Making Pediatric Medications Palatable for Kids with the Help of Compounding Pharmaceuticals
There are many barriers to medication adherence for children. Parents need to be able to afford the medication in the first place, and they need to understand the instructions for administering it. Then they need to remember to dose it as scheduled. Many parents are concerned about drug side effects, so they give suboptimal doses to their children. Parents of kids on long-term therapy often mistakenly let their kids stop taking their medications when they see signs of remission. Perhaps the biggest problem with medications for children, however, is a seemingly simple but sometimes disastrous one: the taste.
The Most Common Medication Problem for Kids
The taste of medicine is most often cited as the reason a child refuses to take it. This can create frustration for the parent trying to give it. Studies show that stress over administering medication is a major reason why parents don’t stick to prescribed dosing regimens. Texture and odor are related issues with oral medications that can cause children to refuse them or spit them out. Injections aren’t practical for home use, and many children have a fear of needles. Most small children aren’t able to take pills either, so that route is not a viable alternative.
Why Compounding Medications Helps
In order to get kids to take their medications many parents resort to adding sweet things or trying to disguise the medication in a food item. This can backfire, however, because if the food is an integral part of the child’s diet and they detect an unpleasant medication within, they may start to reject that food any time it is offered. Also, most children already have an overabundance of sugar in their diets and don’t need more sweets added to it. Certainly, adding a sweetener is not an option for children with diabetes.
A better strategy is to obtain the child’s prescription from a compounding pharmacy where it can be made more palatable with sophisticated methods and where other vital concerns will be addressed as well. Many pediatric drugs can be compounded using products from trusted compounding pharmaceutical companies like PNA, and can include medications for:
- respiratory disease
- head lice and scabies
Medications that are normally found in capsule or tablet form can be put in an oral suspension. A compounding pharmacy can add flavorings without necessarily adding sweeteners. The flavorings can take into account taste preferences for different ages, as well as cultural preferences in flavor. Compounding also allows for the option to remove dyes and allergens, like gluten and soy, and they can get rid of gritty textures and offensive odors often found in commercial medications.
Compounded pediatric medications can also often be made in more kid-friendly formulations, such as lollipops, gummy treats, sparkling drinks, rapid dissolve tablets, and lozenges. Lollipops and lozenges are great alternatives for swish-and-swallow medications that need to remain in the mouth for a certain period of time, like treatments for candida. Other benefits of compounding pediatric medications include:
- The dose is custom-made for each child. If they are between standard doses, there are no worries about under- or overdosing the medication by parents or caregivers.
- Compounding medications eliminates unintentional food interactions that can occur when food is added to make medicines more palatable at home, but can render drugs less efficacious.
- Certain medications need to be buffered or maintain a correct pH to be effective; compounding can ensure this happens.
- Compounding can often combine multiple medications in one dose, improving compliance.
- When there are shortages of commercially produced medications, compounding pharmacies can usually still obtain the raw ingredients to make prescriptions.
Many parents are not aware that compounding is even an option for them, so as a clinician you can be a hero with the entire family by referring them to a reputable local compounding pharmacy. And if you are interested in adding compounding to your practice or your commercial pharmacy, contact PNA to see how easy and relatively inexpensive it is to get set up.
Special Considerations: Kids on Long-Term Pharmaceutical Therapy
Children on long-term or lifetime drug therapy are particularly vulnerable to lapses in pharmaceutical regimens. Taking medications for cancer, post-transplantation, cystic fibrosis, or mental illness can mean the difference between life or death for some kids. We make the following recommendations for prescribers or pharmacists assisting children in this category:
- Recognize that taste buds change over time. While overall taste is most sensitive in infants and very young children, certain elements of taste become more pronounced as children age. What tastes good to a child of three may not be appealing at age eight or twelve.
- Chemotherapy and other treatments can cause nausea and changes in perceived taste. Medications for these patients may need adjustment.
- Kids who have chronic illness can feel stigmatized by and different from their peers. Using medications in lollipop or gummy form may help them feel like they stand out less.
- Chronic illness can also make children feel like their lives are out of control, and refusing to take medications can be one way they counter that. Getting kids involved in their treatment and feeling that they have some measure of control can help mitigate this.
- Long-term or terminal illness can precipitate depression in some kids. Caregivers should be on the lookout for this and think about how to minimize pharmaceutical treatment if the patient is already on a host of medications that could interact with antidepressants.
- Kids who are chronically ill often have their illnesses take over their entire lives. Making their drug therapy as minimal as possible can help them lead a more normal existence.
Until we are able to make medications completely flavorless, kids will always have issues with how medications taste. The most important thing is to ensure that children are taking their medications as prescribed. Working with a compounding pharmacy is probably the best way to help this happen, while making kids less resistant about drug therapy overall.
Pharmaceutica North America would like to be your resource for compounding products for pediatric medications. If you don’t currently compound and would like to start, or if you need a great supplier of wholesale compounding materials, please contact our very knowledgeable and friendly team here at PNA.