OTTUMWA — A pharmacy in Ottumwa is among only a few in the state that mixes chemicals to make custom medications for patients.

NuCara Pharmacy has the staff and equipment to compound different chemicals, and they do it on a daily basis. The pharmacy started compounding in 1999, said Pharmacist Ron Hartman.

“About 50 years ago, every pharmacy was a compounding pharmacy,” Hartman said. Now, the main reason pharmacies do compounding is because for some people, the commercial medicines don’t work.

NuCara pharmacists are able to put different chemicals together into creams, gels, capsules or injectable medicines, depending on what works best for the patient.

NuCara has other compounding pharmacies nearby in Coralville and Waterloo. In Ottumwa, they specialize in compounding medicines for Hospice patients and women’s health, and even do a bit of veterinary compounding. The Ottumwa pharmacy mainly serves customers in southeast Iowa.

Hartman warns, though, that compounded medicines may not be covered in some insurance plans. Getting compounded medication means the patient needs a prescription from a doctor, and customers have to pay up-front for the medications.

“Compounding is another option, I can’t say it’s better,” Hartman said. “But medicine isn’t one size fits all.”

The technology needed for compounding can be expensive, and it takes extra training for staff.

They won’t compound just anything, though. In order for the medicines to work, they have to make sure that it is safe, and there is research to back up what they are mixing.

“Our first concern is always the safety of our customers, so we’re always very aware of that,” Hartman said. “We never guess.”

“With custom making, there is a lot of research involved. We have to make sure it can be made, but then also, should it be made,” he said.

On average, it takes about one-to-two hours to complete a compound, and they usually only make what is needed. Another reason someone may need specially compounded medications is because of specific allergies.

“There’s always potential for side effects when using medicines,” Hartman said. “But we have had a lot of success.”

For example, women going through menopause are losing hormones in their body. The commercially produced hormone replacement medicines have different ingredients that mimic the lost hormones. There has been concern with the risks of taking the commercial medicines, Hartman said. Examples of these types of medicines are Provera and Premarin, he said.

At NuCara, they use chemicals that have the same hormones that the body produces, which makes it easier for the body to break them down.