Compounded Medication

The NSW Pharmacy Trial Revolutionising Medication Accessibility

Empowering Access to the Contraceptive Pill

In a groundbreaking initiative, the NSW Pharmacy Trial is reshaping the landscape of healthcare accessibility, bringing important medications directly to the community through specially trained pharmacists. From September 2023, over 1,000 pharmacies in New South Wales will be able to offer a resupply of oral contraceptive pills (‘the pill’) to eligible women without the need for a traditional prescription.

Participating pharmacists are equipped to resupply a range of oral contraceptive pills, including Combined Oral Contraceptive pills (COC) and Progestogen-Only Pills (POP or the mini-pill). COCs contain a combination of oestrogen and progestogen, while POPs focus solely on progestogen.

Which Contraceptive Pills Are Included?

  • It’s important to note that pharmacists can only resupply pills containing specific types of oestrogen and progestogen, including:
  • Ethinyloestradiol (40μg or less)
  • Levonorgestrel
  • Norethisterone
  • Drospirenone (single-ingredient preparations only).

The helpful team at Fresh Therapeutics will be able to identify what pill you’re taking and confirm whether your pill is included in the trial. The trial emphasises that pharmacists cannot alter the type of pill a patient is taking, ensuring continuity and adherence to the medication prescribed by a doctor or nurse practitioner.

With various brands available, each offering different types and doses of hormones, patients are encouraged to discuss their preferences with the participating pharmacist. While the trial expands accessibility, it remains committed to maintaining the integrity of the patient’s existing prescription, ensuring that pharmacists supply the same pill initially prescribed by the healthcare professional.

What About Other Medications?

This innovative trial extends beyond contraceptive care, with trained pharmacists also empowered to provide medications for treating urinary tract infections (UTIs) for eligible patients between 18-65 years of age. The goal is to evaluate the safety and convenience of obtaining these essential medications directly from pharmacists, eliminating the need for a doctor’s prescription. The study places a strong emphasis on ensuring seamless communication between pharmacists and doctors to guarantee consistent and comprehensive care for patients.

Progressive Patient Care in NSW

The NSW Pharmacy Trial marks a significant step toward a more patient-centric and accessible healthcare system. By leveraging the expertise of pharmacists, this initiative not only streamlines the process of obtaining crucial medications but also strengthens the collaboration between healthcare providers, paving the way for a future where healthcare is more readily available to all. As the trial unfolds, it holds the promise of reshaping how we approach community healthcare, making a lasting impact on the accessibility and convenience of essential medications.

For personalised advice and more information about how this trial could impact your contraceptive choices, visit the pharmacists at Fresh Therapeutics today!

Compounding Chemist Pharmacy

Do You Know the Difference Between a Chemist & a Compounding Pharmacy

When it comes to one’s health, there should be no compromises made. A blanket approach to medication may not work for every individual, and instead a tailored approach is what may be required. Compounding pharmacies make your medicines ‘from scratch’ for you, based on your needs and medical history. Customising medicines with the help of a compounding pharmacist can work wonders, as the medication better serves your specific needs.

What Is a Compounding Pharmacy?

As the name suggests, compounding pharmacies compound your medicines for you. Most times, people visit a chemist or community pharmacy when they need any medication, whether it be over the counter or a prescription. However, compounding pharmacies are a great option, especially when a patient cannot use a commercially manufactured medicine. Compounding medicines is can be a good option for people with specific allergies, or for infants who need only a small dosage of a certain medicine. Pharmacy compounding is also a viable solution for medication for your pets. It’s important to note though that you can only access compounded medication with a prescription.

Compounded medication can come in various forms, like capsules, mixtures, nasal sprays, gels, rapid dissolving tablets, sub-lingual drops, pessaries, suppositories and much more to suit the specific needs of the patient.

The Top Benefits of Compounding Pharmacies

A lot of people don’t know about compounding pharmacies, even though they might be a better option for them over a traditional community pharmacy. There are numerous benefits when you choose to go to a compounding chemist with your prescription, and you should seriously consider them, the next time you need medication that is not available in a manufactured form. Some of these benefits are:

1. Tailor-Made Medicines to Suit Your Needs

The biggest and clearest advantage of compounding medicine is that it can be customised exactly as you need it to be. This is especially helpful for people who may have specific allergies or have shown reactions to certain ingredients used in medicines in the past. Through compounding, ingredients such as preservatives, alcohol or lactose, can be completely sidelined, based on the allergies you have.

2. More Inclusive & Supportive Medication Options

Even if you don’t have any noted allergies, compounded medication can still be advantageous to you by being more inclusive of your specific issues. You may want your medicine in a lower or higher dosage than what is available on the market, or you may want to replicate a medicine that worked well for you but has since been discontinued. A compounding pharmacist can even make vegan medicines for you, since there is complete control over the ingredients and consumables such as the type of capsule.

3. Improved Medical Care for You & Your Family

Because of the customised nature of compounded medication, your doctor and pharmacist will work together to provide the best possible medical solution for you. Your compoudning pharmacist can also help with issues like palatability and add flavours to help make it easier for you to regularly take your medication.

Why Choose Fresh Therapeutics?

Fresh Therapeutics is a compounding pharmacy in Bondi Junction. Our priority is to find the best solution for you and your health, whether that be customised compounded medicine, a wellness plan, screening for major illnesses or even advice about your prescription medicines. At Fresh Therapeutics, we improve outcomes for patients by solving problems pertaining to palatability, allergies, dosage, formulations and even discontinued or unavailable products. We are qualified to tailor-make medicines for you and your pet alike, using state of the art equipment and devices.

