{"id":13630,"date":"2026-02-06T05:00:00","date_gmt":"2026-02-06T12:00:00","guid":{"rendered":"https:\/\/dh.durangoherald.com\/tj\/durango-compounding-pharmacy-fills-niche-role-in-rural-health-care-web\/"},"modified":"2026-03-31T03:38:48","modified_gmt":"2026-03-31T03:38:48","slug":"durango-compounding-pharmacy-fills-niche-role-in-rural-health-care-web","status":"publish","type":"post","link":"https:\/\/dh.durangoherald.com\/tj\/durango-compounding-pharmacy-fills-niche-role-in-rural-health-care-web\/","title":{"rendered":"Durango compounding pharmacy fills niche role in rural health care web"},"content":{"rendered":"\n

\"Jordyn
Jordyn Daily, a certified pharmacy technician at Rivergate Pharmacy and Compounding Center in Durango, mixes a Polyox bandage that contains a pain killer and a antibiotic as Tammy Tucker, right, a certified compounding technician, mixes Progesterone capsules on Thursday. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

When a medication doesn\u2019t exist in the right dose, form or formulation, patients are left with few options \u2013 a challenge in rural areas like La Plata County.<\/p>\n

That gap is filled by compounding pharmacies such as Rivergate Pharmacy and Compounding Center in Durango.<\/p>\n

\u201cCommercial products are made for the masses,\u201d said Lori Kearney, pharmacist and owner of Rivergate. \u201cBut not everybody can take them. What we do is individualized.\u201d<\/p>\n

Located in the Animas Surgical Hospital complex, Rivergate has a small compounding lab behind the pharmacy counter.<\/p>\n

There, stainless steel scales sit beneath a protective hood that pulls stray powder into HEPA filters. A planetary mixer spins creams until they reach a smooth, uniform texture, while an ointment mill presses medication through rollers so finished products don\u2019t feel gritty on the skin.<\/p>\n

This is the world of pharmaceutical compounding \u2013 the practice of combining, mixing or altering medications to meet the specific needs of a single patient or animal.<\/p>\n

Unlike mass-produced drugs, compounded medications are prepared one prescription at a time. That can mean removing dyes or preservatives for someone with allergies, adjusting a dose that doesn\u2019t exist commercially, or turning a pill into a flavored liquid for a cat that refuses tablets, Kearney said.<\/p>\n

\u201cIt\u2019s basically because everybody\u2019s an individual,\u201d she said. \u201cI\u2019m making drugs for that individual.\u201d<\/p>\n

\"Pharmaceutical
Pharmaceutical compounding \u2013 the practice of combining, mixing or altering medications to meet the specific needs of a single patient or animal \u2013 is a critical part of the complex health care web. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

For many La Plata County residents, that individualized care can be life-changing, and in some cases, the difference between being able to remain in a rural community.<\/p>\n

April Stewart, a Bayfield resident of 25 years, said Rivergate\u2019s services have been an integral part of her family\u2019s life for more than a decade.<\/p>\n

Stewart is the mother of seven adopted children. One of her sons is medically fragile and relies on a feeding tube, meaning he cannot take medication orally and requires compounded prescriptions every month.<\/p>\n

\u201cRivergate has been compounding meds for him for over 10 years,\u201d Stewart said. \u201cWithout a compounding pharmacy, it would be a lot more difficult for us to get him his medication.\u201d<\/p>\n

She said having a local compounding pharmacy makes it possible for families like her\u2019s to live in Southwest Colorado.<\/p>\n

\u201cIt offers high-needs kids access to a rural community,\u201d she said. \u201cIf they weren\u2019t here, I don\u2019t know that we would truly be able to live here.\u201d<\/p>\n

Beyond the medications themselves, Stewart said the pharmacy\u2019s reliability and responsiveness ease the stress of managing complex medical care.<\/p>\n

\u201cWith a medically complex kiddo, we have medication changes, trial-and-error meds and insurance hurdles,\u201d she said. \u201cHaving one part of his care network that\u2019s local and trustworthy takes a lot of stress off.\u201d<\/p>\n

\"Lori
Lori Kearney, left, owner of Rivergate Pharmacy and Compounding Center, talks with her employees Jordyn Daily, center, a certified pharmacy technician and Tammy Tucker, a certified compounding technician at Rivergate Pharmacy and Compounding Center, on Thursday at the Durango business. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

