Treatments for nausea and vomiting can include some oral medications, rectal suppositories, and IV combinations.  Through compounding new routes of administration or combinations can be made, including transdermal and intranasal routes. Oral combination antiemetics in patients with small cell lung cancer receiving cisplatin or cyclophosphamide plus doxorubicin.

Intranasal metoclopramide. 

Nasal absorption of ondansetron in rats: an alternative route of drug delivery. 

Bioavailability of Promethazine in a Topical Pluronic Lecithin Organogel: A Pilot Study

Anti-Secretory Agents

In end of life care anticholinergic medications are common to help with Death rattle as well as excessive oral secretions. Systemic anticholinergics can have many adverse side effects; a compounded drop used sublingually can help minimize these effects. Sublingual atropine drops for the treatment of pediatric sialorrhea.

Chronic Pruritus

Chronic itching is a common problem that can come from many different sources like dermatitis, psoriasis, or as a side effect of chronic opioid use.  Treatment often includes corticosteroids or antihistamines, but these can be unsatisfactory in some patients who will then need a more individualized treatment.  Options that can be compounded would include a topical naltrexone cream, topical immunomodulators, urea creams, topical anesthetics, and many more. Therapy of pruritus. 

Treatment of pruritus with topically applied opiate receptor antagonist.

Dry Mouth, Stomatitis, and Mucositis

Problems like dry mouth, stomatitis, and mucositis are common in cancer patients and other populations.  By treating these ailments at the site of the problem with compounded mouthwashes, solutions, lozenges, and topical products the patient is able to receive relief without as many side effects of other therapies. Use of orally administered anhydrous crystalline maltose for relief of dry mouth.

Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy.

Allopurinol mouthwashes in the treatment of 5-fluorouracil-induced stomatitis.

Topical Morphine for Oral Mucositis in Children: Dose Finding and Absorption.

Palliation of radiation-related mucositis.


Dyspnea, or shortness of breath, is very common in patients at the end stages of terminal diseases that can be very distressing for the patient as well as care givers.  Treatment for this can include morphine or other opioids used to target receptors in the lungs by using an inhaled form or possibly using sublingually or through other routes. Lung opioid receptors: pharmacology and possible target for nebulized morphine in dyspnea.

Pain Management

Many options for pain management are possible. See section “Pain” for examples and citations.

Wound Care

With so many differences in wounds depending on site, depth, cause, and therapy goals there can be a need for a specialized treatment. Compounding allows for the use of unique medications tailored to the patient’s specific need. Creams or ointments can also be mixed to allow the patient to only apply one product while getting multiple drugs, like a combination of an anesthetic and an antimicrobial agent. Role of phenytoin in healing of large abscess cavities.

Topical sucralfate: effective therapy for the management of resistant peristomal and perineal excoriation.

Benzoyl peroxide in the treatment of decubitus ulcers.

Local anesthetics as antimicrobial agents: a review.