Jeff's Topcare Pharmacy

10/22/2025

We are now compounding sub-lingual Tirzepatide. Since it is dissolved in mouth and enters the blood stream this process helps it work extremely well.

The tablet version of Tirzepatide is not as effective as they go through the liver and a lot of the active drug in Tirzepatide is destroyed before it can enter the blood stream.

We have seen customers using the sub-lingual Tirzepatide achieve similar results as the injectable version.

The sub-lingual dose has to be taken daily instead of once a week as the injectable but it is a lot more affordable

Call us for details and prices and let it help you achieve your weight loss goals.

07/15/2025

We are looking for a delivery driver. This position is for Monday through Friday 1:30pm to 5 pm. This usually is within a 7 mile radius from our location and averages 10-15 deliveries. We are looking for someone that is dependable and customer service oriented. Please reach out and ask for Jeff at 832-861-0081. You get paid for the shift and if you finish early you still get paid for those hours.

08/21/2024

What’s with all the GLP-1 hype
What are the medications involved and what should you expect once you start

There's a class of type 2 diabetes drugs that not only improves blood sugar control but may also lead to weight loss. This class of drugs is commonly called glucagon-like peptide 1 (GLP-1) agonists. A second class of drugs that may lead to weight loss and improved blood sugar control is the sodium glucose cotransporter 2 (SGLT-2) inhibitors. These include canagliflozin (Invokana), ertugliflozin (Steglatro), dapagliflozin (Farxiga) and empagliflozin (Jardiance).

Weight loss can vary depending on which GLP-1 drug you use and your dose. Studies have found that all GLP-1 drugs can lead to weight loss of about 10.5 to 15.8 pounds (4.8 to 7.2 kilograms, or kg) when using liraglutide. Studies found people using semaglutide and making lifestyle changes lost about 33.7 pounds (15.3 kilograms) versus 5.7 pounds (2.6 kilograms) in those who didn't use the drug.

Diabetes drugs in the GLP-1 agonists class are generally taken by a shot (injection) given daily or weekly and include:

Dulaglutide (Trulicity) (weekly)
Exenatide extended release (Bydureon bcise) (weekly)
Exenatide (Byetta) (twice daily)
Semaglutide (Ozempic) (weekly)
Liraglutide (Victoza, Saxenda) (daily)
Lixisenatide (Adlyxin) (daily)
Semaglutide (Rybelsus) (taken by mouth once daily)
These drugs mimic the action of a hormone called glucagon-like peptide 1. When blood sugar levels start to rise after someone eats, these drugs stimulate the body to produce more insulin. The extra insulin helps lower blood sugar levels.

Lower blood sugar levels are helpful for controlling type 2 diabetes. But it's not clear how the GLP-1 drugs lead to weight loss. Doctors do know that GLP-1s appear to help curb hunger. These drugs also slow the movement of food from the stomach into the small intestine. As a result, you may feel full faster and longer, so you eat less.

Along with helping to control blood sugar and boost weight loss, GLP-1s and SGLT-2 inhibitors seem to have other major benefits. Research has found that some drugs in these groups may lower the risk of heart disease, such as heart failure, stroke and kidney disease. People taking these drugs have seen their blood pressure and cholesterol levels improve. But it's not clear whether these benefits are from the drug or the weight loss.

The downside to GLP-1 drugs is that all but one has to be taken by a shot. And, like any drug, there is a risk of side effects, some serious. More common side effects often improve as you continue to take the drug for a while.

Some of the more common side effects include:

Nausea
Vomiting
Diarrhea
Low blood sugar levels (hypoglycemia) are a more serious risk linked to the GLP-1 class of drugs. But the risk of low blood sugar levels often only goes up if you're also taking another drug known to lower blood sugar at the same time, such as sulfonylureas or insulin.

The GLP-1 class of drugs isn't recommended if you have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia. Lab studies have linked these drugs with thyroid tumors in rats. But until more long-term studies are done, the risk to humans isn't known. They're also not recommended if you've had pancreatitis.

