Nice and Easy: The Benefits of Compounded Transdermal HRT Troches
Once health care professionals have chosen to work on a customized treatment plan for patients, there is still one important decision remaining — how will medications be delivered so that they work most effectively? Troches are an excellent transdermal HRT delivery method that allow for both convenience and maximum impact of active ingredients.
The first time I heard of modern pharmacies compounding troches I was surprised; I had heard of them, but only in the context of 19th-century medicine. But don’t think that troches are outdated or lack sophistication. This form of transdermal HRT is efficient, effective, and holds very few drawbacks for users.
Troches date back to the 1800s, and combine the convenience of an oral pill with the benefit of bypassing the digestive system. They are small lozenges in various flavors that slowly dissolve in the mouth, usually between the cheek and gum. It takes about 30 minutes for a troche to dissolve, and during that time whatever active ingredients it contains are gradually absorbed by the thin, blood-rich tissues of the mouth and passed directly into the bloodstream. Full absorption within 30 minutes is comparable in speed to oral medications.
Commonly Prescribed Troches
Some of the most common kinds of troches that are compounded are those created for use in hormone replacement therapy (HRT). Another type of troche is a clotrimazole or nystatin version that is used to treat candidiasis, especially thrush. This offers an effective, more easily delivered treatment method for pediatric patients, in particular. Thrush is also found in cancer patients receiving chemotherapy, and given the nausea that accompanies chemotherapy, these kinds of troches are especially useful for these patients.
Troches in Focus: Hormone Replacement Therapy
Perhaps the most popular use of troches is in the administration of hormone replacement therapy (HRT). There are many reasons why troches are such a useful form of transdermal HRT. Some of the natural benefits that ideally inure from HRT are lost during digestion. During the body’s natural processes for hormone distribution, glands distribute hormones directly into circulation locally. The digestive system is not part of the path of distribution.
Another drawback to traditional oral dosage is that the hormones for the day’s dosage all flood the liver at once, overburdening it, especially if the patient takes other medications. This kind of overburdening can result in gallbladder disease, liver injury, and even liver toxicity. Also, the liver immediate reacts to these high hormone levels by working to counteract them, limiting access to the hormones that the body needs. Unfortunately the liver’s reaction doesn’t just act against the HRT hormones, but also other hormones such as cortisol, thyroid hormones, and the protective hormone antithrombin III that helps prevent heart attacks and strokes. Therefore, these liver effects can cause high blood pressure, high cholesterol, reduced thyroid function, mood swings, and increase the risk of heart attack and stroke.
Other possible delivery options include injections and transdermals. For obvious reasons, injections are less than ideal. Among transdermal HRT delivery methods, troches are the most consistent, most convenient, and easiest route for delivery. Suppositories and skin creams are other possible transdermal delivery methods, but suppositories are clearly less convenient, and skin creams, which are impacted by variations in body fat levels and skin types, provide absorption which is unpredictable and far less consistent.
Transdermal HRT troches are typically prescribed for use twice daily. This is because your own natural hormones last between 8 and 12 hours in the body. These troches typically contain some blend of estrogen, progesterone, and testosterone. While commercially-produced HRT medications contain only a limited number of set doses of each hormone, custom compounded troches can be made to fit the specific hormonal needs of the patient. Other hormonal troches, such as those containing HCG (human chorionic gonadotropin), are used to stimulate fertility in women.
Troches are a reliable, effective form of transdermal HRT. As need for this kind of custom compounded product continues to grow, there is no sign of their popularity decreasing. Women are demanding more from their healthcare than ever before, and are taking charge of their HRT regimens. As a preferred method of delivery, troches will be an important supply area for pharmaceutical professionals.
Compounded troches for hormone replacement therapy and other custom medications is a specialty area. We are eager to provide our customers with reliable information and high-quality products. For more about pharmaceutical compounding and purchasing bulk APIs, please contact Pharmaceutica North America, your trusted compounding resource.