Have questions? We have answers.

HeathWealth is more than just a pharmacy – it's our approach to revolutionizing personal healthcare. Traditional pharmacies often offer one-size-fits-all solutions, but HeathWealth is all about crafting personalized medical solutions tailored to individual needs. We pride ourselves on our commitment to "the human element" in healthcare, ensuring each patient receives a warm, personalized, and proactive approach. In practice, this means we'll work with you and your provider to customize medications (strength, form, ingredients) that best suit you, rather than simply handing out a standard formulation that might not be ideal. Patients often tell us they can feel the difference – we treat you like an individual, not a number.

Compounding is the art and science of formulating medication specifically for an individual. Instead of dispensing a commercially mass-produced drug, a compounding pharmacist customizes the medication's ingredients and dosage form for a particular patient. This can mean altering a dose, combining multiple medications into one, changing the form (for example, from a pill to a cream) to make it easier to take, or removing allergens like dyes or fillers. Compounding opens up a world of personalized treatment that remains pharmaceutically sound and rigorously regulated, but is tailored just for you. It's especially useful for patients who have unique health needs – like a child who needs a smaller dose or a flavored liquid, someone who is allergic to an ingredient in the commercial product, or anyone who hasn't found success with off-the-shelf medications.

Emphatically, yes – compounding is safe, and at HeathWealth we hold ourselves to the highest standards of quality and safety. All of HeathWealth's compounded medications adhere to state and federal regulations (we are a licensed pharmacy), and we go above and beyond those baseline standards. Our safety and quality measures include: • Rigorous vendor and ingredient vetting: We only source chemicals from reputable, FDA-registered suppliers. Every chemical (active ingredient or excipient) goes through a qualification process to ensure purity and quality. • Third-party testing: We regularly test raw materials and even samples of compounded batches via independent labs to verify potency and sterility (for injectables). If something doesn't meet specifications, we don't use it. • Continuous training: All HeathWealth compounding pharmacists and technicians undergo ongoing education and proficiency assessments. We cultivate mastery in sterile technique, calculations, equipment handling – every aspect of compounding. • Internal Quality Assurance: We have robust QA programs – monitoring temperatures where meds are stored, performing regular audits of processes, and continually updating procedures to align with best practices. We also perform end-product testing for certain formulations to ensure they contain exactly what's prescribed. • Stringent facility standards: Our compounding lab maintains aseptic conditions for sterile products (like injections), with ISO-classified cleanroom environments. Equipment is sanitized meticulously to prevent cross-contamination. In short, we never cut corners. Healthcare is personal to us, meaning we never settle when it comes to custom formulation quality. "Striving" for unrelenting quality is in our company name and nature.

The short answer: We're a compounding pharmacy that cares about people. The longer answer: Unlike a typical pharmacy that just dispenses what big pharma produces, we consider all your health factors and formulate custom medications just for you. We're addressing a gap in healthcare – the human element. Too often, healthcare has become an industry that forgets the individual behind the prescription. HeathWealth is fixing that imbalance. When you walk into HeathWealth (or call us), you're seen and welcomed as a real person with a real life and unique needs – not just a prescription number. We take into account everything you share: your symptoms, your struggles with previous medications, your preferences. Our joy comes from helping distinct human beings lead fulfilling, healthy, happy lives where every aspect of their wellness is considered. This philosophy permeates everything – from a friendly pharmacist who takes time to explain your medication, to a customized pill that has exactly the combo of ingredients to address your concerns. In essence: Big pharmacies = one-size-fits-most. HeathWealth Pharmacy = one-size-fits-YOU.

It depends. Some insurance companies do cover certain compounded medications, some decide coverage on a case-by-case basis, and others do not cover compounds at all. Insurance can be a bit unpredictable with compounding because these medications are custom-made. However, an important point: the benefit of compounding is it often makes treatment accessible and affordable, even if insurance doesn't pay. In many cases, compounded medications are cheaper out-of-pocket than commercial alternatives or than high copays for brand-name drugs. We are happy to provide you with receipts ("superbills") that you can submit to your insurance for reimbursement if possible. Some flexible spending or health savings accounts (FSA/HSA) will reimburse compounded prescriptions with a doctor's note. We also sometimes coordinate with insurance to see if they'll cover the ingredients (for example, they might cover the cost of the active ingredient, leaving you just a small compounding fee). Additionally, we can often save costs by making larger batches for you. For instance, asking for a 90-day supply instead of 30-day can be more efficient and cost-effective – you pay one compounding labor cost but get three months of medication. We'll work with you on this; if a longer supply is stable and safe to compound, we're happy to do it to reduce your expenses. In summary: insurance might cover, but if not, don't worry – we HeathWealth to keep our prices fair. We'll help you explore options, and often patients find the out-of-pocket cost quite reasonable compared to alternatives (and worth it for the personalized benefit). We're here to help you look at your options!

