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Thinking Out of the Box with Medications

We are officially switching from OTC Benadryl to a compounded form that has only the active ingredient diphenhydramine & cellulose filler. When taking the OTC form, my kid gets bright red, puffy lips. Not a good thing. The allergist has told us that they should not take any medication that causes allergic type reactions, i.e. rashes, swelling, puffiness (obviously, right?!). That’s great, but what to do when your child reacts to of all things, Benadryl.

Weigh benefit vs. risk (reaction). We’ve doled out medications as sparingly as possible - basically when it can’t be avoided to deal with symptoms or non-viral illness. Last year I consulted with the compounding pharmacy that makes the Ibuprofen & found out that it would be expensive to compound the allergy medicine. I was told & agreed that we didn’t want to do that unless we were out of other options. And now here we are compounding Benadryl & crossing our fingers that my kid's body will tolerate it without the other ingredients.

My son’s first dose of medicine aside from OTC gripe water was a liquid suspension of Amoxicillin at 6 months old. Huge eczema flare & a yeast infection. Due to medication or illness? Who’s to know for sure? Over the next 2 years they had reactions to any medication given from Infant Tylenol to numerous allergy & asthma medications, including meds used in nebulizers. As far as we could tell they seemed to tolerate one type of gripe water & one type of teething gel – both homeopathic & without preservatives, dyes, added sugars, etc…

Between our observations, incessant logging & conferring with the doctors to the best of our ability we’ve figured out a laundry list of things that kiddo does not tolerate. In a nutshell, medications need to be free of gluten, dairy, soy, corn, preservative, dye, sugar, and artificial coloring/flavoring. As the compounding pharmacist asked – what’s left?

Which brings us to why we are at a compounding pharmacy.

Even with that list, there are meds that have to be avoided. We’ve gotten creative to get away from the standard liquid suspensions & chewables that are chock-full of the things that cannot be had. When younger, I asked a pharmacist about doing the “adult” version of medications in tablet, modified dose & ground up to sprinkle on food. Said pharmacist thought that was probably the best route to take. The first doctor was not exactly supportive, but humored me. When needing medications that’s what works the best.

It is almost impossible to get a medication that is free of all aggravators. We first have to research the med in the PDR, hopefully while still at the doctor’s office. And, I go to the same pharmacy if at all possible. I make sure to go when they are less likely to be busy. Sometimes that just can’t be avoided, though. When I hand over the script, I let them know that I need to see the ingredient list prior to getting it filled. There was a learning curve to get to this point and I still get puzzled looks or assistants that want to argue the necessity.

When your child’s sick & needs the medicine, all you want to do is get it in their body as quickly as you can to help them start feeling better. And, what kid is “behaving” when feeling like crude, being at the doctor & then dragged to the store. Our trips to the pharmacy are never quick. It can be draining to say the least.

Next is checking the ingredient list at the actual pharmacy because different manufacturers use different ingredients. There have been times that we’ve had to call the manufacturer to clarify the ambiguous. Once all that’s done, the pharmacist may have to recommend an alternate medicine. The ingredient checking starts all over again. Then the pharmacist may need to call the doctor to get a different script sent over. Due to my kid's situation & building the relationships we have with the main doctors, we don’t end up being charged that out of office script call-in fee.

And, fortunately my kid's not been a “picky” eater. They can’t be. I didn’t really consider the taste of meds. It was more important for the medicine to get in the body. Pharmacists have told us that certain meds are flavored to mask how horrible they taste & they do not believe that my kid will take it sprinkled on food. We have not had to cross that bridge – knock on wood!

One time when I was crushing Zithromax & mixing it into pears, I got some on my finger. Didn’t think twice, licked it off and it was the most bitter, disgusting thing I have ever put in my mouth. I was amazed that my kid ate the “tainted” pears. There’s no way I would have without putting up a huge fight. At times like those, I cannot help but pause in complete awe of my kiddo.

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