You can order your prescription in person or by filling out a simple form online. Most medicines can be compounded in a day, but it could take several days in some cases, if an ingredient or special formulation needs to be sourced, so do keep that in mind. If you have any questions, feel free to call us at one of our pharmacies — Bondi Junction (02 9389 3168) — or come visit us in person.

Urinary Track Infections

Fresh Therapeutics Is Participating in NSW Health’s UTI Medication Pharmacy Trial

Fresh Therapeutics is participating in NSW Health’s UTI Medication Pharmacy Trial. As part of this clinical trial, eligible women from across New South Wales can visit our pharmacy for the treatment of uncomplicated urinary tract infections (UTIs), including receiving advice on how to best manage their UTI.

This clinical trial is being led by the University of Newcastle to gather data on the safety and ease of having pharmacists assess symptoms of a UTI and dispense a medication if appropriate. The data gathered may be used in future research, reports, publications and presentations.

You will not need a prescription for UTI medication from your GP or doctor; our pharmacists will evaluate your condition and dispense the medication if appropriate. Additionally, you will not need to pay for a consultation with our pharmacists. The only fee will be for the medication itself.

To be eligible to participate in this clinical trial and receive UTI medication from our pharmacists, you will need to meet the below criteria.

  • Be aged 18–65 years old.
  • Be female.
  • Have symptoms, such as burning or stinging (hurts) when urinating and/or a frequent or urgent need to urinate.

For further information about this clinical trial, we have provided some answers to frequently asked questions below. Additionally, you can speak with one of our pharmacists or visit the NSW Health website.


What is a clinical trial?

A clinical trial is a research study used by experts to examine a new approach to the prevention, screening, diagnosis or treatment of a medical condition. The aim is to help to continue to deliver safe care with improved understanding.

In this trial, participating pharmacies can supply medications to treat UTIs without women needing to acquire a prescription from their doctor first. The trial is examining how safe and easy it is to get these medicines from a pharmacist.

What is a urinary tract infection?

Commonly referred to as a UTI, this condition is an infection in any part of your urinary system. The urinary system includes your kidneys, bladder, ureters (the tubes that join your kidneys to your bladder) and urethra (the tube that carries urine outside your body).

The infection typically occurs in your bladder (known as cystitis), but it can also present in your urethra (urethritis), kidneys (pyelonephritis) or in multiple locations in your urinary system.

Key symptoms of an uncomplicated UTI are:

  • Burning, stinging or hurting when you urinate.
  • Having a frequent or urgent need to urinate.

What is the difference between an uncomplicated and a complicated UTI?

In this trial, our pharmacists can only provide medication to women they assess as having an uncomplicated UTI.

Your UTI will be classified as uncomplicated if:

  • You are otherwise healthy.
  • You are not pregnant.
  • Your urinary tract is not abnormal and/or has no obstructions.
  • There is an infection in the lower section of your urinary tract (bladder and urethra), as suggested by the symptoms listed above.

If you meet any of the below criteria, your UTI is more likely to be classified as complicated.

  • You are male.
  • You have had a UTI more than once, such as 2 or more in the last 6 months or 3 or more in the last 12 months.
  • You are pregnant or have recently given birth.
  • You are immunocompromised.
  • You have diabetes.
  • You have renal (kidney) disease and/or impaired renal function.
  • You have an abnormal urinary tract, have had surgery or stents on your urinary tract and/or a history of urinary tract obstructions.
  • You have a catheter or had one in the last 48 hours.
  • You have an intrauterine device (IUD).
  • You have symptoms suggesting a more serious infection or one that has moved into the upper urinary tract, like:
    • Fever or chills
    • Rapid breathing or difficulty breathing
    • Raid heart rate
    • Chest pain
    • Headaches, nausea or vomiting
    • Confusion

If one of our pharmacists assesses that you have a complicated UTI, they will refer you to your GP or an Emergency Department as appropriate. This helps ensure you receive the medical care you require.

What will happen if I have symptoms of an uncomplicated UTI?

Firstly, our pharmacist will ask if you would like to participate in the NSW Health UTI Clinical Trial. If you agree, they will ask you to scan the pharmacy QR code and provide consent for your information to be used by the researchers. If you consent to participating in the trial, the pharmacist will take you into the consulting room to ask more questions about your symptoms.

If you are assessed as having an uncomplicated UTI, our pharmacist will give you a urine collection jar and explain that you will need to collect a midstream urine sample before commencing any treatment. This sample will need to be labelled and stored in the fridge to be taken to your GP if symptoms do not improve within 48 hours.

Then the pharmacist will advise the best treatment for your symptoms which may include an antibiotic. The antibiotic should not be taken until the midstream urine sample has been collected. The pharmacist will then explain what to expect from the treatment including any side effects and give you a “Urinary Tract Infection Fact Card.”

How much will it cost to get UTI medication from my participating pharmacist?

In this clinical trial, you will not need to pay for a consultation with our pharmacist. The only fee will be for the medication; this will be the same as if you have a prescription from your GP. You can learn the exact pricing by speaking with one of our pharmacists.

Are pharmacists qualified to prescribe this medication to me?

As part of this clinical trial, our pharmacists have received additional training from the University of Newcastle and the Pharmaceutical Society of Australia to help them assess the appropriate treatment for your symptoms. This training is based on international best practice.

This training includes guidance and protocols to follow in regards to who is eligible to receive the UTI medication, and who should be referred to to their GP or an Emergency Department. This ensures you receive appropriate care, whether you have a complicated or uncomplicated UTI.

If I participate in this trial, what personal information will need to be provided and how will it be used and kept safe?

To receive advice and medication from our pharmacists, you will need to provide:

  • Your name
  • Your date of birth
  • Your contact details
  • Your GP’s name (if you have one)

You will also be asked for your consent to participate in the trial. This includes consenting to receiving a follow-up call or survey from the trial researchers 7 days after speaking with one of our pharmacists. All information you provide will be kept confidential and secure by our pharmacists. The research team will then collect it from us.

