As outlined in the editorial by Missouri Medicine Editor John C. Hagan, III, MD, (March/April 2025; 122:76–80), physicians should be aware of the ways compounding pharmacists (CPs) can uniquely contribute to better patient care. This is especially relevant when FDA approved medications are unavailable, unaffordable or require changes in dosage, unique combinations of medications or delivery method.
Compound pharmacies are present in most large cities and in many mid-sized ones. Accredited compounding pharmacies (which may be located using the search tool of the Alliance for Pharmacy Compounding—https://a4pc.org/find-a-compounder) can mail special medications within specified states throughout the US. Ideally, physicians would have a working relationship with a CP. These compounding pharmacies should be licensed to dispense or ship to your state or residence.
Local CPs should be able to formulate the 0.5% timolol nasal spray for acute migraines that Dr. Hagan and other researchers have found useful. See publication in The International Journal of Pharmacy Compounding (https://ijpc.com/Abstracts/Abstract.cfm?ABS=5349).