The drugs already discussed are indicated in people living with type 2 diabetes. There is also a drug that has a higher dose of liraglutide (Saxenda) that's approved for the treatment of obesity in people who don't have diabetes.

If you have diabetes and wonder if one of these drugs may be helpful for you, talk to your diabetes doctor or pharmacist.

At our pharmacy we are here to help you.

04/29/2024

Topical Estrogen

Topical Hormone Replacement Therapy (HRT) is a commonly used delivery system, and Bi-Estrogen cream is popular with female patients.

Bi-Estrogen (also called Bi-Est) includes two forms of estrogen:

Estradiol, which is the most common form of Estrogen in the body.
Estriol, which was shown to help address menopause symptoms when combined with Estradiol.
Read on to learn how to apply Bi-Est effectively for maximum absorption.
How to Apply Bi-Estrogen Cream

Estrogen cream is typically applied once per day unless your provider directs otherwise (always follow your provider’s instructions).

If your Bi-Est cream includes Progesterone, it’s typically best to apply in the evening. Anytime up until the hour of bedtime should work.

If your Bi-Est doesn’t contain Progesterone, you can apply in the morning or evening, depending on what works best for you.

Bi-Est application sites include:

The inner thighs
Calves
Abdomen
Intravaginally
To prevent breast sensitivity and pain, we do NOT recommend applying Bi-Est to the:

Breasts
Neck
Collar area
Before applying, wash and dry your hands.

If your Bi-Est cream is in a topi-click container, you can apply directly to your skin from the container. If your Estrogen cream is in a pump bottle, make sure the pump is activated and the container is distributing a full dose. If your Bi-Est is in a pre-filled syringe or packet, it’s likely measured at a full dose already (follow all pharmacy and provider instructions).

Once you’ve applied, avoid swimming, bathing or taking a shower for at least forty minutes, as this can wash away the hormone cream and interrupt absorption. Your HRT will be less effective is this happens.

You should also avoid exercising or working up a sweat for at least two hours to ensure better absorption.
How to Avoid Hormone Transference

Topical hormone creams and lotions can be transferred to others via skin-to-skin contact. Be careful not to let pets, children, and/or your partner touch the application site for at least half an hour after you apply.

To avoid transference, you should also wash your hands directly after applying your Bi-Est cream – especially if you apply your cream by hand.

It may also be a good idea to shower two hours after applying the topical hormone. This should allow for maximum absorption but remove any leftover Bi-Est cream so it doesn’t transfer to others.
Other important Bi-Est Instructions:

Don’t mix or layer over other hormone creams or skin lotions onto your Bi-Est cream.
Store your Bi-Est cream at room temperature in a dry place away from direct sunlight, and do not remove it from its original container unless applying.
Always be sure to follow the directions provided by your pharmacy and provider.
Contact your medical provider if you have any questions or concerns. Defy Medical patients can email Care@DefyMedical.com for prompt assistance.
The Benefits of Bi-Est Cream

As we’ve discussed, Bi-Estrogen creams contain two kinds of estrogen: Estradiol and estriol.

Estradiol is the most abundant form of Estrogen. It’s also the most active and makes up the majority of the Estrogen used by the body.

Estriol is a weaker form of Estrogen than Estradiol, but it’s shown to be effective at minimizing menopause and perimenopause symptoms in many patients.

Estradiol has a larger impact on Estrogen levels in the blood, while Estriol works to target life-derailing symptoms of hormone imbalance. That’s why many female patients respond well to a Bi-Est cream.

Compounded Bi-Est cream can also incorporate other hormones into the formula, including Progesterone and Testosterone. This is helpful for patients who require more than one hormone. By combining medications, patients can have one simple daily application

All information contained within this site is for informational purposes only. It is not intended to diagnose, treat, cure, or prevent any health problem. No action should be taken solely on the contents of this website or our testimonials.