Absolutely. In fact, compounding can be extremely beneficial for children. Kids are often the ones who hate the taste of a medicine or can't swallow pills – and that's where we come in. At HeathWealth, we can change the flavor, form, and dosage of medications to make treatment a lot more pleasant (for the child and the parent!). For example, say your child needs a heart medication that only comes in an adult-strength tablet – we could compound a fruit-flavored liquid in the exact small dose needed. Or if a toddler needs a medicine that tastes bitter, we can add a flavoring (bubblegum, grape, cherry – you name it) to mask that bitterness. We've turned many a medicine battle into an easier routine by tailoring meds for kids. Also, for children with sensitivities (like dye allergies or lactose intolerance), we can make dye-free, lactose-free formulations. Compounding also lets us combine multiple medications into one dose if a child needs several (reducing the number of administrations). Safety is our top priority, so we ensure accurate pediatric dosing and often work closely with pediatricians on these scripts. Bottom line: when kids have to take medicine, compounding often makes it a smoother process. No more forcing a yucky-tasting pill – we transform it into something manageable, helping kids get the treatment they need without the tears and tantrums.

Yes – we treat our furry family members too! Your pets have unique needs and preferences just like humans do, and compounding can make a huge difference in giving pets their meds. If your dog or cat hates their medication and keeps spitting it out, we have ways to make it easier. For example, we can create flavored medications (think chicken-flavored liquid for a cat, or beef-flavored chew for a dog) so they'll willingly take it. We also adjust dosages because pets come in all sizes. If a commercial pill is for a 50 lb dog, what do you do for a 5 lb rabbit? We can compound the exact dose needed for any species. We can also change forms – maybe turning a pill into a tuna-flavored treat, or a capsule into a transdermal gel that you can rub into the pet's ear (commonly done for cats who refuse oral meds). HeathWealth works with veterinarians to compound all sorts of pet medications: thyroid meds for cats, pain meds for dogs, even applied oncology meds for pets. We ensure the medication is safe for that animal (some ingredients safe for humans aren't for pets – we know the differences). To summarize: Yes, we compound for pets! We love helping animals stay healthy by making it easier for owners to give them their needed meds. If Fluffy or Fido is refusing their current prescription, ask your vet about a compounded alternative – we likely have a solution (and a flavor) that will work. (For more on pet compounding, see our Veterinary section above. We treat pets with the same care and quality as humans – they are family, after all.)

The process is collaborative and straightforward. Typically, it starts with your healthcare provider evaluating you and determining that a standard medication isn't ideal – maybe you need a custom dose or formulation. Your provider then works with us: they either write a prescription for a compounded medication directly, or consult with us on options. We often "unearth your needs" together – meaning our pharmacist might discuss with your doctor (with your permission) to fine-tune what to prescribe. Once we have a prescription, our compounding pharmacist will formulate the medication according to the prescription's specifications. We'll communicate with you regarding any preferences (for example, "Would you like this in a cream or a gel?" or "Which flavor might your child prefer?"). Then we compound the medication in our lab, perform quality checks, and dispense it to you – often shipping it directly to your home for convenience. Throughout this process, we keep you informed and involved. If it's a recurring medication, we'll follow up to ensure it's working well. If not, we'll coordinate with your provider to adjust it. Essentially, you, your provider, and HeathWealth form a team. You bring your health goals and feedback, your provider brings medical oversight, and we bring the custom pharmacy solution. This teamwork ensures you get a one-of-a-kind treatment that truly fits your life. Many patients find this reassuring – they're not alone; they have a whole support system optimizing their therapy.

It's easy! You can call any of our HeathWealth Pharmacy locations and ask to speak to a pharmacist. We actually encourage you to do so, especially if you have questions about how your compounded medication works or how to use it. Our pharmacists are excited to discuss your treatment and ensure you're comfortable with it. If you're not near one of our physical locations, no worries – just give us a call (you can find our numbers on our website or use the main line). We also respond to emails if that's easier for you, but voice-to-voice is often best for detailed questions. And of course, you can always walk into one of our pharmacies if you're local; we love meeting our patients in person. To find contact information, check our list of locations on our website and call the one nearest to you. We're licensed in many states, so even if you're not in the same state as a pharmacy, one of our pharmacists licensed in your state can speak with you over the phone. We are excited to work with you on medications specially formulated for you – that personal connection and guidance is a hallmark of HeathWealth. Don't hesitate to reach out; no question is too small. Whether it's "How do I apply my cream?" or "What's the stability of this solution?" or "Can you explain why my doctor chose these ingredients?" – we're here to help.

