Compounding Pharmacies in Australia
Compounding Pharmacies make custom medicines including implants, injections, progesterone, topical anesthetics, and hair restoration compounds. You will need a prescription.
According to wikipedia
In pharmacology, compounding (done in compounding pharmacies) is the creation of a particular pharmaceutical product to fit the unique need of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools.
This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose(s) needed or deemed best of particular active pharmaceutical ingredient(s). It may also be done for more optional reasons, such as adding flavors to a medication or otherwise altering taste or texture.
Although I've listed various medicines for each pharmacy they would make many more that that - I've only listed the ones I've heard of.
The location is not important - I've not heard of any that will refuse to post anywhere in Australia.
| Date | Pharmacy | Price |
|---|---|---|
| 2021 | Hinchinbrook Pharmacy | $115.50 for 200 capsules |
| 2021 | SuperPharmacy | $70 for 100 x 200mg capsules |
Implants are popular and reasonably common in Australia, and there's a number of Australian compounding pharmacies who make them. There's several factors in choosing them
People often say one supplier is better than another, but I think its usually due to the size rather than the supplier itself.
All Australian made implants made by compressing a powder in a press/die. Since Organon left in 2011 there are none that use the heat fused technique (unfortunatly). The powder is pure estradiol, and there may be a small percentage of an excipient used to help in the manufacture (I think its only stearic in Australia). I don't believe the excipient makes any noticable difference in use.
The doctor will need a trocar to insert the pellets, and there are some suppliers listed here.
There's a limited number of doctors in Australia who will do implants (look in the Dr page of this wiki). Assuming you can find one, they also vary in what dose and levels they are prepared to offer. In Sydney its mostly a maximum of 100mg. I've heard of a few women getting 200mg (2x100mg), but if very difficult to access these days. I started on 200mg many years ago, and the first set last 6 months. As is normal subsequent implants lasted longer, 9 months in my case, except for two occasions of 15 months. I suspect the increase was due to weight loss, but its hard to be sure. You should be getting new implants when your levels drop to a specific level, which for my doctor was around 800 or 900 pmol/L. Some doctors won't do new implants until 400 pmol/L, which causes seriously negative effects for some women (me), and personally I'd avoid them. As the lifetime of my implants is mostly the same and I can feel when I need new ones I try to do a single blood test when I think I new need ones, and it usually works. I ask for multiple test scripts from the doctor and a copy of the test results sent to my home so I can do a few tests if necessary and without wasting my time going back to the doctor, but some doctors refuse - I assume they want the money from pointless visits and I avoid unethical doctors, plus I dislike wasting my time, so I avoid them also. Scripts only last a year, so that may not work anyway if your implants last longer than that. There's a lot of new doctors doing implants asking for regular blood tests - as far as I'm concerned this is for their benifit not mine and as I don't like needles I refuse.
I've heard of a few women getting unusually low levels on their first implants, and getting additional ones a few months later. I've also heard of a few women not needing new ones until two years, but its not common. Although there's doctors who would have the data on levels and time by now, nothing has yet been published. Higher doses of implants do last longer - ie 200mg lasts longer that 100mg. I've heard of some doctors doing less than 100mg - I'd also avoid them. 50mg or 75mg would be even worse. And there's some who do 150mg (100mg + 50mg), which seems like a bad idea due to the different life of the two implants, but doctors are scared of high levels for some reason.
Related wiki pages
Suppliers
There's only a few suppliers of implants in Australia. It requires a sterile facilities (which are regulated) and many are not. Eg NuGen in the past could only make non-sterile preparations such as oral and creams - no implants and no injections. It also requires a press and die set, which not everyone would have (although they are cheap as far as pharamcy equipment goes).
| Date | Pharmacy | Price for 100mg, ex postage |
|---|---|---|
| 2021 | Complementary Compounding Services | $95 |
| 2021 | Stenlake | $131 |
| 2021 | Green | $198 |
| --- | Hollywood Pharmacy | --- |
I don't know much about these in Australia, but they are available. I've heard that the endo Dr Jon Hayes has prescribed 50mg implants for post-op trans women with low testosterone levels.
Note that testosterone implants don't last as long as estrogen implants, so would need replacing well before the estrogen implants, which is not overly practical. Testosterone (and progesterone) implants also have much higher rates of extrusion than estrogen.
Many, if not most, doctors will give you a prescription for your implants rather than having a supply of their own. If your doctor requires blood tests and an appointment to review levels before writing your prescription then you run the risk of having to wait a considerable time before recieving them. It can be 6 weeks in some cases, during which time you are presumably low HRT. For some of us (me) that's a serious issue. Personally I don't think this is acceptable, and since you cannot insert your own implants there appears to be no reason to do this except to increase their own income.
