Challenges of compounding for patients on the ketogenic diet

A child on a ketogenic diet is a classic example of a patient who cannot take commercially available drug products. The ketogenic diet is a treatment option for young children who have catastrophic, intractable epilepsy or inborn metabolic defects involving glucose metabolism. Most children stay on the diet for 2 to 3 years and must be monitored by a team of healthcare professionals consisting of neurologists, nurses, dieticians, and pharmacists. The ketogenic diet is a high-fat, low-carbohydrate, and low-protein diet designed to increase the body's dependence on fatty acids for energy rather than glucose. The calculations of daily allowances of protein, fat, and carbohydrates must be exact. Compounding pharmacists assist the caregivers or patients and their dieticians by preparing medications whose carbohydrate content is calculated exactly.