Individually Prepared Preparations (IPP)

Basics of Prescribing IPP

• IPP stands for Individually Prepared Preparations, also known as magistraliter.
• IPPs involve preparing medications from official medicinal substances and excipients.
• The popularity of IPPs is currently increasing after a period of decline.
• IPPs are commonly prescribed in dermatovenerology, ophthalmology, Ear Nose Throat (ENT), pediatrics, general practice (GP), and dentistry.

Advantages of IPPs

• IPPs allow for individualization of pharmacotherapy.
• They can provide a positive psychological effect on patients.
• IPPs enable avoiding unnecessary substances.
• They can replace unavailable Ready-Made Preparations (RMP).

Disadvantages of IPPs

• IPPs are not available for every preparation and dosage form (DF).
• There is a risk of mistakes during preparation.
• They carry a risk of incompatibilities between ingredients.
• IPPs generally have a short shelf life.

Composition of the Prescription for IPP

• The IPP prescription includes the same main components as the RMP prescription:
  • Inscriptio
  • Invocatio - Rp.
  • Praescriptio (Ordinatio)
  • Subscriptio
  • Signatura

Praescriptio: Components

• Requires Pharmacopoeial Latin names of medicinal substances
• Names must be used in the genitive singular
• Each component (remedium) name is written on a separate line, starting with a capital letter:
  • Remedium cardinale: main ingredient
  • Remedium adjuvans: supporting ingredient
  • Remedium corrigens: to improves taste, smell or appearance
  • Remedium constituens (vehiculum, basis): highest-quantity component

Praescriptio: Doses

• Doses of individual components must be in grams (without abbreviation "g").
• Use Arabic numerals with at least one decimal place.
• The dose should be on the same line as the component, right-aligned.
• Use an exclamation mark for intentional exceeding of the dose.

Praescriptio: Doses (Abbreviations)

• aa (ana partes aequales): in equal parts
• ad: add to the total amount
• aa ad (ana partes aequales ad): add in equal parts to
• q.s. (quantum satis): as much as needed, especially for solid dosage forms

Subscriptio

• Instructions for medication preparation which include the following main points
  • Misce fiat / Misce fiant: indicates to mix to make
  • Required dosage form
    • Capsule (Cps.)
    • Powder (Plv.)
    • Dusting powder (Plv. adsp.)
    • Ointment (Ung.)
    • Gel
    • Suppository (Supp.)
    • Cream (Crm.)
    • Solution (Sol.)
    • Syrup (Sir.)

Subscriptio: Number of Required Dosage Form Units

• For piece-divisible DFs the following is required
  • Shape-specific (suppositories, capsules)
  • Requires a Roman numeral + Latin words in brackets

Subscriptio: Request for Expedition Method

• Da ad vitrum: Put it to a glass
• Da ad ollam: Put it to a plastic jar
• Da ad vitrum guttatum: Put in a dropper bottle
• Da ad lagenam pro infusione: Put in the infusion bottle
• Da ad lagenam fuscam: Put in a brown bottle
• Da ad capsulas gelatinosas: Put in gelatin capsules

Additional Subscriptio Instructions

• Other instructions for the pharmacist include:
  • Sterilisetur! - To be sterilized
  • Adde bacillum! - Add a small stick/applicator
  • Adde guttatorium! - Add a dropper
  • Sine conservante! - Without preservative
  • Sine antimicrobico! - Without antimicrobials

Signatura

• S: (signa = sign, mark), providing instructions.
• DS: (da signa = issue to a patient and sign, mark).

Additional Signatura Instructions

• S. c. f.: Signa cum formula (Issue with a copy description of the recipe).
• S. s. n.: Signa suo nomine (Include the name of the preparation).
• S. s. v.: Sub signo veneni (Issue under the label "Poison!").