Not all compounding pharmacies are the same.

[since95]

I thought I would post the following to help anyone that is considering tapering paxil through compounding.

I currently live in Canada (born and raised) and liquid paxil is not available, nor does it look like it ever will be. The only option I have in order to taper slowly, other than shaving pills with a nail filer, is to use a compounding pharmacy. After much discussion with my doc and the help of this website, he gave me a prescription that stated that I was to start off at 18mg and decrease by 1mg every 6 weeks. If I want to start on a lower dosage sooner, I can.

It was up to me to find the compounding pharmacy and I by luck, I found one close to home through an advertisement in the yellow pages. I stopped by and told the owner/pharmacist my story and how I want to taper of paxil very slowly. He was willing to help but had never compounded paxil before. He told me it could be done but that it would be in a liquid suspension form. Perfect I said! However, he told me that because it is in a liquid suspension, I would need to keep it in the fridge and could only pick up a 2 week supply at the max.

This became very inconvenient, as I travel a lot with my job and do not have access to a fridge during the week at times. Especially if I am driving for 8 hours. Also, it became very annoying having to refill the prescription every two weeks. After getting a little bit fed up, which is very easy during wd, I asked if the pharmacist could put it into capsule form. He said he could try but that it could be very difficult and that me insurance most likely would not cover it. I told him that cost wasn't an issue. He agreed to try it in capsule form for my next refill but he ended up calling me to say that he wouldn't be able to do it in a capsule. His reasons didn't make sense but it sounded like he only had the tools to create liquid suspension compounds.

So, I went shopping for a new pharmacy and found a huge dispensary on the other side of town. I picked up my first capsule prescription from them today and all is well. My insurance didn't cover the whole thing (mainly because capsule compounding takes more time to do) but I am lucky that in my situation cost is not a big concern. When I asked my new pharmacy about the one I just left, they told me that there are many smaller pharmacies that offer compounding but many of them have only the bare minimum of tools to do the job. The main reason that I could only get two weeks supply in liquid form is that the pharmacist probably didn't have the proper instruments to test how long the suspension would last.

The main reason for my post is that not all compounding pharmacies offer the same services. Make sure to talk to two or three before you choose one and pick the one that seems to know what they are doing. Now that this is all done, I can go back to tapering without any distractions.