Magistral formulations and pruritus therapy – What is established, what is confirmed, what is new?

Pruritus is a common symptom encountered by many different specialties. One must clinically differentiate between pruritus associated with skin disease or inflammation and pruritus with normal skin. Searching for possible underlying diseases is indispensable, because pruritus can be very chronic and has multiple pathogenetic mechanisms. Therapy – especially topical therapy – is difficult and often not successful. Very often systemic treatment has to be combined with topical approaches, considering both the active ingredients and appropriate vehicles. There are still open therapeutic gaps in the pharmaceutical product market, which can partially be resolved by using standard prescriptions for formulations. Due to the new pharmacy practice order, standardized compounded formulations should be given preference, since individual formulations often do not pass the plausibility check of the compounding pharmacist. Also the use of cosmetic ingredients (by example, commercial cold creams) is no longer permitted, since only ingredients with pharmaceutical quality can be used in compounding. We will show – based on practical cases – different therapeutic options for treatment with standardized magistral formulations from the NRF (New German Pharmacopoeia for compounded medications).