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Why does compounded ecnoglutide potency vary between pharmacies?

Asked 20 Jul 2024Modified 22 months agoViewed 27k times
13

I would like to understand the process rather than be told to try harder.

I want to know whether this is a real physical effect or an artefact of how it is measured.

What prompted the question is an inconsistency between two sources I otherwise trust.

Is the standard explanation correct, and if so, what is the evidence for it?

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TM
askedthabo_maseko28k3820 Jul 2024

5 Answers

Accepted answer first, then by votes
33

Accepted answer

Answering this needs the jurisdiction, since the framework differs substantially between countries and even between states.

A compounded preparation has no marketing authorisation, no batch release by a qualified person and no pharmacovigilance obligation attached to it. That is the structural difference from a licensed product.

Ask for the certificate of analysis on the compounded lot. A serious facility will have one; the request itself is informative.

Beyond-use dating for compounded sterile preparations is governed by published standards keyed to the compounding environment.

The framework is jurisdiction-specific. Check yours rather than a general answer.

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answered · acceptedcoldbox941k13821 Jul 2024
8Worth adding that the medical policy document is public and states the criteria explicitly. – Dr_Fatima_Belkacem 4 months ago
3Any figure for how often peer-to-peer review resolves a denial? It seemed high when I did it. – tamsin_wray 2 months ago
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40

Answer first: a compounded preparation is made for an individual under a prescription and is not an approved product, so it carries neither the release testing nor the pharmacovigilance of one.

Regulators generally prohibit compounding what is essentially a copy of a commercially available product, with a shortage listing being the usual exception that permits it temporarily.

In practice, beyond-use dates on compounded sterile preparations are set by standards that depend on the preparation environment and are much shorter than a manufactured product's shelf life.

Compounding is defined in regulation as preparation for an individual patient under prescription and is distinguished from manufacturing by scale and by the patient-specific requirement.

Ask for the certificate of analysis on the lot. A serious facility has one.

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DB
answeredDr_Aoife_Brennan20k2712 Aug 2024
25

The relevant detail is that the relevant distinction is between compounding for an individual patient and compounding at scale, which are regulated differently.

Salt forms matter: a compounded preparation using a different salt from the approved product is not the same active moiety, and that has been the specific object of regulatory warnings.

It helps to be literal here: compounding is the preparation of a medicine for an individual patient in response to a prescription, where an approved product is unsuitable. It sits outside the approval framework by design rather than by omission.

Nothing here is medical advice.

Compounded means unapproved by definition. That is structural, not pejorative.

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DA
answeredDr_Yusuf_Adeyemi54k14723 Aug 2024
14

Concretely, this is an area where the legal position and the quality question are separate and both matter.

Facility quality varies enormously and is the practical determinant of what you receive. The relevant questions are about sterility assurance, potency testing and beyond-use dating.

Prohibitions on compounding essential copies of commercially available products are explicit in the relevant regulatory frameworks, with shortage listings as the usual exception.

A compounded preparation is unapproved by definition, which is a statement about the framework rather than about the facility.

Check the beyond-use date and what it was based on.

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TA
answeredtess_amankwah22k271 Aug 2024
7The registration-check suggestion is the one verifiable thing in this whole area. – assay_blank 3 months ago
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11

On the detail: salt forms and additives are the usual point of divergence and are worth asking about specifically.

Additives are the other divergence. Preparations combining an active with vitamins or other agents are not equivalent to the approved product and have not been studied in that combination.

Ask which salt form. A different salt is a different active moiety.

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TW
answeredtare_weight60k14826 Sept 2024
Does the salt-form question apply outside that jurisdiction, or is it specific? – tobias_maartens 44 days ago
Thank you — treating this as a paperwork problem with a paperwork solution reframed it for me. – Dr_Fatima_Belkacem 10 months ago
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Your answer

Ask PeptideStack is a static archive. Posting is closed, but the norms are worth stating: answer the question that was asked, show your working, cite the trial or the certificate, and say plainly where the evidence runs out.

Not medical advice. Research-use-only compounds are not approved for human use.