Your personal information and data will be securely stored by the University of Newcastle for at least 15 years after the project has been completed. It will be stored according to the University of Newcastle’s Research Data and Materials Management Guideline (or any successor Guideline), as well as any other applicable University of Newcastle policy provisions.

Additionally, if the data gathered from the trial is used in future publications, reports and presentations, it will be presented in such a way that no participants can be identified.

Do You Have a UTI?

If you are experiencing UTI symptoms and meet the eligibility criteria described above, please visit our pharmacy. Our pharmacists can assess if you have a complicated or uncomplicated UTI, and provide medication or referrals accordingly.

Mental Health Connected To Physical Health

How Your Mental Health Is Connected to Your Physical Health?

Mental health often isn’t given the weight it deserves in day-to-day life. Most of the time, it is shoved off as nothing at all or just a lazy excuse to get out of doing things. However, this is never the case. Mental health is a vital part of your existence and has a great impact on how you live your everyday life. It is important to treat mental health problems seriously and seek appropriate help.

Why You Shouldn’t Ignore Your Mental Health+?

In today’s society, mental illness has a lot of stigma attached to it. It is often talked about in whispers or with an air of judgment. Due to the way in which mental illness is perceived, many tend to ignore or dismiss any signs of mental health problems, like anxiety or depression, and console themselves by saying ‘it’s all in your head.’ However, this can have adverse effects on the body in the long run.

Mental health issues left unmanaged may lead to much more serious health risks in the future. So, it is always advised to seek the help you need to nip it in the bud and deal with the problem as soon as you spot it.

The Link Between Your Mental & Physical Health

A physical illness is an indication that a part of your body is damaged and, in response to that, you need to seek treatment to help that body part heal and get better. It is the same thing with mental illness. The body part in question here is your brain.

When you are dealing with issues like anxiety and depression, you need to seek ways to help your brain. If it is not given the proper care and treatment it deserves, things can deteriorate over time, and you may find that your body also becomes affected.

With advancements in medical studies, it has been proven that there is an inextricable link between our mental and physical health. If either one of them swings out of balance, it can be harmful to us. For instance, it has been observed that people with mental illness are more likely to develop physical illnesses and have a shorter life expectancy than the rest of the general population. In fact, those with mental illness are at a higher risk of developing chronic diseases over time.

Some physical problems that can arise as a result of ignoring or not treating a mental illness include weakening of the immune system, weight loss or gain, migraines, and chronic diseases like cardiovascular disease. In addition to this, people who have untreated mental illness may be more prone to engage in smoking, alcohol or substance misuse as a coping mechanism. These unhealthy habits can lead to further drops in one’s physical health, leading to problems with the liver, lungs and blood among other things.

Signs of Mental Health Issues You Should Never Ignore

You can only treat a mental health problem if you are able to recognise it in the first place. If you have not experienced mental health issues before, you may write off warning signs, until the problem has snowballed. With common mental illnesses, including depression and anxiety, things can start small. You may not even notice the initial symptoms. However, knowing what to look for can make treatment and recovery easier. Some common signs are:

  1. Chronic insomnia
  2. Extreme fatigue
  3. Social withdrawal
  4. Unexplainable and long-lasting sadness or irritability
  5. Dramatic loss of appetite or increased appetite
  6. Extreme mood swings
  7. Loss of interest for things you once enjoyed doing
  8. Overthinking and constant worrying

Finding Treatment

It can be difficult to accept that you are dealing with a mental illness. However, it is nothing to be ashamed of. What is important is to ensure you are cared for and advocating for yourself. Once you have spotted the signs, it will be easier for you to seek appropriate help.

Taking the Next Steps

At Fresh Therapeutics, we have pharmacists trained in Mental Health First Aid and who have completed the Mental Health Community Pharmacy Program. This means we have been recognised as safe pharmacies to discuss mental health problems with people in the community.

Our pharmacists are also participating in research through Sydney University looking at “Establishing Mental Health Friendly Pharmacies to Assist in the Early Identification and Support of Older Adults at Risk of Depression”.

We have self-care health information that can provide you with the necessary facts for maintaining your mental health. We may also provide information and referrals for managing mental health problems like anxiety, depression, PTSD and sleeping problems. Additionally, if you have been prescribed medicines for a mental illness, we always try to help you understand what to expect from the medication and how best to manage it.

If you have a mental health problem are and in Bondi and need a chemist near you, our pharmacy staff can be of assistance. Contact Fresh Therapeutics today on (02) 9389 3168 (Bondi) to feel better sooner!

Vaccine is Important

Why Vaccinate?

Vaccinations are a common topic of discussion these days, but it isn’t always easy to find clear and accurate information on what they are or why they are recommended. As a trusted compounding pharmacy, our team at Fresh Therapeutics understands the importance of feeling comfortable before getting vaccinated. This is why we have decided to create a straight-forward guide to vaccination that will address all of your unanswered questions.

How Do Vaccines Work?

Vaccinations are developed to prevent the occurrence and spread of disease. Miraculously, they protect us from harmful diseases before we even have the chance to catch them. They do this by working with our body’s natural defences to build resistance to certain infections.

Vaccines contain killed or weakened forms of germs like bacteria or viruses. When you get vaccinated, your immune system will respond by first recognising the invading germ, and then producing the correct antibodies to fight it. From this point onwards, your immune system will remember the disease and know how to combat it. If you are exposed to that same germ in the future, your immune system will be able to respond quickly and destroy the infection before you get sick. It should be noted that the weakened form of the germ contained in the vaccine is not strong enough to actually cause the disease or put you at risk of its effects.

