Compounding for Endometriosis: Exploring Vaginal and Transdermal Treatments with Pentravan®

Endometriosis is a complex condition that affects millions of women worldwide, often leading to chronic pain and fertility issues. While there is no definitive cure, innovative treatments are emerging that bring new hope to those managing this condition.

The Advantages of Transdermal Hormonal Therapies

In one study from the UK, researchers examined the relationship between different hormone replacement therapies (HRT) and the risk of venous thromboembolism (VTE). The study analyzed data from over 80,000 women diagnosed with VTE and nearly 400,000matched controls. The findings revealed that oral HRT, particularly formulations containing conjugated equine estrogen, significantly increased the risk of VTE compared to those not using HRT. In contrast, transdermal HRT, such as those delivered via creams or patches, showed no increased risk, making it a safer option for long-term hormone therapy.

Despite this, oral HRT remains the more commonly prescribed form, underscoring the need for greater awareness of the benefits of transdermal treatment options. Personalized transdermal therapies not only reduce the risk of unwanted side effects but also offer a more convenient and comfortable way to manage chronic conditions like endometriosis.

Why Pentravan® Stands Out

For patients with endometriosis, who often require long-term treatment, comfort and safety are paramount. Fagron’s Pentravan® is a unique transdermal vehicle specifically designed to transport hormones effectively through the skin. It provides a stable and efficient delivery method for personalized treatments, making it an ideal choice for both vaginal and transdermal applications.

As research continues to advance, it’s clear that transdermal therapies, especially when compounded with innovative vehicles like Pentravan®, have the potential to dramatically improve the quality of life for patients. For those managing endometriosis, opting for a personalized, low-risk transdermal treatment could be a game-changer, offering both efficacy and convenience over the long term.

By embracing these new compounding strategies, we can offer safer, more effective treatments that align with patients' needs, paving the way for better outcomes in managing chronic conditions like endometriosis.

Compounding with Pentravan® - personalize the treatment of your patient

Compounding with Pentravan involves several key steps to ensure the active pharmaceutical ingredient (API) is properly incorporated for effective skin or mucosal absorption. Here is a general guide on how to compound with Pentravan:

·  Calculate the quantity of each ingredient required for the total amount to be prepared.

·  Accurately weigh each ingredient.

·  Reduce all powder(s) to uniform, fine consistency. Process through Three Roll/Ointment Mill (at least 3 times).

·  Levigate the powder(s) with an appropriate amount of ethoxy diglycol to form a smooth paste, mixing well. If compounding for a vaginal application, consider almond Oil as an levigating substance.

·   Geometrically, add sufficient Pentravan® to thefinal weight and mix well.
   Package and label.

Tips and Tricks:

For optimal results, this formulation should be compounded using a mixing device (FagronLab Unguator, PM140, and PM300 PRO) to ensure thorough mixing.

Next, process through a three roll/ointment mill to reduce ingredient particle size, eliminate grittiness, and enhance the elegance of the final compounded product. Finally, remix in a mechanical mixing device to ensure thorough dispersion.

Dissolution can be easily accomplished by gradually adding a non-volatile (fixed) oil, e.g., sweet almond oil, to the powder(s). The oil may be substituted by another suitable solvent, e.g. propylene glycol or ethanol.

Pentravan® Plus can be used to obtain a thicker transdermal cream.

Important Notes:

Pentravan is specifically designed for transdermal delivery, allowing the API to penetrate the skin effectively. It is safe to use on vaginal mucosa, as several studies have shown.

Follow all safety and handling guidelines specific to the API being used.

Safety and Efficacy Proven by Clinical Studies

Clinical studies underscore the safety and efficacy of Pentravan® in delivering therapeutic agents for various gynecological conditions. The cream base has been extensively tested and validated for intravaginal use, offering a reassuring profile for both patients and healthcare providers. Its proven effectiveness in enhancing the permeation of APIs across the skin barrier demonstrates Pentravan®’s vital role in advancing personalized medicine in women’s health.

References:

·       (2018). Treatment of Endometriosis and Leiomyoma with the Association of Miodesin and Gestrinone in Pentravan Through the Vaginal Route. Journal of Clinical Review& Case Reports.

·       Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases BMJ 2019; 364 :k4810 doi:10.1136/bmj.k4810

·       https://fagron.com/formulary/formulas/danazol-10-in-pentravan-transdermal-cream

·       Polonini H, Ferreira AO, Dijkers E.Compatibility of Gestrinone, Nimesulide, and Piroxicam in Pentravan for Transdermal and Transmucosal Application. Int J PharmCompd. 2021 Sep-Oct;25(5):422-426. PMID: 34623968.

·       https://austinpublishinggroup.com/reproductive-medicine/fulltext/ajrm-v2-id1021.pdf

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