We're here to help! For any questions about the price of your medication or insurance billing, you can reach out directly to us. The quickest way: • For pricing questions: email us at pricing@. Our team will respond with cost details, and can provide itemized quotes if needed. If you prefer phone, call our main number and ask for the billing department – but email ensures we can send written breakdowns which some patients find useful. • For billing questions: email billing@. This could include issues like a charge on your credit card you need more info about, questions on superbills for insurance, or setting up payment plans. We know dealing with medical costs can be stressful, so we aim to be transparent and responsive. When you email these addresses, include your full name and, if you know it, your prescription number or the medication name – that helps us find your info quickly. Our billing specialists are friendly and will work with you on any concerns (for example, if you need to change the billing date or use a different card). Remember, because we're a smaller pharmacy, you won't get lost in a bureaucratic shuffle – we'll personally make sure your billing questions get answered promptly and clearly. Your peace of mind matters to us. If you have any confusion about charges or coverage, just ask – we'll clarify everything so you feel comfortable moving forward.

We're coming! HeathWealth Pharmacy is growing and we intend to "flip the script" in healthcare all over the map. If we're not in your state yet, it's likely just a matter of time. Give us a minute, we'll get there, as we like to say. Setting up a compounding pharmacy in a new state involves regulatory approvals and building a great team – we expand carefully to maintain our high standards. In the meantime, if you need our services, note that we are licensed to ship to many states even if we don't have a physical storefront there. So you might still be able to get HeathWealth compounds delivered to you. Check our locations page to see states we serve. And if you really want HeathWealth local to you, let your providers know or even shoot us a message – we consider patient demand when choosing our next locations. We're committed to bringing personalized, compassionate pharmacy care to as many people as possible. So hang tight – HeathWealth might be opening near you sooner than you think. We won't rest until we've made this people-first approach to pharmacy available nationwide and beyond. Thank you for wanting us there – we want to be there for you too! (If you have any other questions not covered above, please feel free to reach out. The HeathWealth team is always available to ensure you feel informed and supported in your healthcare journey. Remember: Don't settle when it comes to your health – HeathWealth for More.)

Semaglutide mimics GLP-1 to regulate blood sugar by increasing insulin release when needed and reducing glucagon. Glycine helps preserve muscle mass during weight loss, and B12 helps reduce treatment-related nausea.

Side effects like nausea, vomiting, or diarrhea are usually transient. They often subside within the first few weeks as your body adapts to the medication.

Many patients notice appetite suppression soon after starting treatment, often within the first week or two. Significant effects on appetite can typically be observed in the first month.

It is administered subcutaneously (under the skin) in the abdomen or outer thigh. Our pharmacists can provide guidance on proper injection technique for comfort and efficacy.

Those with a personal or family history of Medullary Thyroid Carcinoma or MEN-2 should avoid Semaglutide. Use caution in individuals with pancreatitis, severe kidney issues, or diabetic retinopathy. Pregnant women should not use it, and it should be discontinued at least 2 months before a planned pregnancy.

Treatment duration varies per individual. Some may use it short-term to reach health goals, while others stay on longer for sustained benefits. The plan should be personalized based on effectiveness and health objectives, in consultation with your provider.

Compounded Semaglutide is customized to patient needs – for example, specific doses or combined ingredients (like glycine/B12) not found in the commercial drug. HeathWealth Pharmacy tailors Semaglutide formulations to ensure patients get the exact dosage and ancillary nutrients needed for optimal outcomes.

Tirzepatide may increase the risk of thyroid tumors, including cancer. Tell your healthcare provider if you experience a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath, as these may be symptoms of thyroid cancer. Do not use Tirzepatide if you or a family member have had medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Do not take Tirzepatide if you (or an immediate family member) have a history of MTC or MEN 2. Use caution if you have a history of pancreatitis, acute kidney injury, diabetic retinopathy, gallbladder disease, or if you have any sensitivity/allergy to Tirzepatide. Pregnant or breastfeeding women should not use Tirzepatide, and those planning to become pregnant should discontinue it 2 months before trying to conceive.

Most medications and foods are compatible with Tirzepatide, but you should always inform your provider of all drugs and supplements you are taking. Avoid situations that could lead to hypoglycemia and follow your provider's guidance on diet and alcohol while on this medication. (Additional specific provider guidance would be given case-by-case.)

Generally, GHK-Cu is safe for most. Those who might avoid copper peptides are individuals who have experienced gastrointestinal issues or nausea specifically from copper supplements in the past. If you have Wilson’s disease or other disorders of copper regulation, discuss with your physician.

Inform your provider of all your medications (prescription and OTC), supplements, and vitamins. There are no known drug-drug interactions with GHK-Cu, but keeping your healthcare team informed ensures safe, coordinated care. No special drug or food restrictions are known with GHK-Cu.

GHK-Cu has an excellent safety profile. In clinical observations, it’s very well tolerated with side effects indistinguishable from placebo. This means significant side effects are rare. Users typically do not report adverse effects, but as with any compound, if you notice any unusual symptoms, report them to your healthcare provider.

Chronic inflammation can interfere with weight loss. Obese individuals often have elevated internal inflammation. By adding LDN, which decreases inflammation, patients may experience more successful weight loss as their bodies respond better to diet and exercise. In essence, LDN can help “cool off” inflammation that might be hampering metabolism.