11/26/2023

Hormone Therapy for Menopause Symptoms

Learn about hormone therapy including estrogen for treating menopause symptoms and hot flashes, during menopause and into the postmenopausal period.
Many women hesitate to treat menopausal symptoms with hormone therapy or avoid it all together. That’s because of the concerns that were raised by the landmark Women’s Health Initiative (WHI) trial back in 2002. But a follow-up study in 2017 found that hormone therapy wasn’t as bad for women as it once was thought to be. Hormone therapy includes pills, patches, or vaginal creams.

Women’s Health Initiative (WHI) 2002

The WHI was a clinical trial. More than 27,000 women, ages 50 to 70, were randomly assigned to receive either oral estrogen plus progestin, estrogen alone, or a placebo, for an average of five to seven years.

Here are the most notable findings:

Hormone therapy slightly increased the risks of strokes and blood clots.
When combined hormones were taken for more than three to five years, it increased the risk of breast cancer.
The increase in breast cancer was about one extra case per 1,000 users a year.
After the first WHI results came out in 2002, millions of women stopped hormone therapy or never started. That included many who would have benefited from its effective treatment of hot flashes and other symptoms. Now that may change.

WHI follow-up study 2017

Researchers continued to follow the surviving participants. In 2017, they concluded1 that the use of hormone therapy was not linked with increased or decreased death rates. That was true of the women who took estrogen plus progestin, as well as those taking estrogen alone.

The findings support the guidelines endorsing use of hormone therapy for recently menopausal women with moderate-to-severe symptoms.
Yet, the findings do not support the use of estrogen/progestin for the prevention of chronic diseases.
For women with troubling symptoms, premature menopause, or early-onset osteoporosis, hormone therapy appears to be both safe and effective.
Two things to keep in mind:

First. Hormones used today (such as patches, gels, and sprays) are different from the ones used in the WHI trial. They will require more long-term testing. But the new hormones are often in lower doses. And because of that, they are thought to be just as safe—or safer.
Second. For women who have had their uteruses removed, estrogen alone has a better risk/benefit ratio than estrogen plus progestin. But a woman with an intact uterus cannot opt for estrogen alone. That is because it can cause uterine cancer, as was discovered in the 1960s and 1970s. Progestin is added in order to counter this risk.
Hormone advice from the North American Menopause Society

Here’s a summary of advice from the North American Menopause Society.

For the treatment of menopausal symptoms such as hot flashes, the sooner after the onset of menopause a woman starts oral hormone therapy, the lower her risk of adverse events such as stroke and blood clots.
The longer a woman waits, the greater the risks.
The point at which these risks outweigh the benefits of hormone therapy depends on many factors such as the following examples:
Risk factors for cancer and heart disease
Medical history
Severity of her menopausal symptoms
But the turning point is often reached somewhere between 10 and 20 years after the onset of menopause, or between ages 60 and 70, whichever occurs first.
Treatment should be individualized. A woman thinking about hormone therapy should discuss the pros and cons with her doctor.
Reasons to withhold estrogen/progestin therapy include:
Unexplained vaginal bleeding
Coronary heart disease
Stroke
Thromboembolic disease
Certain types of breast and uterine cancers
Your doctor will review your medical history to make sure you don’t have these, or any other conditions that could cause problems, before starting hormone therapy.

Vaginal estrogen

Vaginal estrogen is prescribed for the ge***al and urinary symptoms of menopause. Some 20% to 45% of menopausal women have had the following symptoms:

Vaginal dryness, burning, and pain during s*x, due to thinning of the vaginal lining
Urinary symptoms such as frequent or painful urination and recurrent urinary tract infections
Low-dose vaginal estrogen is available in creams, tablets, or an estradiol ring. It reverses the thinning of the vaginal lining and other vulvovaginal symptoms. It can be prescribed as an effective alternative to hormone therapy. But it doesn’t treat hot flashes.

11/14/2023

Treating Allergies with Over-the-Counter Medications

Most allergies can be treated successfully with over-the-counter drugs. Here is a rundown on the most common non-prescription allergy medications.
Allergy symptoms can often be treated successfully with over-the-counter (OTC) drugs. If these don’t work well enough, your doctor can prescribe alternatives. Some of which are stronger versions of OTC products.

