The agency has latched onto this false conclusion from a report it commissioned, and it is another direct threat to estriol and compounded bioidentical hormones’ future. Action Alert! The FDA’s announcement regarding bioidentical hormones came just hours after the National Academy of Sciences, Engineering, and Medicine (NASEM) released their report reviewing the “clinical utility” ofApr 29, 2011 · The term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16. Bioidentical hormones are man-made hormones derived from plants, often soy and yams, that are chemically identical to those the human body produces. As such, they bind to the estrogen and testosterone receptors in the same way as women’s endogenous hormones have throughout their lives . The U.S. FDA has approved some forms of manufactured ...Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies. UConn toxicologist José Manautou, who heads the department of pharmaceutical sciences, served on the committee that wrote the National Academies report.A long list of FDA-approved hormone products contain 17-beta estradiol and, therefore, are bioidentical. Examples include oral esterase, estradiol transdermal patches (Climara®, Vivelle®) and the vaginal ring (Estring®). Prometrium® is an oral FDA-approved bioidentical progesterone product. The next misconception is that progesterone ...Bioidentical progesterone replacement therapy is commonly used by perimenopausal and postmenopausal women whose shifting hormone levels severely affect their well-being, causing symptoms such as irritability, hot flashes, difficulty concentrating, loss of libido, and more. However, women of reproductive age may also choose to take bioidentical ...Oct 24, 2013 · The FDA has approved several bioidentical hormones. Somers' books, however, describes custom-compounded bioidentical hormones, meaning they are produced by a pharmacy mixing ingredients of various ... Menopause is a normal, natural change in a woman’s life when her period stops. That’s why some people call menopause “the change of life” or “the change.”. During menopause a woman’s ...Bioidentical hormones have the exact same chemical and molecular structure as hormones that are produced in the human body. Bioidentical hormones are available as FDA-approved hormone formulations. Nonapproved custom-compounded preparations are marketed as bioidentical, but content is uncertain.Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...Compounded drugs have long been part of the medical armamentarium. Through drug compounding, compounders may offer therapeutic alternatives for patients with unique medical needs that cannot be met by U.S. Food and Drug Administration (FDA)-approved drug products (FDA, 2017a). The Federal Food, Drug, and Cosmetic Act (FDCA) of 1938 is the primary source of FDA's authority over prescription ...Jul 7, 2010 · "It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ... Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process.Dec 12, 2022 · The U.S. Food and Drug Administration (FDA) has approved some forms of manufactured bioidentical hormones, including bioidentical estriol (a weak form of estrogen) and progesterone. A list of FDA-approved testosterone products can be found by searching for ... Testosterone is a hormone essential for the growth and development of male sex organs and maintenance of secondary ...Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ...FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval ManufacturerApr 14, 2021 · not currently available as an FDA-approved drug product” (p. 195). “The term ‘bioidentical hormone’ generally refers to sex steroid hormones, usually an estrogen, an androgen or progesterone, that has the same chemical and molecular structure [and Apr 14, 2021 · not currently available as an FDA-approved drug product” (p. 195). “The term ‘bioidentical hormone’ generally refers to sex steroid hormones, usually an estrogen, an androgen or progesterone, that has the same chemical and molecular structure [and Compounded drugs have long been part of the medical armamentarium. Through drug compounding, compounders may offer therapeutic alternatives for patients with unique medical needs that cannot be met by U.S. Food and Drug Administration (FDA)-approved drug products (FDA, 2017a). The Federal Food, Drug, and Cosmetic Act (FDCA) of 1938 is the primary source of FDA's authority over prescription ...However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ... Jul 10, 2020 · The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation. They are created at a molecular level in order to be as close a match as possible for their patients. On the other hand, since no conclusive study has yet been made, it can't be concluded that bioidentical hormones are any safer than synthetic ... Aug 17, 2022 · Bioidentical hormones are synthetic (artificial) hormones often confused with natural hormones derived from plants. Standard BHRT is tested, approved, and regulated by the FDA, while cBHRT is not. Many people prefer BHRT because of its perceived safety and because it can be customized. Bioidentical testosterone is currently not FDA approved or commercially available for women. Through compounding pharmacy technology, the product can be formulated for off-label use, but again, will not be covered by insurance. Two gels are approved in the U.S. for men only: AndroGel and Testim (1%). There are no FDA approved products for cis ...Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Research health conditions. Check your symptoms. Prepare for a doctor's visit or test. Find the best treatments and procedures for you. Explore options for better nutrition and exercise. Learn more about the many benefits and ...Compounded “bioidentical hormone therapy” (BHT) products, such as progesterone and testosterone, are used by some providers and patients instead of FDA-approved drug products for hormone therapy.The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones. Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration (FDA) has approved certain types of bioidentical hormones. Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA).Oct 18, 2017 · The good news for women who make this choice is that there are many FDA-approved bioidentical hormone products that supply estradiol that you can buy...with a prescription, of course...at any neighborhood pharmacy. They have names such as Estrace, Alora, Climara, Estring and Vagifem. A list of FDA-approved testosterone products can be found by searching for ... Testosterone is a hormone essential for the growth and development of male sex organs and maintenance of secondary ...Jul 10, 2020 · The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation. They are created at a molecular level in order to be as close a match as possible for their patients. On the other hand, since no conclusive study has yet been made, it can't be concluded that bioidentical hormones are any safer than synthetic ... A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...May 25, 2023 · Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA). Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process. The FDA’s Pharmacy Compounding Advisory Committee (PCAC) should review select hormones for the Difficult to Compound list, including estradiol, estrone, estradiol, progesterone, estriol, testosterone, and the pellet dosage form. The federal government and State Boards of Pharmacy should expand and improve oversight of 503A “traditional ...(See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treat A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...The author falsely claims that bioidentical hormones have not been proven safe and effective as required for FDA approval process. Take a look at the list of bioidentical prescription hormones above. These are all FDA approved and proven safe and effective.compounded drugs, and then it reviews key regulatory issues related to the U.S. compounded drug market. 2 FDA-APPROVED DRUG PRODUCTS. FDA approves a new drug for public use only after careful review of data from preclinical studies in animals and human clinical trials that determine whether the benefits of the drug outweigh its known and potential risks. There are FDA-approved bioidentical hormone products available, including estradiol (Estrace, Climara, Vivelle) and progesterone (Prometrium). Many compounded hormones are also considered to be bioidentical. These are hormones made just for you. But they aren’t FDA-approved and can vary in quality. Table of contents About bioidentical hormones UsesFDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy. FDA has approved drugs ...Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...(See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treatIn contrast to FDA-approved drug products, compounded bioidentical hormone therapy (cBHT) preparations lack standardized production methods, potentially leading to state-by-state and even pharmacy-by-pharmacy variability in the medications dispensed to patients.The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or other endocrine-based disorders. In recent decades ...Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies. UConn toxicologist José Manautou, who heads the department of pharmaceutical sciences, served on the committee that wrote the National Academies report.Companies that make bioidentical hormone therapy use the term “bioidentical” to suggest that their products are exactly the same as natural hormones. Many of these companies also claim that their products are safer than menopausal hormone therapy. However, the FDA does not recognize this term or regulate these products. No studies have been ...Prescribers Should Restrict the Use of Non-FDA-Approved Compounded Bioidentical Hormones, Except for Specific Medical Circumstances. The National Academies of Sciences Engineering Medicine ...They have names such as Estrace, Alora, Climara, Estring and Vagifem. A woman who still has her uterus and who goes on hormone therapy for menopause symptoms should also take progesterone to reduce her risk for uterine cancer. FDA-approved bioidentical progesterone products, such as Prometrium, are available as well.The FDA has not approved these compounded hormones, and it does not regulate them. As a result, they may pose safety risks. There is little evidence supporting bioidentical hormones, particularly ...Context: Since 2002, when the US Food and Drug Administration (FDA) placed a black box warning on women's hormone replacement products, women and their providers have been struggling with whether to proceed with hormone replacement therapy. Out of the controversy has grown a popular movement promoting the use of bioidentical hormones. FDA Approved Bioidentical Hormones Preparations: All the hormones used in compounded preparations have been FDA approved and are used OFF-Label in compounded preparations. Here is a partial