Patients on testosterone who wish to stem or reverse testicular shrinkage may use either gonadorelin or low-dose hCG. Gonadorelin may come with fewer estrogenic effects compared to hCG and is generally considered the drug of choice in younger patients with fertility aspirations.

Gonadorelin enhances semen production by increasing total expressible volume. It does appear to impact sperm quality.2

Oxandrolone will sometimes be co-prescribed with testosterone. This is because oxandrolone can make endogenous testosterone levels plummet, and this is an important hormone with multiple functions in the body. Oxandrolone has a high myotrophic (muscle promoting) to androgenic (masculinizing effects) ratio, and there's no advantage to using it together with other anabolic steroids like nandrolone or stanozol with a comparable anabolic profile. Oxandrolone would be favored when weight gain is desired, such as in catabolic conditions like trauma, burn injury or surgery.

Ascorbic Acid (Vitamin C) Injection is primarily used to treat or prevent vitamin C deficiency in patients unable to take oral supplements, or in clinical situations where higher plasma concentrations are required, such as certain infections, wound healing, or adjunctive therapy in specific protocols.[1][3]

This injectable formulation allows for much higher plasma concentrations of vitamin C, bypassing the limitations of gastrointestinal absorption and providing rapid systemic availability.[4][6]

Individuals with known hypersensitivity to ascorbic acid, those with a history of oxalate kidney stones, G6PD deficiency, iron overload disorders, or severe renal impairment should avoid this product.[7][9]

Side effects may include local injection site reactions, gastrointestinal disturbances, hypersensitivity reactions, hemolytic anemia in G6PD-deficient patients, and kidney stone formation in susceptible individuals.[13][15]

Use during pregnancy and lactation should be limited to cases where the benefits outweigh the risks, as high-dose parenteral administration has not been fully studied in these populations.[16][18]

Store at room temperature (20-25°C), protected from light and moisture. Do not freeze. Discard any unused portion after the expiration or beyond-use date.[22][24]

Yes, Ascorbic Acid (Vitamin C) Injection is a compounded medication available only by prescription from a 503A compounding pharmacy. Disclaimer: This compounded medication is prepared under section 503A of the U.S. Federal Food, Drug, and Cosmetic Act. Safety and efficacy for this formulation have not been evaluated by the FDA. Therapy should be initiated and monitored only by qualified healthcare professionals.

Bioidentical testosterone administered through the skin bypasses gastrointestinal and hepatic metabolism, thereby reducing the risk of side effects compared to oral formulations. Transdermal delivery may also offer patient friendly advantages over injectable forms, as properly dosed topical testosterone is less likely to produce supraphysiologic serum levels. Notably, the TRAVERSE trial found no increased cardiovascular risk with transdermal testosterone compared to placebo.¹ However, testosterone cream may present dosing challenges, as factors such as daily adherence, skin hydration, and application technique can contribute to variability in achieving consistent serum levels.

"Bioidentical" means it is the same exact molecule as produced naturally by the body. In contrast, methyltestosterone is a synthetic, and the body may metabolize it differently and may have physiological effects that diverge from naturally produced testosterone. Bioidentical hormones provide some reassurance that the medication behaves in a normal physiologic fashion and potential unwanted effects are minimized.

Strive's testosterone creams are compounded using pharmaceutical-grade ingredients in bases specifically optimized for hormone delivery. Unlike commercial gels, which are typically formulated for male dosing, compounded creams can be customized to meet the individualized needs of patients, especially women, who often require significantly lower doses. This tailored approach helps reduce the risk of dosing errors and improves therapeutic precision.

Yes. Even though testosterone is often viewed as a male hormone, it is critical in both men and women, albeit in different amounts. With levels in women generally one-tenth of that in men, extra care must be taken when dosing in women. Though testosterone is sometimes given to menopausal women along with progesterone and estrogen, a decline in levels appears to be age related throughout the adult years rather than at onset of perimenopause. Low testosterone in women may manifest as symptoms of declining body composition, frailty, low libido, depression or anxiety disorders, low energy levels, pain with intercourse, and an increased risk of Urinary Tract Infections (UTI). Despite this, there is no FDA approved testosterone product for women! Multiple Strive testosterone medications can fulfill the unique dosing requirements of testosterone in women.

Some patients may notice benefit within a few weeks, but it might take several months for the full benefits to be observed.

Consult your healthcare provider before stopping therapy, as abrupt discontinuation may affect hormone levels.

Apply the missed dose as soon as you remember unless it's almost time for your next dose.

Infusion therapy involves the administration of medication through a needle or catheter. It is prescribed when a condition is so severe it cannot be treated effectively by oral medications, or there are no oral therapies that meet the needs of the patient. Typically, infusion therapy means that a drug is administered intravenously, but the term may also refer to subcutaneous infusions. Prescription drug therapies commonly administered via infusion include intravenous immunoglobulin (IVIG), antibiotics, antifungals, antivirals, chemotherapy, hydration, pain management, and parenteral nutrition. Infusion therapy is also provided to patients for treating a wide assortment of often chronic and sometimes rare diseases for which specialty infusion medications are effective when given on a weekly or monthly basis.

