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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by platinumbride on May 2, 2004, at 14:05:57
I posted a few days ago that my pdoc suggests I try seligiline 20mgs in a pharmacist compounded cream form. I guess the pharm. says that he can compound the seligiline into a cream, thus rendering transdermal delivery of the drug (like the patch) but without the patch. ( I live in the USA).
I'm not sure if this is snake oil or actually a good, true and legal way of bypassing the country's slowness in legalizing the patch. It seems that if this is indeed efficacious, it would be happening already, yet I have not read of anything of the sort.
Do you have any opinions?
Thank you,
Diane
Posted by chemist on May 2, 2004, at 19:28:02
In reply to question for chemist re: seligiline, please, posted by platinumbride on May 2, 2004, at 14:05:57
> I posted a few days ago that my pdoc suggests I try seligiline 20mgs in a pharmacist compounded cream form. I guess the pharm. says that he can compound the seligiline into a cream, thus rendering transdermal delivery of the drug (like the patch) but without the patch. ( I live in the USA).
>
> I'm not sure if this is snake oil or actually a good, true and legal way of bypassing the country's slowness in legalizing the patch. It seems that if this is indeed efficacious, it would be happening already, yet I have not read of anything of the sort.
>
> Do you have any opinions?
>
> Thank you,
>
> Dianehi diane, chemist here....i wouldn't call it snake oil, but the pharmacist better be a pro at compounding, which is a rapidly-fading art (in the US, at least) and has made the New York Times within the past 3 weeks or so as the topic of a problematic facet...you are being prescribed an MAO-B inhibitor, and i suspect that you are having trouble titrating slowly. however, even if this is the case, it makes no sense: there are tablets and capsules offered, and these can be cut/spilled to smaller doses. there is a LARGE problem with transdermal delivery of drugs: the cream (and whatever else) had better be able to take the drug through your epidermis in the right period of time, otherwise you will be over-dosed or under-dosed. the FDA's therapeutic equivalence list for generics vs. brand names for things like retin-a and other gels/creams/etc. is evidence that the goop in which the drug is mixed is of great import for reaching blood levels of the drug being applied. the generics come out not so well, because they save money by using, say, petroleum jelly instead of a better compound. finally, selegiline is a salt, not a free base, and as such there is very little chance that if this compound is put in an oil-based cream that the free base will emerge and thus cross through your skin (little to no chance, really). keep me informed, but it sounds fishy to me....all the best, chemist
Posted by chemist on May 2, 2004, at 19:32:43
In reply to question for chemist re: seligiline, please, posted by platinumbride on May 2, 2004, at 14:05:57
> I posted a few days ago that my pdoc suggests I try seligiline 20mgs in a pharmacist compounded cream form. I guess the pharm. says that he can compound the seligiline into a cream, thus rendering transdermal delivery of the drug (like the patch) but without the patch. ( I live in the USA).
>
> I'm not sure if this is snake oil or actually a good, true and legal way of bypassing the country's slowness in legalizing the patch. It seems that if this is indeed efficacious, it would be happening already, yet I have not read of anything of the sort.
>
> Do you have any opinions?
>
> Thank you,
>
> Diane
diane, there are a few posts concerning the selegiline patch higher-up on the board. evidently, it sounds quite promising. however: if your doc is recommending a pre-release version via a formulary, keep in mind the statement concerning the salt vs. free base and the delivery system (cream/gel/ointment/solvent)....all the best, chemist
Posted by platinumbride on May 3, 2004, at 10:54:08
In reply to Re: question for chemist re: seligiline, please » platinumbride, posted by chemist on May 2, 2004, at 19:28:02
Thank you, Chemist, for that information.
You mentioned that you guessed I was having a problem with titration. Actually, I haven't even begun anything with this med. I think my doc is trying to avoid the dietary issues.
He apparently has had success with this pharmacist compounding testosterone into a cream for other patients of his, and I guess the pharmacist said that he could do the same with seligiline...makes me worried, though, because how can this guy know for sure that this would work?
And then there is my insurance company, which apparently has it's OWN compounding pharmacy. They may not pay for this unless they cannot compound it themselves, and yet, if they CAN, I don't imagine that they will be paying attention to the vehicle through which it is delivered. They are sure to go with the cheapest thing possible.Well, you have given me some food for thought. I might just go ahead and take the plunge with pills I swallow rather than messing around with this.
If I DO go with the compound, I will surely keep the board posted, because if it works, it might be a help to Americans waiting around for the selig. patch.
Best to you,
Diane
Posted by platinumbride on May 7, 2004, at 7:54:17
In reply to Re: question for chemist re: seligiline, please » platinumbride, posted by chemist on May 2, 2004, at 19:28:02
>is evidence that the goop in which the drug is mixed is of great import for reaching blood levels of the drug being applied. the generics come out not so well, because they save money by using, say, petroleum jelly instead of a better compound. finally, selegiline is a salt, not a free base, and as such there is very little chance that if this compound is put in an oil-based cream that the free base will emerge and thus cross through your skin (little to no chance, really). keep me informed, but it sounds fishy to me....all the best, chemist
Chemist:
Funny you should mention the oil-base. I called the pharmacy and found out that the whole thing is in a hydrogenated vegetable oil base!
Having said that, I must also say that since taking it I feel as if I have spent a day in the ocean - you know, that feeling of having salt water taste in your mouth after a swim in the ocean???
Not sure if this is a sign that the thing is getting in there somehow....I guess I will give it all the old 6-8 week trial.
Thank you very much for helping so many people here.
Diane
Posted by chemist on May 7, 2004, at 11:49:32
In reply to Re: question for chemist re: seligiline, please, posted by platinumbride on May 7, 2004, at 7:54:17
> >is evidence that the goop in which the drug is mixed is of great import for reaching blood levels of the drug being applied. the generics come out not so well, because they save money by using, say, petroleum jelly instead of a better compound. finally, selegiline is a salt, not a free base, and as such there is very little chance that if this compound is put in an oil-based cream that the free base will emerge and thus cross through your skin (little to no chance, really). keep me informed, but it sounds fishy to me....all the best, chemist
>
>
> Chemist:
> Funny you should mention the oil-base. I called the pharmacy and found out that the whole thing is in a hydrogenated vegetable oil base!
> Having said that, I must also say that since taking it I feel as if I have spent a day in the ocean - you know, that feeling of having salt water taste in your mouth after a swim in the ocean???
> Not sure if this is a sign that the thing is getting in there somehow....
>
> I guess I will give it all the old 6-8 week trial.
>
> Thank you very much for helping so many people here.
>
> Diane
hi diane, thank you for your kind words in re: the witch hunt...i don't know about the salty taste, i have heard that when some people start meds that ``taste perversion'' occurs once in a while, perhaps that's it? glad to hear it's working with you, and keep us posted if (when?) that excess saltiness abates.....with best wishes, chemist
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