New prescription · hormone therapy

Build the preparation

Laid out in the same blocks as the pharmacy’s own order form, and carrying nothing the form does not. Pick a block, choose a strength and a dose form, and the rest is worked out and shown exactly as the pharmacy will read it.

PatientStep 2 of 3 · the preparationReview and sign

Dose form

Renata Gil · 04 Jul 1978 · Tustin, CA

Pick one. Nothing is chosen for you. These are the six on the pharmacy’s own order form, and only those six. Every hormone below is offered in every one of them, so you can change your mind about the form without losing a strength. Sustained release is a property of a capsule rather than a separate dose form, so the two capsule choices are alternatives, never both.

Estrogens

none yet

Tick what this patient needs. Each one opens its own strengths once ticked.

Pregnenolone is switched off. Pregnenolone has no USP monograph and is not a component of an FDA-approved drug, so it sits only on FDA’s interim Category 1 list. That is enforcement discretion, not a lawful basis under section 503A. It is printed on the paper form, and the pharmacist-in-charge has to clear it before it is switched on.

How much, how often

assembled, not typed

Choose a strength and a frequency. The daily amount is worked out from what you picked above, never typed in.

Supply and refills

quantity is worked out, not typed

Supply90 daysRefills2

Schedule III allows a maximum of five refills within six months. The count above never exceeds that.

Attestation

required before you can continue

This preparation is for Renata Gil under my care, and I have determined it will produce a clinically significant therapeutic response for her compared with a commercially available product.

A 503A pharmacy may not compound something that is essentially a copy of a commercial product unless the prescriber has made that determination. It has to come from you, so we capture it here rather than assuming it.

Compounded preparations are never supplied as office stock. Every order names one patient, which is what makes it lawful for a 503A pharmacy to fill.

Or open one of your own saved formulas, or pick a block above and build one.