FREQUENTLY ASKED QUESTIONS FOR THE DOCTOR / PHARMACIST

This section is continually updated. Please refer back periodically.

1. What is DiffusiMAX ^®?

DiffusiMAX is Pluronic Lecithin Organogel or PLO gel. It is an organic base that is used as a vehicle for the absorption of medications through the skin. DiffusiMAX kits and DiffusiMAX premixed gel do not contain active ingredients; medications are added by a pharmacist. The medications most commonly used in DiffusiMAX are the non-steroidal anti-inflammatory drugs. However, a wide variety of agents are increasingly being compounded in DiffusiMAX including antiemetics and hormones. Please refer to the Compounding Tables section in this website for a listing of commonly used drugs. 

2. What is the difference between the DiffusiMAX kit and the pre-mixed cream?

 Pre Mixed      Compounding Kit

The final product is the same regardless of which one you choose. DiffusiMAX kits contain the two components in separate bottles - when mixed together, PLO gel is formed. DiffusiMAX pre-mixed cream is a ready-to-use PLO gel. The question of which one to use is a matter of convenience. 

1. Kits: Drugs, depending on their solubility, are incorporated into their respective component of the DiffusiMAX kit. DiffusiMAX is made from two components or phases - a lipophilic (Compound A) and a hydrophilic (Compound B). Water-soluble medications are incorporated into the hydrophilic component, medications that are not water-soluble are mixed into the lipophilic component. The resulting mixture is then incorporated with the other component in a ratio of 3:1 hydrophilic to lipophilic. For example, since non-steroidal anti-inflammatories are water insoluble, they are incorporated into the lipophilic (A) component first. The hydrophilic (B) is then slowly added in a ratio of three to one. The kits are packaged in a three-to-one ratio. A 100 mL DiffusiMAX kit contains 75 mL hydrophilic and 25 mL lipophilic which when mixed together make 100 grams of PLO gel.

2. Pre-mixed Cream: This has the two components already mixed together in the correct ratio. The drug is simply incorporated into the cream.

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3. Do I need to use a solvent when compounding medications into DiffusiMAX?

Medications can be mixed with solvents prior to incorporating into DiffusiMAX. The solvent may enhance drug release of the medication presumably by reducing the viscosity of the PLO gel. Use of the solvent may also allow for easier incorporation of the medication into DiffusiMAX. It is important when mixing a PLO gel- based prescription that the recommended amount of solvent is not exceeded. Doing so will result in a diluted final product that will be unattractive in appearance. In general, use enough solvent to make the medication into a paste. It is not necessary to dissolve the drug completely with the solvent. Final dissolving will take place in the gel over a short period of time.

For tables showing the proper solvent to use with a given medication please see COMPOUNDING MANUAL on this Website.

4. Can I crush tablets or capsules or do I need to use the pure powders?

In general, it is preferable to use pure chemical powder. Crushing tablets will incorporate the incipient ingredients found in the tablets. Pure powders are typically less expensive and generally preferable, as the ingredients are ready to mix. Most off-patent medications, such as diclofenac sodium, are available in pure powder form from your local wholesaler.

5. How much DiffusiMAX does a patient apply and how quickly will it work?

For the non-steroidal anti-inflammatories, it is not necessary to apply a measured aliquot as it is being used for local or site-specific absorption. A small amount is simply applied to the affected areas three or four times per day or as directed by the physician. Relief of pain should come soon thereafter. Complete relief may take 2 - 3 days.

If a medication is being used in DiffusiMAX for systemic absorption it should be dispensed in a syringe (without needles) so patients can apply a measured dose. To get the prescription into the syringe, simply cool the DiffusiMAX until it turns into a liquid and then draw it into the syringe. Occasionally, it may be difficult to draw the DiffusiMAX into the syringe. Use a larger syringe (60cc) and inject into a smaller syringe if necessary. 

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6. Where can I buy DiffusiMAX?

DiffusiMAX can be ordered from your local wholesaler. Please see ORDERING INFORMATION on this Website.

7. Storage

1. At the Pharmacy: DiffusiMAX pre-mixed cream should be stored at room temperature. For DiffusiMAX kits, the hydrophilic (B) component must be put into the refrigerator at least 10 minutes prior to mixing to get it into a liquid state. Many pharmacists refrigerate the B component until required. The lipophilic (A) component is stored at room temperature.

2. DiffusiMAX that is compounded with a medication should be stored at room temperature.

3. Patients: Patients should be instructed to store their prescriptions at room temperature. If a patient inadvertently exposes their prescription to cool temperatures it may become thin or runny. The prescription can be restored to its original consistency by allowing to return to room temperature. Re-mixing with a clean utensil may also restore consistency.

8. What is the shelf-life of DiffusiMAX?

DiffusiMAX kits are stable for twelve (12) months. Similarly, DiffusiMAX pre-mixed cream has a shelf life of twelve (12) months. Once compounded with drugs, DiffusiMAX prescriptions are stable for six (6) months. 

9. Does DiffusiMAX have a Drug Identification Number (DIN)?

DiffusiMAX does not have a Drug Identification Number. In many provinces, government insurance plans may cover the cost of DiffusiMAX if the drug compounded into it is part of the provincial formulary.  Other provinces may have a schedule of covered compounding bases. For information on reimbursement with private insurers, please contact the insurer to determine eligibility for coverage.

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