Many allergy medications work best when taken before you come in contact with allergens and have symptoms. That way the drugs can prevent or reduce the productions of chemicals responsible for the allergic reaction.

Antihistamines

Antihistamines are often the first choice. They treat the effects of histamine, which are sneezing, runny nose, and itchy eyes. But it does not treat nasal congestion. Products come in pills, nasal sprays, and eyedrops.

“Second-generation” antihistamines are long-lasting—12 or 24 hours. They often do not cause drowsiness.

Examples include:

Cetirizine (Zyrtec)
Desloratadine (Clarinex)
Fexofenadine (Allegra)
Loratadine (Claritin, Alavert)
Most are available as less expensive OTC generics. Some also contain a decongestant. This is indicated by a “D” appended to the brand name.

Older “first-generation” antihistamines have side effects. They should be used with caution.

Examples include:

Diphenhydramine (as in Benadryl)
“Pheniramines” (such as chlorpheniramine, as in Chlor-Trimeton)
Antihistamine effect wears off after several hours. But they can cause drowsiness that sometimes lasts more than 12 hours. For this reason, people take them before going to bed. The sleepiness can still impair driving the next day, even if you don’t feel drowsy. What’s more, these drugs have anticholinergic effects. That means they interfere with the neurotransmitter acetylcholine. Side effects of which include:

Cause or worsen memory problems, confusion, and cognitive impairment in older people
Worsen urinary symptoms in men with prostate enlargement
Decongestants

Decongestants shrink dilated blood vessels in the nose, lessening swollen nasal passages. They come as OTC pills, capsules, liquids, and nasal sprays.

Oral products contain pseudoephedrine or phenylephrine.
Sprays contain phenylephrine or oxymetaxoline.
Pseudoephedrine and oxymetazoline provide symptom relief longer than cold formulations containing phenylephrine.
You shouldn’t use decongestant nasal sprays for more than two or three days in a row. That’s because they lose effectiveness and can cause a rebound effect, resulting in even worse nasal congestion.

Talk with your healthcare provider or pharmacist before using either oral or nasal decongestants if you:

Have high blood pressure, heart disease, glaucoma, thyroid disease, an enlarged prostate, or diabetes
Are pregnant or breastfeeding
Are taking other medications on a regular basis (many of which interact with decongestants)
You may be able to use decongestant nasal sprays even if you are advised against pills or capsules. That’s because they are less likely to have systemic effects. Finally, these drugs can cause nervousness, sleeplessness, and palpitations in some people.

Cromolyn sodium nasal spray

Cromolyn sodium nasal spray is safe and effective for preventing hay fever symptoms in adults and children as young as six.

It blocks the release of histamine.
It is best started before allergy season begins.
It won’t help as much after symptoms appear.
Unlike decongestant nasal sprays, it doesn’t produce rebound congestion. It also has the fewest side effects of any allergy drug, but it isn’t as effective as nasal steroid sprays.

