We can make your medicines for you ^^ Come and lick it

Make sure you lick all your medicine
16 October 2004 The New Paper By Teh Jen Lee jenlee

Hormone therapy medication now comes in form of lollipops and lozenges

HOW would you like to take your medicine in a yummy lollipop?

You can pick from over a dozen flavours including caramel mint and vanilla butternut.

Or if your skin feels dry from lack of hormones, you can get a doctor's prescription and a pharmacist makes a cream containing what you need.

The Specialist Compounding Pharmacy (SCP), in Camden Medical Centre, can do all that. Compounding is the preparation of customised medication for individuals.

Mrs Holly Amiri, 47, a nurse, was picking up her prescription, in the form of lemon-mint lozenges, when The New Paper visited the SCP.

Pointing to head pharmacist Thomas Khoo, she said: 'I can honestly say that man has changed my life... Conventional hormone medicine made me very ill, nauseous.'

Conventional hormone replacement therapy (HRT), usually prescribed to relieve the hot flushes and heart palpitations that come with menopause, uses synthetic hormones. It is known to cause side effects like nausea and bloatedness.

INCREASED RISK OF HEART DISEASE

And a study in the US has shown that it is associated with an increased risk of heart disease, heart attacks, strokes and breast cancer.

SCP provides bio-identical HRT (BHRT) using hormones that are more similar to those in human bodies. They are produced from plants like soy and yam, and converted to the human hormone progesterone, which can be further changed to testosterone.

Dr Ian Lee, one of 20 doctors who works with SCP, said: 'It's what your body is used to and the pharmacy customises the hormone treatment to suit the patient's exact problems. It's not one-pill-fits-all.'

Mr Khoo, whose mother and mother-in-law are SCP's clients, said: 'It makes common sense, if no two persons are the same, why should the medication be the same?'

Dr Lee said the number of patients on BHRT here has been going up.

'It's very popular in countries like Australia and the US, not just for menopausal women but also women with very bad pre-menstrual symptoms, or problems with fertility,' said Dr Lee, who has been practising since 1985.

Dr Lee got into BHRT because of his interest in nutritional medicine and natural healing.

For BHRT, doctors start by testing the blood and saliva for hormone levels. Careful monitoring is then done to fine tune the hormone doses.

Dr Lee said: 'I stress to my patients that they must learn to listen to their own bodies and work in partnership with the doctor. If you are under more stress, your body's hormonal demands will be different.'

THE COST

Hormones are powerful chemical messengers that control every function of the body, and even small changes in dosage can make a difference. Does that make BHRT and compounded drugs expensive?

It depends on the type of dosage form and equipment required, plus the time spent researching and preparing the medication.

Mr Khoo said his patients pay $30 to $90 a month. Conventional HRT can cost anything between $12 and $105 a month.

Mrs Sue Phillips, 53, a property manager who has been going to SCP for a year, said: 'When I got off birth control, I became very irritable and didn't want anyone near me.

'I would grit my teeth if my husband put his arm around me. But within a few months of going on compounded BHRT, I was sleeping better. I was calm and basically happy with myself again.'

The natural mix is legal if...

IS it legal to mix and match medicines?

According to the SCP website ( www.scp.com.sg), the preparation (or compounding) and dispensing of a medicinal product in a registered pharmacy is allowed under the Medicines Act.

But these activities must be carried out under the personal supervision of a pharmacist, and in accordance with a written prescription from a medical practitioner.

The Health Sciences Authority (HSA) said SCP appears to be the only pharmacy engaged in compounding customised hormonal products here.

SCP pharmacist Thomas Khoo (right) said pharmacy students spend one-third of their university course on compounding, but it has become a lost art after drug companies started to produce standard preparations in the 1950s.

In an e-mail reply to our queries about the side effects of compounded medicines, a spokesman for HSA said: 'Like any other commercially manufactured product, compounded medication contains active pharmaceutical substance(s) prescribed by the medical practitioner.

All active pharmaceutical ingredients have the potential to cause side effects.

'All patients are advised to discuss with their doctors and pharmacists if they need any customised medication at all, the contents of the medications, as well as the benefits and potential adverse effects which may arise from any medications prescribed to them.'