Compounding for Patients with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurological and developmental disorder that can have a significant impact on sensory processing. Those with ASD commonly have increased sensitivities to different food textures or flavors. These sensitivities may manifest in difficulty administering pills or even oral liquids, especially to pediatric patients. 

Methods to increase acceptance include compounding solid oral dosage forms into oral liquids with patient-specific flavoring options, as well as chewables, rapid dissolve tablets, sprinkle capsules or powder packets, nasal sprays, and transdermal options, among others.

• Oral Liquids: Suspension or solution vehicles containing sweeteners and bitterness blockers can improve palatability and may be an option for patients who struggle to swallow pills.
• Chewable Options: Some medications may be candidates for reformulation into chewable vehicles such as gelatin bases. Gelatin bases may also be tailored to patient preferences with specific flavors, and palatability improved with the use of sweeteners or bitterness maskers.
• Rapid Dissolve Tablets: Rapid dissolve tablets eliminate the need for whole pill swallowing. These tablets may be made using a variety of techniques. 
• Sprinkle Capsules/Powder Packets: Sprinkle capsules can be made to avoid the need for a caregiver to crush a tablet in the home if a capsule is not already available. Powder packets may be considered for larger doses of medications or supplements that do not easily fit into capsules.
  
  Powder packets may be sprinkled on top of food or added to liquid to make a suspension or solution for medications that may otherwise not be stable long-term in liquid form. These suspensions can also be effective for supplements when the excessive volume of liquid needed may make a pre-made liquid option a challenge.

• Nasal Sprays: Some medications that have been studied in patients with ASD, such as oxytocin, have data to support the nasal route of administration. This route eliminates the need for swallowing. However, this may not be an option for all medications.
• Transdermal Options: Some medications have been evaluated via the transdermal route, or through the skin. Where data exists for specific therapies, the transdermal route offers an alternative for patients who struggle with swallowing. However, like nasal sprays, not all medications can be administered transdermally.

Compounding allows pharmacies to offer patient-specific dosage forms and flavor profiles to patients with ASD who may struggle with sensitivities to specific tastes and textures that make the use of conventional commercially available options a challenge. If you have any questions about the additional dosing options available for yourself or a loved one's medications, speak with your compounding pharmacist and prescriber.

By Claire Concowich, VP Sales Enablement, Fagron

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