Compounding serves a wide range of purposes in medicine, from addressing unmet clinical needs to responding to emergencies and medication shortages.<\/p>\n

Kearney recalled instances in which veterinarians contacted Rivergate after tourists\u2019 dogs became seriously ill shortly after arriving at high altitude.<\/p>\n

\u201cWe stop what we\u2019re doing and get it done within hours,\u201d she said. \u201cSometimes it\u2019s lifesaving medication.\u201d<\/p>\n

In another case, Kearney said a patient came in requesting large amounts of topical pain medication for an infected, open wound. Instead of simply filling the request, she contacted the patient\u2019s physician and helped develop a custom-compounded powder \u201cbandage.\u201d<\/p>\n

The powder can be mixed with antibiotics, antifungals and pain relievers such as lidocaine and then applied in layers to a wet wound. It absorbs moisture and forms a dry, protective surface. Within a few weeks, the wound healed.<\/p>\n

That kind of problem-solving, Kearney said, is what defines compounding.<\/p>\n

\u201cIt\u2019s equal parts science and problem-solving,\u201d she said.<\/p>\n

\"\u201cIt
\u201cIt offers high-needs kids access to a rural community,\u201d said April Schneider, a Bayfield mother of a son with high medical needs. \u201cIf they weren\u2019t here, I don\u2019t know that we would truly be able to live here.\u201d (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

Rivergate is one of the only compounding pharmacies operating at this level in Southwest Colorado. The nearest comparable facilities are in Farmington or Grand Junction.<\/p>\n

\u201cHere in Durango, we\u2019re pretty isolated compared to metropolitan areas,\u201d Kearney said.<\/p>\n

That isolation can make the pharmacy a critical backstop. During past medication shortages, including a year when children\u2019s flu medicine was nearly impossible to find locally, Rivergate compounded medications to meet community demand.<\/p>\n

Compounding medications that resemble commercially available drugs is a significant part of the practice and also a frequent source of controversy.<\/p>\n

Drug manufacturers have argued in court filings that compounded versions of medications such as Ozempic are \u201cunregulated\u201d and unsafe. Kearney said that characterization misrepresents traditional compounding pharmacies.<\/p>\n

\"Tammy
Tammy Tucker, a certified compounding technician at Rivergate Pharmacy and Compounding Center, presses Progesterone into capsules on Thursday at the Durango business. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

\u201cWe are regulated,\u201d she said. \u201cThe Board of Pharmacy inspects our lab, our records, our storage, everything we do.\u201d<\/p>\n

Compounded medications themselves are not FDA-approved products, but the ingredients used to make them must be FDA-approved. Unlike branded drugs that undergo large clinical trials, compounded medications are customized for individual patients and do not go through a separate multiyear approval process.<\/p>\n

As a 503A pharmacy, Rivergate is legally limited to compounding medications for one single patient at a time and must avoid producing anything considered \u201cessentially a copy\u201d of a commercially available drug.<\/p>\n

To do so legally, there must be a meaningful difference, such as a different dosage form, strength or formulation.<\/p>\n

\u201cIt usually comes down to sensitivities,\u201d Kearney said, \u201cor a dosage form that doesn\u2019t exist.\u201d<\/p>\n

When providers ask whether multiple drugs can safely be combined into a single cream, capsule or powder, the answer comes from research, not guesswork.<\/p>\n

The pharmacy relies on pharmaceutical reference texts such as Remington\u2019s Pharmaceutical Sciences, clinical literature and its membership in the Professional Compounding Centers of America, which conducts compatibility studies and publishes formulations.<\/p>\n

\"Rivergate
Rivergate Pharmacy and Compounding Center offers flavors that can be added to medication for pets and different flavors for humans. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>

\u201cIf we have compatibility issues, we\u2019ve got our resources,\u201d Kearney said. \u201cWe check the literature or tap into consultants. It\u2019s all based on what\u2019s gone before us \u2013 basically, research.\u201d<\/p>\n

She has considered expanding into sterile compounding, which includes injections and eye drops, but the investment and regulatory requirements are significant.<\/p>\n

\u201cThat might be for the next generation,\u201d she said, nodding to the young pharmacist filling a prescription.<\/p>\n

jbowman@durangoherald.com<\/a><\/em><\/p>\n

\"Progesterone
Progesterone capsules on Thursday at the Durango business. (Jerry McBride\/Durango Herald)<\/span>cca<\/span><\/figcaption><\/figure>\n<\/p>","protected":false},"excerpt":{"rendered":"

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