Why Should You Get Vaccinated?

Medical professionals strongly encourage vaccination for two reasons; to protect yourself, and to protect others. Getting vaccinated will minimise your risk of becoming seriously ill or disabled from an illness. The danger posed by potentially life-threatening illnesses such as measles, meningitis, tetanus, pneumonia, and polio are significantly lessened by vaccinations. According to WHO, childhood vaccines alone are estimated to save over 4 million lives every year.

Although some of the diseases listed are no longer common, it is important to take the preventative measures available and get vaccinated. The germs that contribute to the spread of these diseases still exist in some or all regions of the world, and can easily cross borders to infect unprotected populations. Making the choice to get vaccinated will also protect others, as vaccinations are not available to everyone. People who are seriously ill or have specific allergies, as well as very young babies, are all unable to get vaccinated. This means that they rely upon others to protect them from vaccine-preventable diseases.

Are There Any Side Effects to Vaccination?

Vaccines can cause mild side effects that last a few days without medical intervention. These side effects include a low-grade fever, or pain and/or redness at the point of injection. Side effects such as these are normal, manageable, and not unlike those experienced from any other medication. Severe or long-term side effects are extremely rare, but vaccines are monitored after their administration on the odd chance that they occur.

How Long Are You Protected After Vaccination?

Vaccines prepare your immune system for the possibility of future infection. After being exposed to the germ via the vaccine, your immune system will remember the associated disease and know how to fight it. Since your immune system has an excellent memory, one or two doses of a vaccine will be enough to keep you protected for years, decades or even a lifetime. Vaccines are so effective because of this very reason. Rather than treating illnesses, they prevent them from ever occurring in the first place.

medAvisor and myPharmacyLink at Fresh Therapeutics

How to use MedAdvisor and myPharmacyLink?

How MedAdvisor and myPharmacyLink Can Help You?

Digital prescription services such as MedAdvisor and myPharmacyLink are more important than ever in light of the Covid-19 epidemic. These services provide an easy, reliable and contactless way to access your medications including compounded medication. If you’re unfamiliar with these services or have yet to visit a compounding pharmacy, Fresh Therapeutics are here to guide you towards an easier process.

What is a compounding pharmacy?

A compounding chemist or pharmacy operates just as a regular, community pharmacy would, apart from one major difference. While a pharmacist provides standard manufactured medications for the general public, a compounding pharmacist can also make prescribed medications for patients with particular needs. These are patients who, due to factors such as their age or allergies, are unable to take commercially made medication. For example, children can sometimes require medication that is made for adult patients. In this case, pediatric compounding is necessary to produce medication in a dosage appropriate for a child.

Recently, compounding pharmacists are in particular demand as a result of Covid-19. Shortages in manufactured medicines have made it difficult for some patients to access their regular prescription medications. To solve this problem, pharmacists can compound medications and provide individualised dosages to various patients.

What Are Compounded Medications?

Compounded medications are created when various ingredients are combined in the exact strength and dosage form required to meet a particular patient’s needs. Medications can be compounded into mixtures, suspensions, capsules, creams, and nasal sprays; and can even be flavoured according to a patient’s preference.

Where Can I Find a Compounding Chemist Near Me?

If you’re seeking a compounding chemist in Sydney Fresh Therapeutics has you covered. Our locations in Bondi Junction that is open seven days a week for your convenience. Along with customised compounded medications, Fresh Therapeutics offer personalised wellness plans and advice for people with minor or chronic illnesses. We also provide services for infant and child health, and breast pumps for hire.

How Do Digital Prescription Services Work?

Digital prescription services provide users with a way to fulfil their pharmaceutical needs online. Both MedAdvisor and myPharmacyLink are free applications that are easy to install and simple to navigate across multiple devices. They essentially act as a virtual pharmacist that caters to your specific medication requirements.

Features of Digital Prescription Services Include:

  • Access to your local pharmacy allows users to easily order and pay for medications online.
  • A notification system that can tell users when their orders are ready to be picked up.
  • Using myPharmacyLink or Medadvisor specifically, users have the option of getting orders delivered to their door.
  • An automatic storage system that keeps a personalised medication history for each user.
  • A notification system that reminds users when to refill scripts and visit the doctor for script renewals.
  • Access to detailed information about relevant medications, including how and when to take medicines, their potential side effects, their ingredients, and more.
  • Option to add other profiles onto a personalised account, which allows users to provide medications for consenting family members.
  • A notification system that can alert users when it’s time to take their medications.
  • A messenger system that connects users directly to their pharmacist.

What Are the Benefits of Using Digital Prescription Services?

The unending process of ordering medications can be incredibly stressful, especially for those with multiple prescriptions. In fact, many Australians find themselves taking their medications incorrectly due to confusion over their dosages or delays between scripts. At Fresh Therapeutics, we encourage the use of digital prescription services in order to make pharmaceutical errands easier. This is made even easier if your doctor prescribed electronic prescriptions (tokens). If you have paper prescriptions you can send a photo of the prescription using the Medadvisor or MyPharmacylink App. You then bring the paper prescription into the pharmacy when you collect your medications.

The Benefits of Digital Prescription Services Include:

  • Limits the time spent inside pharmacies, which is particularly pertinent during the Covid-19 epidemic.
  • Users don’t waste time at the pharmacy waiting for an order, as the apps notify them when their medications are ready.
  • Notification systems and easy-to-access information make it easier for users to take their medications correctly.
  • No unexpected delays between scripts.
  • Stores all scripts in one convenient location.
  • Automatically updates medication history so that users don’t have to keep track.

Should I Be Using MedAdvisor or myPharmacyLink at Fresh Therapeutics?