On the other hand if you are given a prescription for your next implant(s) when you have one inserted there's several issues to be aware of.
Implants are typcially 100mg, but are available as 50mg. The larger they are the longer they will last, and one 100mg implant will last longer than 2x50mg, with lower peak levels. Personally I would never use the smaller implants.
Injections are available in Australia from compounding pharmacies, but very few doctors will prescribe them. Australian doctors regard injections as unproven and dont' want to take a risk (or bother learning), which is the opposite of the USA where injections are popular and implants are unproven.
Related wiki pages
Its posible to get high dose vitamin D3 compounded, including injections. I've used 600,000 IU injections and they are extremly effective, far more so than over the counter suppliments. High dose oral is also available, but I've not tried these.
You'll need a prescription to get this and personally I'd not use it without blood tests. These keep your vitamin D3 levels up for around 12 months. While you can use oral vitamin D3 suppliments instead then don't work well for eveyone (me).
Suppliers
Papers on Vitamin D3
Key Details
CCS are one of the major australian suppliers of estrogen implants (together with Stenlake).
A bit further information on this company. The owner, Dr Michael Serafin, has a Ph.D. in Pharmaceutical Chemistry, which I believe is unusually well qualified for a compounding pharmacy and as a result their facilities are quite advanced.
Estrogen Implants
Implant Cost
CCS can make both 3mm and 4.5mm (ie 5mm) implants. The reason for either size are discussed in Implant Technology. As of 2020 their manufacturing process has not changed in years.
Estrogen Injections
CCS compound injectable estradiol valerate (EV) for around $140 for 5ml of 20mg/ml. I don't know the cost of the more standard 10mg/ml, but I assume its essentially the same as most of the cost is in testing for sterility and labour. Material cost is small. The testing for sterility is interesting as its difficult (and takes 2 weeks), and being able to do it in house is probably related to the owners high level of expertise.
They have recently (as of 2020) started compounding 40mg/ml EV for $145 for 5ml with a 3-month expiry date. As most of the cost is labour/testing doubling the quantity to 10ml costs only slightly more, at around $160 in total. The standard expiry date of 3 months may be an issue for 10ml, but it is possible to ask for a 6-month expiry date (you won't get longer). The advantage of the higher concentrations is that you can inject smaller amounts to achieve your required levels. For the same quantity of EV (in mg) the price is also substantially lower.
Commercially manufactured EV (which is not available in Australia) normally has an even longer two year expiry date, but compounding pharmacies operate under different regulations.
Estradiol Valerate needs to be injected quite frequently and while there other types that have much longer times between injections there's no demand. They could undoubtedly make them, but it would be somewhat expensive to setup and there's no point given the lack of interest. Injectable Estradiol Enanthate is not available as there's no source for the materials (if anyone knows a proper pharmaceutical source please let me know).
Testosterone Implants
I don't know much about this, but Dr Hayes used 50mg on occasion.
Testosterone Injections
I know they make them, but nothing else.
Vitamin D
CCS Compound vitamin D in two forms, both requiring a prescription
Note that its likley vitamin D3 is the one you want.
Key details
Implants
Stenlake are known for producing 4.5mm implants, but I believe they can also make 3mm implants. The reason for either size are discussed in Implant Technology.
50mg implants are $126 each, 100mg implants are $131 each, postage is $10.95 or you can pick them up yourself in Bondi/Sydney.
From April-May 2021 Stenlake were not able to supply implants as their manufacture did not comply with regulatory requirement's (making batches of pellets prior to prescription to reduce cost by the sound of it). Supply has resumed, but there is now an approximate 3-6 week lead time to allow them to serialize them in batches.
Discussion
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NUGen went out of business in April 2021. Their customers are being referred to Terry White Willowdale Compounding
NUGen Pharmacy in Sydney appear to be the most popular and cheapest source of bioidentical progesterone and ship interstate. You will need a prescription.
NuGen can make compound strong topical anesthetics.
NUGen do not (and cannot) supply implants.
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Progesterone, 200mg, $114.95 per 100 tablets in 2020
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Strong topical anesthetics
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Other links
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Estrogen Implants
Implant Cost
Discussion
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Endo Dr Jon Hayes in Sydney uses Biological Therapies "Vitamin D3 Forte 600,000 IU in 1ml OILY Injection". I believe the cost is around $40 or so. This is prescription only.
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Implants
Imports implants from the UK.
Discussion
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Does injections. $85 for 4ml of 20mg/ml Estradiol Valerate (EV). Can also compound Estradiol Cypionate (EC, $120 for 20ml of 10mg/ml in 2020).
Supply injectable estrogen.
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