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Abstract:  Findings from recent studies have shown that cardiovascular disease is best controlled through a combination of blood pressure and other cardiac medications. Most patients with hypertension, for example, need at least three drugs to control their blood pressure and usually take a cholesterol-lowering drug as well. Combine this with the need for medicines for other common symptomatic conditions, such as acid reflux, allergy, depression, and osteoarthritis, and a relatively “healthy” adult could easily be taking five or more medicines per day. Compounding pharmacists have an ideal opportunity to work with prescribers to simplify drug-taking regimens by combining multiple cardiac drugs into a single capsule, thereby increasing treatment flexibility (no fixed doses), decreasing side effects (with lower doses), and most likely decreasing drug costs. The benefits for compliance could be tremendous. Clinical and pharmaceutical issues to resolve include preferred formulations based on clinical trial evidence, starting doses, tolerability of dosage forms, stability, interactions between drugs or with excipients, and the incorporation of extended-release brand drugs. Part 2 in this series will begin to address these questions.

Related Keywords: Catherine A. Harrington, PharmD, PhD, Jacintha Cauffield, PharmD, BCPS, cardiovascular disease, hypertension, heart disease, antihypertensive agents, statins, folic acid, aspirin, blood pressure, cholesterol level, homocysteine, platelet function, prevention, polypill

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