If you are a Sydney resident looking for convenient access to a compounding chemist, we highly recommend the use of digital prescription services. At the Fresh Therapeutics in Bondi, myPharmacyLink is the application of choice.

For more information on our pharmacy and compounding services, visit our website or contact us today.

COVID-19 Coronavirus and Compounded Medication

Covid-19 Compounding Pharmacy More than…

This is the first time we’ve had enough time to put pen to paper to talk about the impact Covid-19 has had on a compounding pharmacy like Fresh Therapeutics

Covid-19 – When you may need a Compounding Pharmacy more than ever

The immediate response for us was to ensure our pharmacies were safe for our customers and staff. We implemented our Pandemic procedures for disinfecting the premises, consumer distancing and staff temperature monitoring as well as the wearing of personal protective equipment. We sourced more than the usual stock of face masks, hand sanitiser and thermometers.

But as the days went on and stockpiling of medicines occurred we found that many patients, particularly parents of young children were unable to access the manufactured form of their much needed medicines.

We found we were compounding a variety of medicines into various dosage forms from mixtures and suspensions to capsules, creams and nasal sprays. Many parents were delighted that we could compound their child’s medicine in a flavour that their child preferred. And adults were happy they could continue taking their medicine without a break in treatment which for some conditions could have been harmful.

As we came out of the first wave we found many of our dermatologists were then inundated with new patients wanting either creams/ointments or gels for newly diagnosed skin conditions or anaesthetic creams for cosmetic procedures.

So if, and when, the second wave hits and manufacturers are again unable to supply your medicine remember to contact our Compounding Pharmacy in Bondi Junction where we can work with your doctor to solve most medication problems.

Mucositis Coding Scale

Cancer Treatments, Mucositis & Mouthwash

Oral mucositis (inflammation of the mucosa lining of the mouth) and mouth of ulcers is a widespread and potentially serious consequence of high-dose chemotherapy and radiotherapy.

Symptoms, which may include altered taste perception, sores, and varying degrees of pain, usually appear 4 to 5 days after chemotherapy or radiotherapy treatment initiation.

A compounding pharmacist can formulate a specialised preparation such as a mouthwash to help manage the discomfort. There are various formulations that pharmacists can use based on the experience and needs of the individual physician and patient respectively.

Mucositis, painful inflammation and ulceration of the mucous membranes lining the digestive tract, can involve both the oral tract and the gastrointestinal tract. Oral mucositis is a widespread and potentially serious consequence of certain high-dose chemotherapy and radiotherapy treatments. It is a devastating consequence of cancer treatment for patients, who then find it extremely difficult to perform simple, everyday mouth-related activities, including chewing, biting, talking, swallowing, drinking, and sipping.

Oral and gastrointestinal mucositis affects up to 100% of patients undergoing high-dose chemotherapy and blood stem-cell transplantation and 80% of patients with malignancies of the head and neck who are receiving radiotherapy. Mucositis also affects a wide range of patients receiving chemotherapy.

Causes of Mucositis

About 5% to 15% of all patients undergoing cancer treatment experience mucositis. TABLE 2 details the grades of oral mucositis as defined by the World Health Organization (WHO). In grade 3 oral mucositis, the patient is unable to eat solid food; in grade 4, the patient is also unable to consume liquids. Radiotherapy to the head and neck or to the pelvis or abdomen is associated with grade 3 oral mucositis in more than 50% of patients. Among patients undergoing head and neck radiotherapy, pain and decreased oral function may persist long after the conclusion of therapy. HIV infection may cause oral thrush.

Grading System for Oral Mucositis

Oral mucositis is characterized by damage to the epithelial or lining cells mouth and throat. Epithelial cells normally serve as a barrier between the inside and outside of your body and protect it from viruses.
Because of their relatively high turnover rate compared with cells in other organs, epithelial cells are particularly susceptible to the damaging effects of radiation and chemotherapy. A reduction of the saliva barrier, disruption of epithelial cells, thinning of the epithelium, and ulceration also occur. Other conditions can contribute to oral mucositis, including oral infections and trauma or irritation.


Cancer patients who are undergoing chemotherapy usually develop symptoms of oral mucositis 4 to 5 days after treatment is initiated. A peak is reached at around day 10, followed by slow improvement over the course of a few weeks. Radiotherapy-induced mucositis, which usually appears at the end of the second week of treatment, may last for 6 to 8 weeks.

As a result of epithelial-cell death, the lining of the mouth thins sloughs off and becomes red, inflamed, and ulcerated. Ulcers range in size from 0.5 cm to greater than 4 cm. Oral mucositis can be extremely painful; the degree of pain, often described as a burning sensation, is usually related to the extent of the tissue damage. As a result of the pain, the patient may experience trouble speaking, eating, or even opening the mouth.

Alterations in taste perception are common, especially in patients receiving radiation therapy to the neck and mouth. An altered sense of taste is a temporary condition that occurs because of effects on the taste buds located mainly in the tongue. Common complaints are that food tastes too sweet or too bitter or continually has a metallic taste. In some cases, only partial recovery of taste occurs. Severe pain and the inability to chew, swallow, or talk may ultimately lead to dehydration and malnutrition. The lack of saliva can cause tooth caries, loss of fillings, mouth ulcers, and pain, as saliva has a cleansing effect on the mouth and controls bacteria.3
Pain and loss of taste perception make it more difficult to eat, which frequently leads to weight loss. Infection of the sores or ulcerations by a virus, bacterium, or fungus can occur. About half of all patients receiving chemotherapy develop severe oral mucositis that may require modification of the patient’s cancer treatment.


For patients undergoing chemotherapy, radiotherapy or preventive strategies should be started before the cancer treatment. These include:

  • a pretreatment dental examination
  • good oral hygiene such as cleaning the mouth every 4 hours and at bedtime
  • brushing the teeth with a gentle toothbrush two or three times daily and a non-detergent toothpaste,
  • flossing between the teeth
  • using an alcohol-free mouthwash.

