'Community compounder' helps cure advanced infections

Personal contact is important to New York compounding pharmacist

Two handwritten thank-you notes hang on the refrigerator at Pharmacy Innovations in Jamestown, NY. Inside one of them the spiraling script of a teenage girl reads, “Thank you for helping me when I was hurt.”

Every day the cards remind Richard Moon, PharmD, just why he loves his work. The compounding pharmacist prepares medications for patients who have no other hope, whether there isn’t a medication commercially available to treat their condition or whether they can’t tolerate a particular ingredient.

“I like the fact that we can touch people on a deeper level than you could with regular pharmaceuticals, filling gaps for people who couldn’t take other medications, finding solutions for problems. I like making a difference in my clients’ lives,” Moon said.

Moon has compounded many medications to treat severe eye infections.  It’s common, he says, for kids who play sports not to notice a scratch to the cornea until it is already badly infected.

By the time patients reach this level of infection, it’s an emergency. Their doctors fit them in immediately and ask Moon to have the prescription ready that day. 

“Usually by the time they get to that point, they want to get broad spectrum antibiotic coverage. There’s no vancomycin eye drop. And the tobramycin that they might use isn’t strong enough. Sometimes they might need a cephalosporin, and there are no cephalosporin eye drops,” Moon said.

So Moon prepares the broad-spectrum antibiotics in eye-drop form, and patients often drive hours to get them.

“When you get someone with an eye issue, they were told by the doctor, ‘If you don’t do this, you will lose your eye,’ so it’s a pretty significant event in their lives,” he said. “That compound saves their eye sight, so that’s pretty powerful.”

Eye infections aren’t the only conditions Moon treats. And people aren’t his only patients. He once prepared a strawberry-flavored antifungal for a litter of red panda cubs that wouldn’t swallow their medicine any other way.

“The vet knew what medication he wanted, but he couldn’t figure out how to get them to take it. That ended up saving those priceless animals’ lives,” Moon said.

Moon and his family operate five stores in five states—New York, Pennsylvania, Virginia, Texas, and South Carolina.  Their New York and Pennsylvania stores were among the first pharmacies in the country accredited by the Pharmacy Compounding Accreditation Board. When Moon first opened them, his work focused more on I.V.s for hospitals and in-home care. Over the years, however, he has gravitated to what he calls “community compounding”—compounding medications for patients who come to store to pick them up. 

“You’re entrenched in the community. You have closer relationships with patients,” Moon explained. “You don’t see them as often as you would if you were giving them blood pressure medication, but when you can help a suicidal woman correct her hormones and get to feeling normal again, it’s a whole lot more fun than just slapping a label on ulcer medication.”