Diseases commonly requiring infusion therapy include neuromuscular, dermatological, and immune diseases and infections that are unresponsive to oral steroids or oral antibiotics, including cancer and cancer-related pain, dehydration, and gastrointestinal diseases or disorders which prevent normal functioning of the gastrointestinal system. Other conditions treated with specialty infusion therapies may include congestive heart failure, Crohn’s disease, hemophilia, rheumatoid arthritis, and more.

The term "specialty infusion therapy" refers to the administration of medications that require specialized infusion methods. In this situation, "specialty" indicates that the drug therapy itself requires significant pharmacy expertise to safely administer the therapy in the home, as well as to obtain third-party payment for the therapy and coordinate the interactions between the home infusion pharmacy and the home health nursing service. Complex ordering, shipping, mixing, storing, delivering, and monitoring activities are all involved in the specialty infusion therapy process.

Until the 1980s, patients receiving infusion therapy had to remain in the inpatient hospital setting for the duration of their therapy. Heightened emphasis on cost-containment in health care, as well as developments in the clinical administration of the therapy, led to strategies to administer infusion therapy in alternate settings. For individuals requiring long-term therapy, inpatient care is not only tremendously expensive but also prevents the individual from resuming normal lifestyle and work activities and may increase the chances of contracting a hospital-acquired infection. The technological advances that enabled safe and effective administration of infusion therapies in the home, the desire of patients to resume normal lifestyles and work activities while recovering from illness, and the cost-effectiveness of home care are important. Consequently, home infusion therapy has evolved into a comprehensive medical therapy service that is a much less costly alternative to inpatient hospital treatment. Home infusion has been proven to be a safe and effective alternative to inpatient care for many disease states and therapies. For many patients, receiving treatment at home or in an outpatient infusion suite setting is preferable to inpatient care. A thorough patient assessment and home assessment are performed before initiating infusion therapy at home to ensure that the patient is an appropriate candidate for home care.

An infusion therapy provider is most normally a “closed-door,” state-licensed pharmacy that specializes in provision of infusion therapies to patients in their homes or other alternate-sites. The infusion therapy always originates with a prescription order from a qualified physician who is overseeing the care of the patient. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies, and equipment are provided to optimize efficacy and compliance. Qualified infusion pharmacies must satisfy licensing and other regulatory requirements imposed by state pharmacy boards as well as accreditation standards required by most third-party payers. Home infusion pharmacies may also provide additional professional therapies and services.

Pertaining directly to the medications used, the infusion pharmacy ensures that infusion drugs are: - Compounded in a sterile environment. - Maintained at an appropriate temperature and in air quality controlled conditions to ensure sterility and stability of the drug. - Administered at exactly the right dose and on the right schedule by a highly trained home IV Nurse. - Administered using an appropriate drug delivery device, typically an electronic pump. - Flushed with the proper flushing solution between doses to assure the IV catheter remains functional. - Monitored for adverse reactions and therapeutic efficacy. Infusion pharmacies also provide an extensive array of professional services: 1. Patient assessment and admission. 2. Education and training. 3. Care planning and coordination with physicians, nurses, and the patient’s payor. 4. Care management by clinical infusion pharmacists. 5. Trouble-shooting and treatment plan oversight. Also essential are the specialized equipment (infusion pumps, etc.) and many administration supplies (such as IV sets, syringes, and more) required for infusion therapy. The infusion pharmacy also supplies these to the patient and services the equipment when necessary.

To ensure safe and proper administration of infusion drugs, infusion pharmacists provide the following services: - Comprehensive assessment that considers patient history, current physical and mental status, lab reports, cognitive and psychosocial status, family/care partner support, prescribed treatment, concurrent oral prescriptions, and over-the-counter medications. - Maintenance of appropriate procedures for the compounding and distribution of sterile infusion products as outlined in the national standards and state and federal regulations. - Drug interaction monitoring and identification of potential drug, dose, or drug catheter incompatibilities. - Comprehensive admission procedures that include patient education of medical and disposable equipment use, medication storage and handling, emergency procedures, vascular access device management, and recognition and reporting of adverse drug reactions. - Comprehensive care planning that considers actual or potential drug or equipment-related problems, therapy monitoring with specific patient goals, and coordination of activities with other providers such as home health agencies and physicians. - Ongoing patient monitoring and reassessment activities to continually assess for response to treatment, drug complications, adverse reactions, and patient compliance. - Laboratory report reviews, as applicable, and subsequent consults with care professionals to adjust medication orders if necessary. - Maintenance of appropriate physical facilities for storage, preparation, dispensing, and quality control of all infusion medications and equipment. - Ongoing employee education and competence validation activities. - Maintaining an active accreditation status with an approved accrediting body. This is a significant commitment that allows the infusion pharmacy to assure outside parties that the services provided to its patients are of the highest quality. It is typically also needed to be allowed to provide therapy for insurance companies and to comply with State and Federal regulations. - Performance improvement programs that include collection of clinical outcomes data, patient perception data, trending and analysis of these and other performance measurement data, and root cause evaluations of all sentinel events. These essential specialized services listed above are paid for by the majority of health insurance plans.