If saliva dries up the patient could:

  • use artificial saliva (ask your compounding pharmacist) or
  • chew sugar-free gum

If the mucositis develops and is painful the patient could:

  • Use a special mouthwash formulated by a compounding pharmacist depending on your specific symptoms that may include an anaesthetic, an antiseptic, an antifungal, a barrier protection agent, an anti-inflammatory or an anti-viral.
  • Drink plenty of liquids – at least 3 litres per day
  • Avoid alcohol
  • Avoid citrus fruits, tomatoes, acidic foods, alcohol, and hot foods that can aggravate mucositis lesions.
  • Eat food that is soft, non-spicy, pureed, or in liquid form. Harder foods should be treated to make them soft and easy to eat.
  • Refrain from smoking.
  • Suck ice cubes. This is a simple, but often effective, method

Compounded Preparations

Your compounding pharmacist can discuss the various ingredients that can be incorporated into a mouthwash depending upon the various symptoms being managed. In addition, they can flavour a custom mouthwash according to the patient’s individual preferences.

Alternatively, the medicines may be compounded into an ice-block, paste or lollipop and can be flavoured.

Two woman looking after unconscious woman

Fresh Therapeutics Is A Trial Site For The Australian Government Take Home Naloxone Pilot

Take Home Naloxone Pilot

The Australian Government is investing $10 million in a take-home naloxone (THN) pilot in New South Wales, South Australia, and Western Australia. This pilot is commencing on 1st December 2020 and will continue until the 28th February 2021.

What is Naloxone?

Naloxone is a drug that reverses the effects of an opiate and can therefore reverse an opioid overdose. It can be injected or delivered through a nasal spray.  In the THN pilot, naloxone (as either Naloxone Hydrochloride (DBL), Naloxone Juno, Nyxoid and Prenoxad) will be available for FREE to people who are at risk of, or who may witness, an opioid overdose. No prescription will be required for the drug.

How does Naloxone work?

Naloxone reverses the effects of opioid drugs, albeit temporarily. This works by displacing the opioid molecules already within the person’s system in the brain and body. During an opioid overdose, drugs fit into receptors and brain signals are therefore blocked. This leads to a slowing or complete failure in breathing. The person may then fall unconscious. However, once naloxone is administered, it fits more strongly into the receptors within the brain and body causing the opioid molecules to be displaced for a time. The brain signals can then resume as normal, breathing will continue, and the person should then regain consciousness. 

What to do if you carry Naloxone with you?

Carrying naloxone with you regularly is always a good idea if you are an opioid user, or if you are regularly around an opioid user. This could be a family member, spouse, close friend, etc. Ensuring that you are stocked on naloxone that is in date is imperative, in case you ever need to administer it. You should set a reminder on your calendar or phone around one month before the naloxone is set to expire. This will give you enough time to arrange for and pick up a replacement.

When do you use Naloxone?

If you know for a fact that someone has overdosed from an opioid drug, then you should administer naloxone. Even if you only suspect they have done so, it should also be used. You should also remember to call an ambulance as quickly as possible. If there are two of you there with the person, one of you should administer while the other calls the emergency services. Even if the person wakes up, you should still call the ambulance, as they could fall unconscious again at any moment. However, always be aware of your own surroundings, stay safe, and keep in mind that they may be aggressive if they do regain consciousness. 

Why is this trial happening?

Unfortunately, throughout Australia, Opioid use is a major cause of both hospitalisation and death. Therefore, the Australian government has now decided to make an active change in order to treat and improve the issue. The following statistics outline just how serious the problem is in this part of the world:

  • Every single day, three people die from drug-induced deaths involving opioid use in Australia, while nearly 150 hospitalisations and 14 emergency department admissions involve opioids across the country.
  • More than 110,000 Australians are currently struggling with opioid dependence.
  • In 2018, 1,740 people died from drug-induced deaths, with opioids present in 1,123 of those deaths (64%).

At Fresh Therapeutics Compounding Pharmacy, we will be offering Naloxone FREE of charge to people prescribed opiates, people that use illicit opiates or people who may witness a person overdosing on opiates. As well as this, we will also be providing clean needles from our needle exchange to those who inject opiates.  

If you are not sure if a drug you or a family member is taking is an opiate, ask our pharmacists or call us on 0292816816

What is an opioid overdose or adverse reaction to opiates?

A person who has taken either a large amount of opioids or some strong opioids can overdose or experience an adverse reaction. They may be:

  • unconscious
  • unresponsive
  • awake, but unable to talk
  • vomiting
  • making choking sounds, or a snore-like gurgling noise

They may also have:

  • stopped breathing or have slow, shallow or erratic breathing
  • bluish-purple skin (in lighter-skinned people) or greyish or ashen skin (for darker-skinned people)
  • a limp body
  • a pale or clammy face
  • blue or purplish black fingernails and lips
  • slow, erratic or no pulse (heartbeat)

If someone at risk is making unfamiliar sounds while ‘sleeping’, try to wake them up in case they have overdosed.

Steps For Opioid Overdose Response - Fresh TherapeuticsPreventing and responding to opioid overdose - Fresh Therapeutics


Who is at risk of an opioid overdose or adverse reaction to opiates?

People who are dependent on opioids are at higher risk of an overdose if their tolerance to the drug is reduced. This can happen if they stop taking opioids for a while (for example if they have been in drug rehabilitation or in prison).

Other risk factors include:

  • using opioids in high doses with other sedatives — for example, benzodiazepines, 
  • some medical conditions — for example
    • depression
    • HIV
    • liver disease
    • sleep apnoea
    • lung diseases, such as chronic obstructive pulmonary disease or pneumonia
  • living in a home where opioids are stored


What to do if you witness a person having an opiate overdose?

