McCues Pharmacy uses state-of- the-art equipment that enables us to create specialized medications designed to meet specific needs. Whether turning an existing medication into an easier- to- take form (capsule, cream, liquid, etc), or creating a medication that is not readily available, our experienced pharmacists will be able to customize your prescription to meet your individual needs. We work together with you and your doctor to find solutions to any problem, whether simple or complex.

Acne

Acne vulgaris is an inflammatory, often long-term skin disease that may cause pore inflammation and unsightly

scarring. The condition occurs when hair follicles become blocked due to dead skin cells and skin oils — often worsened by the heightened growth of the bacteria Propionibacterium acnes. Acne sufferers tend to peak in adolescence, largely resulting from over-production of skin oils.

Conventional treatments of both prescription and over-the- counter treatments involve anti-bacterials, oil secretion reduction, and pore unclogging. Most preparations involve one or two components, but we are also able to compound customized multi-component preparations per your physician. Our unique bases also serve additional functions such as clearing up skin blemishes as well as healing new or old scars.

Rosacea

Rosacea is a chronic condition featuring a red blushing of the facial cheeks, with some cases involving the nose (enlarged), eyes (bloodshot), chin, and forehead. The skin may also present with larger blood vessels, resulting ina rough skin surface. Demographics show that most sufferers are aged 30-50 years old.

Presently, Rosacea has no known cure, but it is believed to arise from both genetic and environmental factors including family history, having fairer skin, skin mites, and possibly sun exposure.

Patients are advised to avoid spicy foods, limit direct sun exposure, high temperatures, and reduce stress — although triggers are strongly patient-specific.

The following sections offer detailed information for some common questions and different elements of rosacea.

Current treatment options include Metronidazole (both an anti-inflammatory and anti-microbial), Vitamin A (anti-inflammatory), Sodium Sulfacetamide and Sulfur (relief of redness and inflammation), as well as other treatments such as laser therapy.

Our lab is able to formulate unique compounds for Rosacea but including other components such as Niacinamide and Biotin, and incorporating them into bases which nourish and soothe the inflamed skin.

Bio-identical Hormone Balancing (capsules, creams, suppositories)

Hormone Replacement Therapy

As women enter menopause, their hormone levels will fluctuate considerably — estrogen production drops as the ovaries approach the end of their functional life, leading to weaker bones, vaginal infections and dryness, mood changes as well as hot flushing sensations. Physicians had traditionally prescribed regular hormone replacement therapy (HRT) until a study was released in the 2000s showing that the side-effects of HRT included clot risks and breast cancer. Physicians and patients then tried to find other sources of hormones, leading to new nomenclature: “Natural” vs “Bio-identical” Hormones.

What are Natural and Bio-Identical Hormones?

“Natural” hormones are those derived from animals, plants or minerals — for example soy or yam plants, or the urine of horses. They have not necessarily been tested for efficacy or potential harm, and thus the name is largely a marketing term.

“Bioidentical” hormones are those identical in structure to those found in women’s bodies. These molecular structures are not found in nature, but are modified from hormones found in Yam and Soy plants. Bioidentical estrogens include 17 beta-estradiol, estrone, and estriol. (Estradiol is the form of estrogen that decreases at menopause.) Bioidentical progesterone is simply progesterone. It’s micronized (finely ground) in the laboratory for better absorption in the body. Our bodies cannot differentiate bioidentical hormones from those that are ovary produced.

The conflict between “Natural” and “Bioidentical” hormones exists whereby some natural hormones are not bioidentical — for example, Premarin, which is naturally sourced pregnant horses, are not bioidentical because they are not found in humans. This could lead to inaccurate hormone test results when measuring one’s hormone levels, and this is one of the main tenets of support for bioidentical hormone use over natural hormones.

Where can I find Bioidentical Hormones?

Bioidentical estrogens and micronized progesterone are made into a range of products, many of which are FDA-approved and available with a prescription at your local pharmacy. Commercially available bioidentical estradiol comes in many forms and include: Estrace, Esclim, Estraderm, Vivelle, Estrogel, Estring, and Vagifem. Orally ingested estradiol is converted in the liver to estrone, a weaker estrogen, but given topically via creams, gels, or patches is more wholly absorbed. Women who still have a uterus and are taking Estrogen replacement therapy should still take a Progestin or micronized Progesterone to decrease the chance of endometrial cancer.

Commercially available bioidentical progesterone is currently available as Prometrium.

Benefits of topical Hormone Creams vs Pills

We are able to compound bioidentical hormones in exact ratios and doses not available commercially. The delivery method also is important. When estrogen is taken as a pill, it’s first processed through the liver. This stimulates proteins associated with heart disease and stroke, such as C-reactive protein, activated protein C, and clotting factors. When delivered by transdermal patch, estrogen isn’t first processed by the liver and — at the same level of blood concentration — doesn’t have these effects.

