[Hospital Formulations for Palliative Medicine]

Palliative care had a role in maintaining and improving the patient's QOL. To optimize symptomatic management, that cannot be controlled using commercial formulations, in-house pharmaceutical preparations customized to meet an individual's clinical needs are sometimes administered. Despite a growing arsenal of oncology drugs, opioids, and other compounds, many elderly cancer patients have a wide spectrum of comorbid conditions that require the help of skilled pharmacists. Although drugs prepared in in-house pharmacies can be customized to the conditions of individual patients, their preparation is time- and resource-intensive, and their benefits sometimes do not outweigh the costs. In addition, it is often difficult to predict the required amount of a drug that will be dispensed to a very small number of patients via these custom formulations. However, we occasionally experience cases in which hospital formulations (HF) significantly alleviate symptoms and improve the QOL of patients with cancer. In fact, efforts to develop HF of palliative medications sometimes pave the way to new marketable products. In fact, collaborations between physicians and pharmacists have indeed produced new types of medications, which have been further developed into commercial painkillers by drug manufacturers. This article presents examples of HF used in clinical practice. It also discusses the future need for HF, taking note of the ongoing shift towards outpatient oncology care. Regarding the use of HF, we believe it is always important to ensure patient safety, to obtain informed consent, and to follow up.