medical Forum / General / Pharmacy / April 2004

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Help compounding docusate (mini-therevac) enemas

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John Beez - 21 Apr 2004 15:39 GMT
I am a pharmacist in a busy retail community pharmacy and we do good
numbers but very little compounding.  I received this order today:

docusate sodium 283mg/3.4ml mini-enemas #30

The patient brought in his previous docusate mini-enemas, which were
filled at an out-of-state compounding pharmacy.  The finished product
is 3.4ml liquid in a 10ml syringe, which is capped.  Prior to
administration, the cap is removed and a rectal applicator is screwed
onto the barrel.

This order looked pretty simple when I received it, but I quickly ran
into problems.  First, what is the best way to get 283mg DOS into the
3.4ml of solution?  I cannot find any DOS solution stronger than
50mg/ml.  Second, looking in my Cardinal wholesaler book, I can't
figure out what the screw-on rectal applicators might be called.

Any help is appreciated - I have a couple weeks to fill the order.  I
would refer the patient to a compounding pharmacy but he is determined
to get all of his scripts filled at our site.
Bruce Wade Hughes - 21 Apr 2004 20:52 GMT
> I am a pharmacist in a busy retail community pharmacy and we do good
> numbers but very little compounding.  I received this order today:
[quoted text clipped - 16 lines]
> would refer the patient to a compounding pharmacy but he is determined
> to get all of his scripts filled at our site.

You need a source for bulk docusate sodium USP.- like Spectrum, Gallipot,
PCCA.
We make it with green soap, polyglycol, and glyceryn.

Brad
John Beez - 26 Apr 2004 15:19 GMT
Would you be willing to share more?  I have located docusate sodium
USP and that won't be a problem.  My only concerns are the vehicle in
which to compound it (you mention green soap, polyglycol, and
glycerin), and the rectal screw-on applicators for the syringes (can't
figure out what the wholesalers call these plastic pieces!)

Still, any tips or details would be highly appreciated.  I know I can
compound the 283mg DOS in 3.4ml sol'n, but really want to make sure it
is well dispersed, stable, etc...

Thank you so much in advance!

> > I am a pharmacist in a busy retail community pharmacy and we do good
> > numbers but very little compounding.  I received this order today:
[quoted text clipped - 22 lines]
>
> Brad
P T - 28 Apr 2004 18:43 GMT
Why not use Enemeez?
Very similar.
John Beez - 29 Apr 2004 05:15 GMT
I agree that Enemeez looks like a great replacement for mini-therevac.
Previously, my patient was paying $3 each to have these compounded.
He would be better off paying the ~$2.30 each for Enemeez (I just
found out about this product, and told him about it).

I figured that I could compound these for him for just the cost of
supplies (30-50 cents each - does that sound realistic?).  If I could
get Enemeez for less than $1.50 though I think we'd both be better off
just going that route.

> Why not use Enemeez?
> Very similar.
 
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