Topic: Creams, Gels and Lotions
Not quite the same ring as trains, planes and automobiles but creams, gels and lotions are an important component to the success of the therapy you prescribe for your patients. Have you given this much thought? I know doctors and most pharmacists in my community do not. The docs write a prescription for a transdermal (whether that be pain medication or bio-identical hormone replacement medications, etc)-tell the patient to go to a compounding pharmacy and have the prescription filled. The patient calls the practitioner in the middle of the night because she is having hot flashes due to her “medicine” not working. Is it the dose, the time of administration…OR is it the base used? The issue occurs when the doc is not specific on what base to use and/or the pharmacist is not knowledgeable or proficient enough in compounding to adequately inform the physician on the best vehicle to use.
This topic will be discussed in detail at our upcoming seminar in Las Vegas. For now, however, let me discuss some practical issues on this subject. Medaus Pharmacy has both anecdotally and quantitatively determined the following:
Lipoderm or PLO bases are alcohol based and has a high rate of absorption. This high rate drives the medication through the layers of the skin and at times through the fat (lipid soluble) resulting in peak-valley pharmacokinetic results. With Bio-identical hormones for example, depending on when (what time) samples are taken for lab purposes (versus when the base is applied) can affect the concentration reading of the hormone. With BHRT this is not the goal so we do not recommend PLO unless
testosterone is the active ingredient.
Vanishing cream as well as Medaus Cosmetic HRT base has less “force” of penetration of hormones for instance, resulting in slower release than other creams and by default results in more consistent levels for the patients. More appropriate pharmacokinetic characteristics for BHRT.
Emollient Cream bases have been around for ages…they are effective but tend to leave an oily/sticky feeling on the patients skin.
Vanishing Cream bases are effective, light and more “cosmetically” appealing than the other bases but is not as consistent as the Medaus Cosmetic Cream HRT base.
In addition, different skin types, among other things, plays a major role in the decision of which cream to chose. At Medaus, we have found that the Medaus Cosmetic HRT cream base or vanishing creams deliver the best results regardless if the patient has dry skin, oily or leathery. Also, age considerations should be noted due to thickness of skin or lack thereof due to aging.
At this point, Medaus Pharmacy is recommending Medaus Cosmetic HRT base for water soluble hormones.
Please do not overlook this important variable. It will keep you and your patients happy.
I hope this information is helpful and for more detailed information please feel free to contact the Medaus Pharmacy at 800-526-9183. I also encourage each of you to exchange ideas on
www.medaus.com pharmacy forum.
Creams, Gels and Lotions 
Linear Mode