Working closely with a woman and her healthcare provider, a compounding pharmacist can help a woman start and maintain a hormone replacement regimen that brings her hormones back into balance and closely mimics what her body has been doing naturally for years. With a healthcare provider’s prescription, the pharmacist can prepare hormones in a variety of strengths.
Our hormonal cream preparations use a proprietary base which simulates natural moisturization. It is smooth, non-irritating, paraben-free and propylene glycol-free. We also use yam sourced Progesterone that has been micronized to an industry leading 5 microns — allowing far greater absorption and stability than the 20 micron particle size of other competitor’s micronized versions.

Come see us for more information today!

Tissue Pain (Knee/Elbow Joints, Muscles, Soft Tissues)

We currently produce an in-house prescription strength 10% and 20% Diclofenac (also known as Voltaren) topical cream using our unique base, which has proven stability and excellent skin delivery properties. Our pain preparations are ideal for athletic injuries, osteoarthritis, and many other situations. Come talk to us today to find out if this may be right for you.

Nerve Pain (Shingles, Diabetic Neuropathy, etc)

Nerve pain differs from regular pain. The cause of nerve pain stems from damage to the actual nerves, causing an unrelenting pain signal despite having no obvious injury. This can arise from viral infections (e.g. Shingles), high blood sugar (poorly controlled diabetes), or other afflictions such as multiple sclerosis or even carpal tunnel syndrome.

Topical compounded solutions are available by physician prescription, whereby we can incorporate multiple medications which serve to dull this transmission of pain at the nerve. The key to efficacy is the base, or carrier used to transport the drug from the surface of the skin into the tissue and ultimately at the nerve.

Our cutting edge bases have been proven to effectively transport at least four different medications simultaneously, and has a fine texture as opposed to previously used PLO (pluronic lecithin organogel) preparations. Our base also remains stable under refrigeration and does not separate over time. We also use a cream mill in-house to ensure that the drug is dispersed evenly and that no grittiness remains — evidence that the drug particles have not been evenly dispersed in the mixture.

Skin lightening for spot treatments

With a prescription from a physician, we are able to compound multi-component mixtures tailored to your skin needs. From collagen stimulation to melanin production inhibition, our bases are able to accommodate and deliver up to 4 different drugs simultaneously through the skin to reach the locations needed. In addition to medications, we can also add other nutrients and anti-oxidants to further nourish the skin area of interest.

Eczema

Eczema is a long-term recurrent inflammation of the skin, resulting in red skin sores and itchiness. The disease has a strong genetic immune component, and tends to occur more frequently in families with prior histories of eczema, asthma, or hay fever. Bouts of the disease tend to flare up periodically in response to various environmental triggers, and it has been hypothesized that a hypersensitive immune system may be a contributing factor.

Rashes tend to appear on the faces and scalps of infants, while older children and adults have them in the skin folds of various appendage joints and the neck.

Most eczema sufferers begin to experience symptoms before the age of 5 years, with symptoms fading with age; however 10-30% of children will have dry and irritable skin throughout their lives.

Environmental stresses that are thought to trigger flare-ups include stress, certain fabrics, strong detergents, sweating, dust mites, smoke, pollen, and many others.

A healthy skin barrier is crucial to preventing flare-ups: a broken skin barrier allows irritants to pass through the skin into the tissue, and thus trigger immune flare-ups more easily. To reduce the urge to itch in young children, the skin can be cooled with a damp towel, as well as anti-inflammatory medications such as steroidal creams. Regular baths and moisturizers are also key.

With a prescription, we offer compounded eczema relief solutions which can include medications that calm the immune system down, and offer a cooling sensation. We mix these compounds in a proprietary base derived from natural boswellic acid, avenanthramides from oats, and phosphatidylglycerol — all which nourish and replenish the lipid bilayers of the skin to restore the skin’s natural barrier and prevent further water loss.

Visit us and find more about how we can help in eczema!

Psoriasis

Psoriasis is a chronic inflammatory immune skin condition that involves red elevated patches and flaking silvery scales. Psoriatic lesions can be painful, itchy and vary in size. Psoriatic patches (also called plaques) are also dry, flaky, and may bleed. Commonly afflicted sites include elbows, knees, scalp, chest and lower back.

The disease is usually seen in adults, and affects both genders equally. Although its causes remain unclear, genetic family history is pronounced risk factor, with a hypothesis being that an overactive immune system triggers inflammatory skin cell growth and subsequent hyperactive shedding.

Common triggers that cause psoriatic flare ups include infections, skin injuries, weather, tobacco use, stress, certain medications and more.

With a prescription, we offer compounded psoriasis relief solutions which can include medications that calm the immune system down, and offer a cooling sensation. We mix these compounds in a proprietary base derived from natural boswellic acid, avenanthramides from oats, and phosphatidylglycerol — all which nourish and replenish the lipid bilayers of the skin to restore the skin’s natural barrier and prevent further water loss.