Depending on local practices, regulation, and availability of skilled infusion nurses, infusion nursing services are provided directly by the infusion pharmacy or by an affiliated or separate nursing agency. Along with the infusion pharmacy staff, infusion nurses are key members of the infusion care team and work closely in the coordination of care plans and other activities with the infusion pharmacy and the ordering physician. When infusion therapy is provided in the home of a patient, the infusion nurse will ensure proper patient education and training and monitor the care of the patient in the home. Infusion nurses will have special education, training, and expertise in home or other alternate-site administration of drugs and biologics via infusion. Services they typically provide include evaluation and assessment, education and training for the patient or caregiver, inspection and consultation of home environment, catheter insertion, and patient assessment.

Medicare Part B covers some IV and enteral nutritional and cancer treatment drugs in the home, but their admission criteria to assure payment is complex and often not obtainable for many patients under actual clinical conditions. Most infusion drugs, including those not covered under Part B, may be covered by the Medicare Part D prescription drug benefit. However, the Centers for Medicare & Medicaid Services (CMS) has determined that Part D does not have the authority to cover the infusion-related services, equipment, and supplies under Part D. Thus, it is recommended that you speak directly to a reimbursement specialist to determine eligibility for your individually ordered medication and services since the Medicare approval process involving Parts B and D can be complex.

CIDP is a neurological disorder characterized by gradually (over a time period of months or years) increasing weakness of the legs and arms. It is caused by damage to the protective covering of the nerves, called myelin. Symptoms are variable and may be mild to debilitating. CIDP is treatable with IVIG home infusion therapy.

A patient with CIDP typically presents with difficulty walking which progressively worsens over months to years. Weakness, tingling or other abnormal sensations may also be experienced, and usually begin in the fingers or toes (on both sides of the body). Physical examination will usually show loss of reflexes, such as the knee and ankle jerk. Evaluation by a neurologist will often include an electrical test, a nerve conduction velocity-electromyography study. Your doctor may obtain blood and urine tests, including analysis of proteins, to look for causes of CIDP. CIDP is usually a chronic condition, which means that it may require long-term treatment.

Although the exact cause is unknown, it is believed that the immune system, which is normally protective, perceives myelin as foreign and attacks it. Just what starts this process is not clear. Some patients are found to have abnormal proteins in their blood, and these may facilitate damage. Over time, the destruction of myelin leads to weakness, numbness and tingling in the arms and legs.

Several treatment options are available. These include steroids, plasmapheresis and intravenous immune globulin (IVIG). The goals of treatment are to stop further damage to the myelin, prevent damage to the nerve fibers (axons), alleviate symptoms and prevent relapse, and if possible, create an environment that allows the myelin to regenerate. In patients with CIDP, IVIG has been shown to reduce disability, prevent relapse and even improve quality of life.

CIDP can be treated with steroids, plasmapheresis (PP) and immunosuppressive drugs. Many patients initially respond to these treatments, but develop resistance to the therapy or experience side effects causing the treatments to be stopped. Researchers believe that intravenous immunoglobulin (IVIG) is longer lasting and provides patients with CIDP a safer, more effective alternative to standard therapies for the disease. IVIG is a drug that has been used successfully to treat other immune-related diseases of the nervous system. IVIG and PP seem to be equally effective. IVIG is generally preferred to PP because it is safer, more accessible and less invasive. Long-term treatment with steroids can have serious side-effects. IVIG is effective in 70% to 90% of cases; however, most patients with initial improvement need long-term periodic doses of IVIG to maintain clinical stability[1]. At least five small randomized controlled studies have demonstrated the benefit of IVIG in the majority of patients with CIDP[2-7]. The ICE study is the largest and most recent trial of IVIG to treat CIDP[7]. The study not only confirmed the short-term efficacy of IVIG, but also demonstrated that a maintenance therapy can sustain improvement, increase quality of life over 12 months, and prevent further axonal degeneration[7-10]. The ICE study advocates IVIG as a first-line therapy, and has led to FDA approval of one brand of IVIG. The study has also shown that repeated therapy is usually needed to improve symptoms and then to maintain that improvement. Typical doses recommended repeat every 1 to 6 weeks. Interestingly, a large part of the IVIG treatment responsive patients were able to wean off of therapy after 24 weeks without showing a relapse before the study period ended. So, the amount of medication and the frequency of the need for repeated doses can vary widely from patient to patient and is usually determined by the patient’s response to the drug and their physician’s experience with other similar patients in the past.

