A Carrollwood store thrives on the almost-lost skill of compounding and mixing medicines to suit a patient's needs.
By SHERYL KAY
Published April 11, 2004
In a scene straight out of Harry Potter, Dan Fucarino smiles with youthful delight as he stands over a sterilized Pyrex beaker, preparing a sticky red concoction that has been precisely measured, mixed, heated and cooled.
In fact, the 50-year-old pharmacist and owner of Carrollwood Pharmacy, a neighborhood icon, might well be compared to a wizard.
He and his technical staff prepare compounded medicines - remedies that are not manufactured by pharmaceutical companies, but are mixed by a pharmacist to suit patients' individual needs.
Every ingredient put into a compound is added following the directions of a medical doctor who writes out a prescription.
Five years ago, Fucarino (pronounced foo-kah-REE-no) estimated he filled about 12 such prescriptions a day.
"Today I fill about 40 to 50 prescriptions every day calling for compounds, which is about half of what we do in conventional prescriptions," he said. And it's the compounds that, in part, contribute to his success as a small local business owner. He provides a service that most chain pharmacies do not.
For centuries, medications were only available in compound form, hence the ubiquitous mortar and pestle symbol for medicine and pharmacies; those tools were used to crush and mix compounds. Even as late as the 1940s, pharmacists made most drugs specifically for each individual patient.
But the next decade ushered in the beginning of mass-produced pills, salves and sprays, and by the 1970s the vast majority of remedies were premade.
"When I went to pharmaceutical school, compounding wasn't even being taught," Fucarino said.
In the 1980s a small group of pharmacists brought back compounding, and customer demand for the individualized remedies began to grow. Doctors became more educated in writing compound prescriptions, and more and more patients sought medicines tailored to their needs.
"What if the conventional product is made with red dye, but the patient is allergic to red dye?" Fucarino said. "Or if a medicine has sugar in it but you're a diabetic, or the filler is lactose and you're lactose intolerant."
Compounding can solve these problems by allowing the pharmacist to create a drug that's custom-tailored to the patient's requirements.
Today, after extensive training in compounding, Fucarino has found a niche market. His pharmacy, which has stood in the same spot for 39 years, creates compounds for everything from dermatological problems to medicines for dogs and cats (prescribed by veterinarians) to female hormone replacements.
For the past year Suzanne Gueterman, 31, of Lake Magdalene has frequented the store often. Her 20-month-old son Stephen was born premature and requires three compounded medications, two specifically to control seizures.
"It's a different feel than what we've seen with other pharmacies in the past," Gueterman said. "They fill the prescriptions quickly, they're always very friendly, and they are extremely knowledgeable."
One of the medications Stephen must take is called Prilosec, used to treat acid reflux in the stomach.
"It's available for adults, but the only form he can take as an infant has to be compounded," Gueterman said.
Fucarino, seeing the need for compounds increasing, built a $200,000 state-of-the-art lab right in the store a year ago. Its shelves are lined with computers, precision scales, an autoclave, convection oven, electronic mortars and pestles, hundreds of chemicals, syringes, and empty capsules.
"It was too small the day we built it," he said.
While the pharmacy continues to build a reputation on its compounding, it also attracts new patients with its medical equipment sales. Customers will find everything from blood pressure cuffs to support compression stockings to wheelchairs and walkers.
Still, one wonders how the pharmacy survives in a strip mall that shares a parking lot with an Eckerd drugstore and is less than a mile down the road from a CVS.
"Chains are most interested in the bottom line," Fucarino said. "Patient care is not their primary concern."
Because his pharmacy is smaller and processes fewer prescriptions per day, Fucarino says he can provide a degree of assistance that the big guys cannot.
Pat Woodroffe, 62, of Original Carrollwood, has been shopping at the pharmacy since 1971. "Back then I liked the convenience and the service, and in those days there just weren't a lot of stores on every street corner," said Woodroffe, a public affairs administrator.
Today, even with a plethora of chain store choices, Woodroffe still goes to Carrollwood Pharmacy.
"I love to go into these new big pharmacies and walk around, but the value of knowing someone through the years, having that respect, and knowing you can ask him anything - it's one of the nicest things about living here in Old Carrollwood, having Dan here," she said.
Fucarino is humbly appreciative of his following (he is the second owner, having bought the business 18 years ago from his father's cousin). He notes that some of his customers have shopped at the store since the first day it opened, while others drive to get there from as far away as Cross Creek and New Port Richey.
"That is the ultimate compliment," he said.
Several years back, he recalls, Eckerd (which was sold last week) sent in a representative to discuss the possibility of the giant chain buying out Carrollwood Pharmacy.
"He said to me, "We need to talk about an acquisition,' " Fucarino said. "And I told him, "You know, I had a feeling it might come to this, and I've been thinking about it, but I still need a few more months before I'd be ready to buy you out.' "
Carrollwood Pharmacy is at 10205 Lake Carroll Way. Hours of operation are 8:30 a.m. to 7 p.m. Monday through Friday, 9 a.m. to 5 p.m. Saturday, closed on Sunday. Fucarino can be reached at 961-8798, or at the business' Web page, www.carrollwoodpharmacy.com