list of FDA approved hormone preparations for Estradiol, Progesterone and Testosterone: Hormone Product Year of FDA Approval ManufacturerThe following lists some basic information about the FDA-approved hormone medicines for menopause. Use this information to help you talk to your healthcare provider about whether hormone...A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...Bioidentical hormones are available as FDA-approved hormone formulations. Nonapproved custom-compounded preparations are marketed as bioidentical, but content is uncertain. The widespread use of compounded bioidentical hormone therapy despite the lack of evidence to support its safety and efficacy is concerning.Companies that make bioidentical hormone therapy use the term “bioidentical” to suggest that their products are exactly the same as natural hormones. Many of these companies also claim that their products are safer than menopausal hormone therapy. However, the FDA does not recognize this term or regulate these products. No studies have been ...Pharmacies that compound bioidentical hormones, though, do not have to submit paperwork since they aren’t FDA-approved. On the surface, this may make it seem as though compounded bioidentical hormones are safer since they don’t list side effects. But the reality is that they simply aren’t known.October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO ….Bioidentical progesterone replacement therapy is commonly used by perimenopausal and postmenopausal women whose shifting hormone levels severely affect their well-being, causing symptoms such as irritability, hot flashes, difficulty concentrating, loss of libido, and more. However, women of reproductive age may also choose to take bioidentical ...In many instances compounded hormones are more affordable. Estradiol vaginal cream can cost well over $300 while compounded estradiol vaginal cream may start at around $50. Some insurance companies may be more likely to cover FDA approved hormones. However, now some compounding pharmacies file insurance too.by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.FDA Approved Drugs. The following database contains a listing of drugs approved by the Food and Drug Administration (FDA) for sale in the United States. Drug information typically includes the drug name, approval status, indication of use, and clinical trial results. A.However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ...Group Tells the FDA to Restrict the Use of Compounded Hormones. That is the message this group is using to convince the FDA to make prescribing compounded products a very restricted field. The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism ...Compounding pharmacies should be aware of recent developments in the law surrounding bioidentical hormone therapy (cBHT). In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit the unique need of a patient which cannot be met with commercially available products. Compounded drugs are not FDA-approved. The Food ...The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or other endocrine-based disorders. In recent decades ...Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process. Read on to learn the definitions of compounded and bioidentical and what being “FDA-approved” tells you about a product. Compounded hormone therapy — sometimes called compounded bioidentical hormone therapy, abbreviated as cBHT — refers to the non-FDA-approved bioidentical options (pictured on the far-right branch of the decision tree ... Doses should be as low as possible to help ease the symptoms, and then taken for the shortest amount of time. For some women, this may be for a few months, for others, years. If you are taking HRT for serious menopause symptoms, you may be reluctant to stop taking HRT, for fear the symptoms will return.The gap between a need for effective menopausal treatment and available therapies with a perceived acceptable risk/benefit ratio vastly expanded the use of non-Food and Drug Administration (FDA)-approved compounded hormone therapy (CHT), 6,7 which has been marketed as safer than HT and has been promoted as a superior alternative to HT. 6,8-10 ...Jul 1, 2020 · The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or ... Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.Aug 12, 2020 · Patented synthetic hormones require extensive testing and funding, which helps keep the FDA in business. When looking at the safety of bioidentical hormones, several things stand out. As mentioned above, the risk of breast cancer is reduced using bioidentical hormones. Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones. Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration (FDA) has approved certain types of bioidentical hormones. Oct 10, 2022 · Bioidentical or body-identical hormones are estradiol and progesterone that are molecularly identical to human hormones. Most (not all) modern menopause hormone therapy is bioidentical. Keep reading for a list of brands. The difference between “bioidentical” and “body-identical” is that body-identical is the preferred conventional term ... (See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treat Jun 23, 2021 · The categories of hormones gets broken down into bioidentical versus synthetic, and FDA-approved versus non-FDA-approved. FDA-Approved Hormone therapy Numerous FDA-approved hormone preparations are available for the treatment of menopausal symptoms, gender-affirming therapy, birth