IVIG is usually given initially at a dose of 0.4 g/kg per day for 5 days, followed by 1.0 g/kg or less as a single infusion in monthly or bimonthly intervals. The response is assessed after 1 to 2 months[11]. A weekly dosing schedule may also be useful for maintenance therapy in select cases[12].

If you have been diagnosed with CIDP and your physician recommends IVIG therapy, you will receive IVIG therapy on a regular basis. The infusion is usually given intravenously, which means through a needle directly into a vein at a doctor’s office, hospital, or infusion center. You may also be able to arrange to have your infusion at home.

Tolerability of IVIG is usually very good and adverse reactions are usually minor. The most common side effects are headache, nausea, chills, flushing, myalgia, hypotension, hypertension, chest discomfort, and fatigue. Infrequent adverse reactions include thromboembolic events, skin reactions, aseptic meningitis, renal tubular necrosis, and severe anaphylactic reaction.

Primary immunodeficiency (PI) or primary immunodeficiency diseases are disorders in which part of the immune system or natural defense system is missing or does not function properly. PI is not visible and it affects any age, race or sex. For people living with PI, infections may not go away or can come back often, even with the use of medications. Infections may be common, severe, long-lasting, hard to cure and may become life threatening.

The basic tests performed when a primary immunodeficiency is suspected include gathering detailed medical and family history, physical exam, blood and immune globulin level tests and response to vaccines to test immune system competency.

Primary Immunodeficiency is an acquired disease and is not contagious. It may be caused by environmental exposures, trauma, medications, etc. Some people with PI have relatives with the same disorder. Sometimes the parents of the patient carry the gene, which puts other siblings at risk of having the same problem. Other times the person may develop the defective gene spontaneously or due to some environmental exposure.

There are a variety of treatment choices for immunodeficient patients. At a minimum, the recurring infections can be treated with antibiotics. These can help prevent damage caused by chronic illness, improving the chances for long-term survival while enhancing the quality of life. Another important treatment intervention is immunoglobulin or IVIG therapy. IVIG works by replacing the antibodies that the body cannot make on its own, or for those with abnormally functioning antibodies. IVIG is now an accepted treatment protocol for a range of Primary Immunodeficiency diseases. In other cases, bone marrow transplants, gene therapy, or other alternative treatments may be appropriate.

There are several treatment options that can help people diagnosed with primary immunodeficiencies (PI) to live normally and live longer. Different types of PI are treated differently. Bone marrow transplantation (BMT) is a possible cure for a number of primary immunodeficiency diseases. However, not everyone is a candidate for bone marrow transplant, because, for a BMT to be successful, there must be a close biological match between the donor and the recipient. Serious health risks are also associated with the procedure. Recipients who have weakened immune systems are at risk of developing graft-versus-host disease after surgery. Some people may experience transplant rejection, in which the body’s immune system attacks the donated organ. For the most common type of PI, antibody deficiencies, lifelong immunoglobulin replacement therapy is the standard treatment. The two common methods of administration for immunoglobulin are subcutaneous (Sub-Q Ig) and intravenous (IVIG). Intravenous immunoglobulin (IVIG) can be given in large, infrequent doses, it is fast-acting, and it avoids the side-effects associated with large subcutaneous injections [1]. The useful effects of IVIG for the preventative treatment of patients with primary immunodeficiency syndromes are well established. Appropriately treating PI with IVIG preserves organ function, improves quality of life, prevents infection-related death and increases lifespan [2]. The long-term goal of IVIG therapy is to render the patient infection free, to the greatest extent possible [2].

The IVIG dose is dependent on many factors including: weight of the patient, physical condition and how well the IVIG treats or prevents symptoms. A starting dose of 400-600mg/kg every 3-4 weeks is recommended[2]. The overwhelming data supports the use of higher doses of IVIG for the treatment of primary immunodeficiency [3]. CUVITRU® CUVITRU® [Immune Globulin Subcutaneous (Human)] 20%, is a liquid medicine that contains immunoglobulin (Ig) antibodies, which help your body protect you against infection. CUVITRU® is indicated to treat adult and pediatric patients two years and older with primary immunodeficiency (PI), a group of more than 300 genetic disorders in which part of the body’s immune system is missing or functions improperly. Immunoglobulin (Ig) is a lifelong therapy provided to prevent recurrent infections in patients with PI, which affects as many as 6 million people worldwide

Dermatomyositis is an uncommon muscle disease that is accompanied by a skin rash. It affects adults and children alike. In adults, dermatomyositis usually occurs from the late 40s to early 60s; in children, the disease most often appears between 5 and 15 years of age. Dermatomyositis affects more females than males. DM is treatable with IVIG home infusion therapy.

Dermatomyositis is a rare chronic condition that causes muscle weakness and a skin rash. Symptoms can include: Skin rash A red or purple rash that can appear on the face, eyelids, chest, back, shoulders, elbows, knees, and knuckles. The rash can be itchy and painful. Muscle weakness A gradual progression of weakness in the muscles closest to the trunk, such as the shoulders, hips, thighs, upper arms, and neck. This weakness affects both sides of the body. Other symptoms • Difficulty swallowing or talking • Shortness of breath • Weight loss • Low-grade fever • Sensitivity to light • Calcium deposits under the skin • Nail changes • Alopecia Symptoms can appear suddenly or develop gradually over time. There is no cure, but treatment can reduce symptoms.

