Compounding Hotline

Mr. Erickson is director of professional affairs at Gallipot Inc.

A physician wants to substitute dehydroepiandrosterone (DHEA) for 7-keto-DHEA milligram for milligram. What is the appropriate dosing approach?

These moieties are not interchangeable. Authorities vary—some claim that 7-keto-DHEA is not metabolized to androgens and estrogens, whereas others claim that the metabolic pathway leads to conversion. In any case, DHEA is metabolized to 7-keto-DHEA.

A literature search for dosing information returned an inconclusive result. It appears that the daily dose of 7-keto-DHEA for adults is about half that for DHEA, however.

Compounding pharmacists should also be aware of adverse regulatory findings where therapeutic claims were made for dietary substances such as DHEA.

What is the importance of the cps in the cellulose derivatives?

The number preceding the ?cps? designation (eg, 4000 cps) is viscosity in centipoise of a 2% solution of the material at room temperature. For compounding, recall that the higher the cps number, the more viscous will be the preparation with the same concentration of material. Generally, use hypromellose (methylcellulose) 1500 cps for gel as a suspending agent. Compound as a 1% solution; use as 50% of the preparation?s vehicle. The other 50% will be active ingredient(s), excipient(s), etc, and syrup (flavored) to make methylcellulose 0.5% final concentration.

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