If you witness someone having an opiate overdose this is what you do:

1. Check for signs of overdose

Approach with care. Check for dangers, such as injecting materials that might be lying around

Check for a response, to see if the person is conscious. You can:

  • shout their name
  • gently shake their shoulders
  • talk loudly into their ear
  • rub their breastbone (sternum)
  • pinch their ear or the bed of their fingernail

Check airways and breathing

Clear the mouth and nose of any blockages

For 10 seconds, check for breathing — is the chest moving? Can you hear breathing sounds? Can you feel breath on the cheek?

 Check for signs of overdose, such as:

  • no response to touch or sounds
  • slow, uneven breathing or no breathing
  • snoring, gasping or gulping
  • blue or purple fingernails or lips

2. Call Emergency Services ‘000’

  • Always call for emergency services immediately, even if the person wakes up.

NALOXONE is not a substitute for emergency medical care or basic life support (such as CPR).

Put your phone in loudspeaker mode if possible, in order to keep your hands free.

Give emergency services as much information as you can, including:

  • your exact location and postcode (if known)
  • what substances you think the person may have taken
  • whether they are conscious and breathing
  • that you plan to give Naloxone

3. Administer Naloxone

Our pharmacist will show you how to administer the Spray or Injection. Peel off the back of the container before taking out the spray itself. With the person lying flat on their back, support the back of their neck and tilt the head back. Remove anything that is visibly blocking their nose. Hold the spray with a finger on either side of the nozzle and your thumb on the bottom of the plunger. Never press it before use. You do not need to test it or prime it. Insert the nozzle of the spray bottle into one nostril, it does not matter which you choose. Press the plunger until you hear a click sound, this will tell you that all of the dose within the bottle has been administered. Take the nozzle away from the nostril. Remember which nostril you administered into in case you need to re-administer into the second nostril later.

Alternatively, you can watch these handy videos:

Nasal Spray:


4. Put the person into the recovery position

Putting someone in the recovery position can improve their condition until the emergency services arrive. However, we appreciate that many people do not know exactly how to put an unconscious person into this position. Place the person’s nearest arm up at a right angle to their body, in a bent position. Then pull their far arm across their chest, placing the back of their hand against their opposite cheek. Get hold of their furthest leg above the knee, lift it, and roll them towards you until they are on their side. Then use their hand to support their head and bend their top leg at the hip and knee.

CALL our pharmacists at Fresh Therapeutics for more information

5. Monitor until help arrives

Stay alongside the person and monitor their breathing, watching for any signs of improvement. Also, monitor their ability to respond to your sound and your touch.

If the person in question is not conscious, nor breathing normally, then now is the time to administer basic life support, but only if you are trained to do so. This includes things such as CPR.

The most important thing is to constantly be aware. Even if the person wakes up, that is no reason to let your guard down, as they could easily fall unconscious and stop breathing again.

6. What to do if there is no response

If you have gone through the above five steps and there has been no improvement after two or three minutes, or the symptoms return, use a brand new spray in the next nostril. Keep the person in the recovery position while you do this.

7. Remember your own safety

If the person in question is dependent on opioid drugs, you must be careful of the acute withdrawal symptoms that some sprays may cause. If and when a person regains consciousness after using the spray, they may act with aggression for a period of time. Keeping your own safety in mind is always imperative. Symptoms of acute withdrawal can include things such as nervousness, irritability, sweating, shivering, runny nose, fever, sneezing, nausea, vomiting, diarrhoea, aches, cramps, and more.

8. What to do once the ambulance

The first thing you should do is inform a member of the emergency services that you have administered a spray, before telling them which spray it is and handing them a sample bottle of it. If you forget to do the above, you should still hand the used bottles over to a pharmacist or healthcare professional in order to arrange proper disposal and replacements.  Never put the sprays into water waste. Never throw the spray bottles in with your household waste or recycling.

 Training Card for Patients and Carers - Fresh Therapeutics What is Nyxoid - Fresh Therapeutics


Check for signs of overdose - Fresh Therapeutics Training Card for Patients and Carers - Fresh Therapeutics

Compounding Pharmacy Australia | Customised Medication

What is a Compounding Pharmacy?

Sometimes a “one-size-fits-all” approach to medication does not work for everyone. It means that patients’ needs are not met by a traditional dispensing pharmacy. We have the ability to compound products tailored to suit the needs of our customers, giving them access to the best medicine for their personal needs. 

You’re likely to visit a pharmacy when you need to pick up your prescriptions, but have you ever visited a compounding pharmacy? 

Most people don’t know the difference between a regular and compounding pharmacy. A compounding pharmacy is a speciality pharmacy that can make a medication prescribed by a doctor, for patients that cannot use a commercially manufactured medication. Often, a compounding pharmacy is used for people with allergic tendencies or for those that are very young and need a small dosage of a certain medication. 

Unlike ordinary pharmacies that sell manufactured medicines, a compounding chemist will compound (mix) and package your prescription onsite – we often say “make it up from scratch”. Compounding is the process of making a medication from raw ingredients that are either not readily available on the Australian market, currently out of stock or were not manufactured in the precise dose and/or dosage form that you have been prescribed. 

Working with your doctor, compounding allows our pharmacists to customise the strength and dosage of a medication according to your individual needs.

Compounding pharmacies will only issue medications that are obtained via a prescription from a medical doctor. This is a safe and reliable way to obtain customised medications. They are individualised for the patient and not administered as a set and predetermined dose like commercial medications.  Some compounding pharmacies undergo an extra quality assessment to provide consumers with confidence that the product has been compounded to compounding standards.  The Pharmacy Boards around Australia are currently reviewing their assessment of compounding pharmacies in an effort to improve the standards of delivery of compounded medicines.