The exact cause of dermatomyositis is unknown, but the disease is similar to other autoimmune disorders, in which your immune system attacks itself. Research is taking place to identify other factors that may play a part in its development, some of which are an infection, underlying skin cancer (more likely in elderly), and genetic predisposition.

There is no cure for dermatomyositis. The primary aim of treatment is to control the skin condition and the muscle strength and function. Treatment options include antimalarial medications, corticosteroids to reduce inflammation, immunosuppressant medications, intravenous immunoglobulins (IVIG) to reduce the immune response, pain relieving medications and steroid-sparing agents. Other important measures in the management of dermatomyositis include physical therapy, speech therapy, and dietary counseling.

The mainstay of dermatomyositis treatment usually involves oral corticosteroids to slow down the rate of disease progression. Immunosuppressive medications may also be used in conjunction with corticosteroids. These medicines all have significant side effects and often a less than adequate response is achieved with this conventional therapy. IVIG is an effective additional therapy for patients with dermatomyositis who fail to respond to conventional therapy or who experience unacceptable side effects. A summary of clinical trials shows an overall response rate of 80% at about 2 months, with maximal response at 4 months. Most patients require ongoing IVIG therapy in addition to conventional treatments given at lower and better-tolerated dosages.

IVIG is recommended to be given monthly at a dose of 1-2 g/kg administered over 5 days. Usually, the effects of IVIG can last up to a month after each administration. IVIG is given as an infusion into a vein over a period of time, usually from 4 to 6 hours.

Skin reactions to IVIG are uncommon. Of all the reported rashes, a blistering type of eczema is the most common.[1] It often begins at about 8 to 10 days after exposure to IVIG. The rash characteristically begins as small itchy blisters on the palms and/or soles that then extends to the rest of the body. The affected individual may become red all over and itchy. Switching the type of IVIG may eliminate the reaction. The skin lesions often resolve within a period of 1 to 4 weeks. The use of steroids controls symptoms and may speed recovery.

Infusion therapy involves the administration of medication through a needle or catheter (intravenous or IV), typically when patients are not able to take medications orally. Since its introduction in the 1970s, a standard modality for patients with many types of infections is long-term IV antibiotic or antifungal therapy.

Home infusion of IV antibiotics or antifungals is prescribed by a doctor for select patients who are well enough to be treated at home, but cannot be adequately treated with oral medications. Appropriate IV access is essential. Only a small number of bacterial infections need to be treated with IV antibiotics in the home. Many mild to moderate infections can be effectively treated with oral antibiotics. Unfortunately, because of the increasing incidence of antibiotic resistance in hospitals and the community, many infections that once had oral antibiotic options can now only be treated with intravenous antibiotics.

The amount and type of IV antibiotics or antifungals are tailored specifically to each patient to effectively treat the infection while allowing the patient to receive treatment in their home (as opposed to remaining in the hospital for treatment). KabaFusion provides an array of acute therapies in the home or alternate site settings which includes antibacterial and antifungal infusion medications. Pharmacists provide careful drug monitoring and patient assessment for safe delivery of infusion therapy and follow Infectious Disease Society guidelines for multidrug resistant infections.

The treatment of infections with IV antibiotics in the home is an established treatment modality. Careful patient selection, safe IV access and appropriate training and monitoring means that many patients can be treated at home. Unfortunately, the rise of multidrug resistant infections means more patients will need prolonged courses of IV antibiotics.

Parenteral Nutrition (PN) is an intravenous (IV) administration which may include carbohydrates, fat, protein, minerals, vitamins, electrolytes, trace elements, and additional medication additives. PN is a method of feeding used when you cannot eat or absorb enough food through the digestive system. It is infused directly into the blood stream using an IV and a pump.

Parenteral nutrition is used when a person cannot meet their nutritional needs with oral intake alone and the digestive system is unable to absorb food. PN is infused directly into the blood stream and bypasses the digestive system.

At Healthwealth infusion, we have a team of dietitians, pharmacists, and nurses that work with your provider to develop the safest and most effective therapy plan. The amount, type, and route of administration are tailored to each person with the goal of improving patient outcomes and minimizing infection while allowing patients to live their lives as normally as possible.

There are many individuals who continue to work and have very full and productive lives while receiving parenteral nutrition. The main determinant will be the degree of disease that caused the underlying GI problem, as well as the ongoing symptoms. Each person needs to be assessed individually as to their wishes and overall medical condition to determine if they are well enough to work.

• Crohn’s Disease • Ulcerative Colitis • Short Bowel Syndrome (or Intestinal Failure) • Gastrointestinal fistula • Bowel obstruction