By Tricia Heitman, PharmD, PCCA Clinical Services

We in pharmacy compounding can help patients with autism spectrum disorder in many different ways. This is especially important for pediatric patients. Children with autism and parents of children with autism have many obstacles. Let’s not make medication delivery one of them.

What are some of the obstacles to medication delivery for individuals with autism?

• Sensory difficulties, such as smell, taste and texture sensitivities¹
• Food and chemical allergies and intolerances¹
• Typically less food variety and more food choices based on texture than children without autism¹
• Often special diets to help with symptoms of autism²

This means that compounding pharmacists are perfectly positioned to help customize medication for children and adults with autism so they can get the medication or vitamins they need.

What Can Compounders Do?

Avoiding offensive taste by using a unique dosage form is one option. More specifically, you can:

• Improve the taste of a suspension with sweeteners and flavors
• Potentially avoid allergies and harmful dyes
• Reduce the texture of a suspension by homogenization or milling

Additionally, you can use topical options that avoid flavor and textural issues altogether. But these are just some of the ways that you as a compounder can help.  

Here are some additional tips:

• Always ask about patient allergies before compounding
• Avoid dye by having dye-free flavors on hand
• For bulky drugs or vitamins, use popsicle or suspension dosage forms
• Check all dosage forms for texture, even transdermals and topicals; they need to be smooth
• Use our pediatric intake form to get all pertinent information (PCCA members can access it here)
• Be creative within the confines of the patient’s needs

If you are unsure which active pharmaceutical ingredients may be used in common dosage forms, you can refer to the table below for help. Please note that the dosage forms and medications below are intended to be examples of pharmacologic therapies encountered by pharmacists and technicians working within a pharmacy compounding setting. This table originally appeared as “Table 9” in my article, “A Compounding Pharmacist’s Role in Managing Pharmacologic Therapies for Pediatric Patients with Autism Spectrum Disorder,” published in America’s Pharmacist in December 2014. PCCA members can access this article here.

If PCCA members have questions about compounding for patients with autism spectrum disorder, please contact our Clinical Services department at 800.331.2498. 

*A nystatin oral suspension is commercially available but commonly compounded in sugar-free form for children with autism spectrum disorder.

Patricia Heitman, PharmD, is a Clinical Compounding Pharmacist at PCCA. She is a graduate of the University of Houston College of Pharmacy and served as a PCCA PharmD Resident for one year post-graduation, which included a teaching position at her alma mater. She has been a full-time PCCA Clinical Compounding Pharmacist since completing her residency in 2000, answering compounding-related calls daily from pharmacists in the United States and Canada. She lectures frequently at PCCA International Seminars and symposiums. Her passions include pediatric compounding—especially options for patients with autism—as well as women’s health, gastrointestinal health and pain management.

A version of this article was originally published in the Apothagram, PCCA’s members-only magazine.

References

1. Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–46. https://doi.org/10.1016/j.jada.2009.10.032
2. Gottschall, E. (2004). Digestion-gut-autism connection: The Specific Carbohydrate Diet. Medical Veritas, 1(2), 261–271. https://doi.org/10.1588/medver.2004.01.00029

These statements are provided for educational purposes only. They have not been evaluated by the Food and Drug Administration, and are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The references cited did not necessarily evaluate PCCA products or formulas included in these statements. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment.