Dan ..
As far as I know only Morphine is commercially available (Infumorph Elkin/Sinns) for the pump.. to put something in the spinal fluid is has to be both sterile & perservative free. As a rule of thumb.. I have been told that the docs pay as little as 25% of the cost of the commercially available products to have the drugs compounded. I have been told that some docs will put some lidocaine type products in the pump ... to "justify" having the product compounded... even though ... when pushed the docs will admit that the lidocaine type products seldom provides any additional benefits. It is all about the money. Just imagine if one or more patients get mennigitis from a contaminated product.. do you think that the doc is going to tell the patient that he was not using commercially available products and that is the reason they were hospitalized or tell their family that is why they died? Who are they going to sue to make them whole? the doc? .. how deep is the pockets of the compounding pharmacy?
I just put an addition on my blog today about how the FDA is failing to protect our drug supply. They found three compounding pharmacies producing commercially available products in Aug 2005 .. it took them ONE YEAR to send a cease/decease letter... no shut down of production, no drug recall... they were not only producing products illegally.. the FDA tested their products and they were both 22% sub-potent and adulterated... all the meds involved were dealing with respiratory meds.. Few if any of the docs that prescribed the meds nor the patients that got the meds were informed that they were getting compounded drugs in place of the commercially available drugs that were prescribed.
According to the FDA published information.. there was million of doses involved and tens of thousands of patients and they were "dispensed" to patients nationwide.
There are other issues with the FDA and our drug supply beside this...
Pharmacist Steve
www.chronicpainresourcecenter.com