How can someone know if compounding is the right choice for their medication or supplements?

There are many situations where compounding medicine can be helpful. Compounded medications can be great for people who cannot swallow pills, such as the elderly or young children, and need an alternative form such as a cream or liquid. Many people are allergic or sensitive to particular ingredients in mass-produced medications, and these can be removed in a compounded medication. 

A compounding pharmacy can also create custom doses for someone who needs larger or smaller doses than the ones that are mass manufactured. In addition, compounding is worth looking into for pet needs, as the medication will be compounded specifically for your animal. 

Overall, compounding is the perfect solution for anyone who cannot tolerate mass-produced medications for any reason. It may also minimise side effects because a compounding pharmacist can help a patient get the appropriate dosage needed whilst removing any ingredients that pose a problem for that patient such as lactose, colouring agents, gluten or preservatives.

There are so many prescription medications available. Why do we need compounded medications?

Some medications are only available by compounding. For people with strict dietary and allergy requirements, compounding the medicine may be the only option. Also, compounding pharmacies cater to medication that has been discontinued or is no longer being manufactured in bulk. 

What is involved in compounding medication? 

  • The dosage compounded is tailored exactly for the patient
  • Medication compounded can come in many forms including patches, chewable’s, suppositories, mixtures, rapid dissolve tablets,  or gels
  • The medicine can be compounded free of problem-causing ingredients like certain preservatives, alcohol or lactose that may cause an allergic reaction 
  • The medicine can be compounded in a vegan (eg. cellulose) capsule instead of an animal-sourced capsule (eg. gelatin)

Can I buy compounded medication without a prescription?

No. Compounded medication acts in the same way as traditional medication. If the active ingredient in the medication can only be prescribed by a doctor then you must obtain a prescription in order to be able to purchase the compounded medication. Most compounding pharmacies (including Fresh Therapeutics Pharmacies) require a prescription for any medicine that is compounded. 

Can I have my prescription medicine compounded if it is cheaper to have it compounded?

No. In Australia, it is illegal to compound and sell medicine that is already produced by a pharmaceutical manufacturer.  Only medicines that are not available by a commercial manufacturer and prescribed by a doctor registered in Australia can be compounded.

I want to visit a compounding pharmacy. Where do I find one?

Your GP will be your first point of contact when it comes to prescription medicines to be compounded. There are many compounding pharmacies in Sydney. Get in touch today. 

What is the difference between a pharmacy and a compounding pharmacy?

Commercially available medications are manufactured by pharmaceutical companies in mass quantities for the general population with no specific patient in mind. Compounded medications are ordered by a physician, individually prepared by a compounding pharmacist and made specifically for a person’s unique medical needs

How long does it take to compound my medication?

The wait time varies depending on the complexity of the prescription required for compounding. Usually, the medicine can be compounded within a day. However, if an ingredient needs to be ordered, the process can take several days so it is best to check with your Compounding Pharmacy. If you need a repeat of a compounded medicine, it will need to be compounded again, as every medicine is bespoke and created to tailor for each specific patient. 

As experienced compounding pharmacists, we have outlined the benefits for compounded medication.

Various Forms
Sometimes, patients may need their medication in a different dosage form. For instance, some people who have difficulty swallowing tablets or capsules may find it easier to take their medication in liquid form. Some medications can be also compounded in cream or gel forms and the medication is absorbed through the skin. As a compounding pharmacy, we can offer medicines in various forms depending on the best solution for you!

Discontinued Medications
When large manufacturers discontinue production of a certain medication, they make it hard for the patients who still need these medicines. Compounding pharmacists play an important role in providing access to discontinued medications by compounding pharmaceutical-based ingredients in order to ensure that patients get the critical care they require. Compounding pharmacies have access to the quality tested pharmaceutical ingredients and can fill the prescription using the latest research, quality control process, and techniques that help meet the individual patient needs. If you want to learn more about discontinued medication, get in touch with us.

Easy to Use
Some medications taste extremely unpleasant, making it challenging for the patients to take them as directed. A compounding pharmacist can customise the prescription from scratch with the patient’s flavour of choice. This is especially handy when dealing with patients who may refuse medication, like young children, elderly patients, or even pets.

We understand that each individual is unique and complex. Many of our patients have issues with allergy, sensitivity, intolerance to dyes, lactose, gluten, fructose or alcohol. These can cause unwanted reactions when taking a certain medication. In other cases, traditional manufactured medications may contain preservatives that cannot be tolerated by the patient because of sensitivities or allergies to these substances. A compounding pharmacist can make a formula without the offensive ingredients, so a patient can still get the right treatment.

Unique Services at our Compound Chemist Bondi
When it comes to compounding, identifying our patients’ needs is our top priority.  What flavour of an oral medicine would they prefer? Can we compound the medicine in a different sized capsule? Can the medicine be safely delivered through the skin, under the tongue, through the nose or maybe through the vagina? Can we safely combine several medicines in one capsule?  What side effects are our patients dealing with? What questions might they have when they take their medicine? We often do a lot of research to source the active ingredients, determine a formula and develop the method to compound the medicine. As a compounding pharmacy, we offer patients a service they can’t receive at most other pharmacies. 

Compounding pharmacies are often unheard of. If you have any specific medical or allergic requirements, speak to your GP about compounding your medicine and how it can help you. Alternatively, we have trained pharmacists onsite that are more than happy to give you reputable advice. 

For your customised compounded medication, including health plans or advice about prescription medicines, get in touch with our friendly and knowledgeable compounding pharmacists today. Visit one of our stores today or call us on 02 9389 3168.