control, and menstrual regulation. The FDA’s Pharmacy Compounding Advisory Committee (PCAC) should review select hormones for the Difficult to Compound list, including estradiol, estrone, estradiol, progesterone, estriol, testosterone, and the pellet dosage form. The federal government and State Boards of Pharmacy should expand and improve oversight of 503A “traditional ...October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO ….Oct 24, 2017 · See Table 1 for a list of FDA-approved bioidentical hormone preparations. Moreover, supplementation with scientifically studied herbs such as Dong quai ( Angelica sinensis ) and licorice ( Glycyrrhiza glabra ) root can further promote healthy metabolism of female hormones and complement the actions of bioidentical HRT. To learn more, review the BIJUVA Patient Information and talk about BIJUVA with your healthcare provider or pharmacist. The FDA-approved product labeling, including Patient Information, can be found here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies.The FDA requires manufacturers of FDA-approved products that contain estrogen and progestin to include a black box warning that reflects the findings of the Women’s Health Initiative. However, compounded products (including “bio-identical hormones”) are not approved by the FDA and have been exempt from having to provide patient packageThe FDA has approved several bioidentical hormones. Somers' books, however, describes custom-compounded bioidentical hormones, meaning they are produced by a pharmacy mixing ingredients of various ...Jun 23, 2021 · The categories of hormones gets broken down into bioidentical versus synthetic, and FDA-approved versus non-FDA-approved. FDA-Approved Hormone therapy Numerous FDA-approved hormone preparations are available for the treatment of menopausal symptoms, gender-affirming therapy, birth control, and menstrual regulation.
Jun 3, 2021 · Most of these hormones, except progesterone, are not approved by the FDA for use in women. Purchasing FDA-approved progesterone requires a medical prescription. Scientists report that FDA-approved progesterone BHRT products also adopt the name “body-identical” to avoid confusion with compounded bioidentical hormones (cBHRT). They are ... . Braves racetrac dollar5 2023
Jul 9, 2020 · The agency has latched onto this false conclusion from a report it commissioned, and it is another direct threat to estriol and compounded bioidentical hormones’ future. Action Alert! The FDA’s announcement regarding bioidentical hormones came just hours after the National Academy of Sciences, Engineering, and Medicine (NASEM) released their report reviewing the “clinical utility” of Bioidentical hormones are synthetic (artificial) hormones often confused with natural hormones derived from plants. Standard BHRT is tested, approved, and regulated by the FDA, while cBHRT is not. Many people prefer BHRT because of its perceived safety and because it can be customized."It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ...Read on to learn the definitions of compounded and bioidentical and what being “FDA-approved” tells you about a product. Compounded hormone therapy — sometimes called compounded bioidentical hormone therapy, abbreviated as cBHT — refers to the non-FDA-approved bioidentical options (pictured on the far-right branch of the decision tree ...Bioidentical hormones are broadly categorized, as either tested and reviewed by the FDA or not. Products approved by the FDA have undergone extensive testing and quality control.Jan 24, 2022 · Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: pharmaceutical products and custom-made products. Pharmaceutical Products: These products have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety are regulated so it is the same high-quality ... FDA approved bioidentical hormones are intended for standard doses that are mass-produced by manufacturers. If you need a dose that is higher or lower than what a manufacturer makes, then you must have it compounded to your individual needs. There are 3 types of bioidentical estrogens. The stronger and more active estrogen against menopausal ...Bioidentical hormones are broadly categorized, as either tested and reviewed by the FDA or not. Products approved by the FDA have undergone extensive testing and quality control.October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO ….May 13, 2016 · The author, an AP medical writer, might be horrified to know that these non-FDA approved bioidentical hormones, (estradiol, progesterone, estriol and testosterone), are floating around in her blood stream right now, and have been since she was born. So, please, don’t do anything impulsive or crazy, like trying to remove these non-FDA approved ... Jul 8, 2020 · Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies. In October 2005 Wyeth Pharmaceuticals, a manufacturer of both FDA-approved bioidentical and non-bioidentical HRT preparations, filed a citizen petition with the FDA asking for enforcement action against compounding pharmacies that dispensed BHT and to investigate labelling and advertising guidelines. Soon after, the FDA took a number of ...Given the lack of well-designed and well-conducted clinical trials of these compounded hormones, ACOG recommended that all of them should be considered to have the same safety issues as those hormone products that are approved by the FDA and may also have additional risks unique to the compounding process..