Visit us and find more about how we can help in psoriasis!

Scar Treatment

Wounds affect skin integrity and can result in the imperfect, although normal, end point of tissue repair, namely, skin scarring. Scars can range from a fine line to a variety of abnormal scars, including hypertrophic and keloid scars and are mainly composed of collagen tissue. Collagen tissue is tough and difficult to enter, thus blocking access to the body’s fibroblast cells, which are used for tissue remodelling and recycling — leaving visible scar tissue.

Pracaxi oil, derived from the seeds of the Pentaclethra macroloba tree indigenous to the Amazon, has several medicinal applications including the treatment of ulcers, stretch marks, bacterial infections, and snake bites. Pracaxi oil contains high amounts of oleic, linoleic, and behenic fatty acids, which are frequently utilized in the cosmetic industry and have been shown to enhance wound closure and improve healing in several wound models. Fatty acids are integral to the formation and maintenance of cell membranes within the stratum corneum, the layer of the skin that provides a barrier to the environment and regulates permeability. In addition, fatty acids have lubricant, emollient, and anti-inflammatory properties, which help to restore the natural oils of the skin and protect the skin from environmental damage. The enhanced permeation of the skin also allows the body’s fibroblast skin cells to penetrate the scar more deeply and dissolve collagen, the main component of scars.

Our over-the-counter ScarFix cream is a topical anhydrous silicone base that can be used alone or with various medications. Application of an anhydrous silicone base containing Pracaxi oil alone or in combination with other active substances has shown to considerable improvements in wound healing and scar attributes and is a potentially useful option in the treatment of surgical, traumatic, or burn wounds and scars.

Apply to the scar twice a day for best results. Time for noticeable difference depends on age and depth of scar tissue.

Burn Treatments

If you’ve suffered any type of burn and are searching for scar reduction and  collagen restoration, we offer several over-the-counter remedies. Our custom burn relief compounds can be used for temporary coverage of partial thickness burns, and offer pain reduction, faster healing, and better scar appearances. The gel base of our burn compounds are derived from organic meadowsweet extract (an antibacterial), and easy to work with in burn cleansing and debridement. The compounds are also adherent, and provides occlusion to maintain a moist environment at the wound/dressing interface — further facilitating the healing process.

Hemorrhoids

Hemorrhoids are a painful condition that afflict many adults at some points in their lives. The condition arises when difficulty in passing fecal matter causes excess muscle straining or excessive defecation time, leading to anal canal vein stretching and subsequent stretching.

The condition typically affects people who have chronic constipation due to diets poor in fibre, constipation due to medicines, as well as pregnant women who experience additional rectal pressure from the fetus.

The most common symptoms of hemorrhoids include bright red blood in the feces, and a physical feeling of the hemorrhoid folds bulging out of the anal canal area.

A physician can tell if you have hemorrhoids by asking about your past health and doing a physical examination. Treatment is often simple, and involves a fibre rich diet, exercise, and the use of over-the-counter remedies such as stool softeners and laxatives.

Our pharmacy can also formulate compounds from physician prescriptions which include blood vessel relaxants, anti-inflammatory components, and cooling agents to relieve discomfort and accelerate healing. We also produce in-house suppositories for painless localized delivery of medications to the anal area. Come talk to us and learn more about our treatments and how to avoid hemorrhoids.

Veterinary Compounding

Pets may greet medications with suspicion or even refuse to consume them. Animals may also have unique medication delivery challenges — smaller throats could impede swallowing, thick fur could hinder topical absorption, and a variety of other difficulties could exist.

The practice of pharmacy compounding is becoming a popular solution to veterinary problems. Compounding is the art and science of preparing customized medications for patients. Its resurgence in recent years extends valuable benefits to today’s pet owners. Animals often have variations of the same diseases humans can have, including skin rashes, eye and ear infections, heart conditions, cancer, and diabetes. Certain animals may have species specific intolerances or flavour preferences.

Our lab is able to compound medications for dogs, cats, horses, rabbits, birds, and many more. We can also compound veterinary medications which may be discontinued. Come ask us about our solutions today!

Discontinued or Manufacturer Shorted Medications

Sometimes, a commercially available medication may be deemed non profitable or having insufficient use, and discontinued by manufacturers. This often leads patients who may depend on these medications to scramble around searching for remaining supplies of these medicines. In other cases, there may be production problems leading to manufacturer shortages of medications. In most cases, we are able to custom manufacture these medications for you. Please contact us for more information.

One common example of a discontinued medication which we produce includes:
Phenazopyridine Capsules (for Urinary Tract Infections)

A website with regularly updated drug manufacturer shortage information is available here:

http://drugshortages.ca/drugshortagehome.asp

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