Saline nasal sprays: help wash out nasal mucus and can be used long term. Neti pots work similarly.
OTC eyedrops that contain antihistamines (pheniramine) may help relieve itchiness caused by allergies.
Some also contain a decongestant that constricts blood vessels in the eyes. These should not be used for more than a few days, since they can produce rebound redness and swelling in the eye.
Don’t use conventional eyedrops, which contain only vasoconstrictors (decongestants).
People with glaucoma should never use eyedrops that contain vasoconstrictors.
Doctors may prefer prescription eyedrops or non-sedating antihistamines for red, itchy eyes.
Artificial tears, preferably without preservatives, can be taken whenever needed for temporary relief of itchy eyes.
Nasal steroid (corticosteroids)sprays are the most effective drugs for treating nasal allergy symptoms. They used to be available only by prescription but now select products can be bought OTC.
They start working within 12 hours. But maximal effect may not occur for seven days or more.
Most people tolerate nasal steroids well. But some drugs cause dryness, irritation, burning, or bleeding of nasal passages, and throat soreness.
There’s some concern that long-term use in children may reduce body growth. This is especially concerning in children also taking corticosteroids for other conditions, such as asthma.
If you have a severe runny nose and can’t tolerate or do not respond to other drugs, oral corticosteroids may need to be prescribed for short-term use.
There are a few potential drug interactions with nasal steroids, so read the label carefully.
Topical steroids are sometimes prescribed for allergic skin conditions such as atopic eczema and hives.
There can be side effects with long-term use.
OTC hydrocortisone cream is usually least effective, but also has fewer side effects.
Monoclonal anti-IgE drugs have been approved to treat allergic asthma but not allergic rhinitis. Some doctors, though, prescribe it for that.
One such drug is omalizumab. It is injected under the skin every two to four weeks.
It decreases IgE antibody levels in blood and IgE receptors on mast cells. Thus, it reduces allergic reactivity and the release of histamine in response to exposure to allergens.
Leukotriene antagonists or blockers inhibit the inflammatory effect that produces nasal congestion.
One such prescription drug is montelukast (Singulair). It is approved for long-term control of allergic rhinitis and allergic asthma.
It reduces swelling of the airways and relaxes smooth muscles around the airways. But in many people it is not as effective as nasal steroids. Thus, they may be given as just one medication in a several drug treatment plan.
Medication adherence

The World Health Organization defines medication adherence as "the degree to which the person's behavior corresponds with the agreed recommendations from a health care provider." Poor adherence to prescribed regimens can result in serious health impacts including hospitalization and death.

About half of all medications for chronic diseases are not taken correctly. People change or skip doses, stop too soon, don’t take them at all, or never fill their prescriptions.

What to do when you get a new medication:

Take notes on what your doctor tells you about the medication.
Double check with the pharmacist on how to take the medication.
Ask questions to make sure you fully understand the medication. Be clear about when and how to take it.
Creating a chart for your daily medication regimen can help you stay on track. So might a pill box with multiple sections. This is helpful if you take more than one medication. This is also helpful if you take medications more than once a day.
If you’re being treated for a chronic condition, check regularly with your doctor about whether you are taking the medication(s) correctly.
If you are concerned about or are experiencing side effects, talk to your doctor.
Do not take yourself off of medications without the knowledge and guidance of your doctor.
If you’re having trouble sticking to your medication, for any reason, talk with your doctor. They may be able to suggest other treatments or refer you to services that can help.

10/27/2022

08/08/2022

People have asked me a few questions about Paxlovid to treat COVID, and I thought I’ll share a few things with you

Paxlovid must be started within FIVE days of start of being tested for positive results for COVID

You take three Paxlovid pills twice daily for five days for a full course that adds up to 30 pills. It helps that the pills are packaged in a “dose card,” basically a medication blister pack that allows you to punch out the pills as needed.

It’s important to note that although health care providers can write a prescription, pharmacists may also provide Paxlovid (with certain limitations) if they’ve opted to do so, provided you can share your electronic or printed medical records, including a list of medications you are already taking, and blood test results from the last 12 months.

Side effects associated with taking PAXLOVID

an altered or impaired sense of taste
diarrhea
increased blood pressure
muscle aches
abdominal pain
nausea
feeling generally unwell
Since Paxlovid is cleared by the kidneys, dose adjustments may be required for patients with mild-to-moderate kidney disease

Avoid taking statin drugs while you are on Paxlovid

The list of drugs that Paxlovid interacts with includes some organ anti-rejection drugs that transplant patients take, as well as more common drugs like some used to treat heart arrhythmias. Paxlovid also decreases the metabolism of anticoagulants, or blood thinners, that many older adults depend on, driving up levels of those medications in the body to a point where they are unsafe, Dr. Topal explains.
It also interacts with cholesterol-lowering medications like Lipitor, but that’s less challenging for patients to overcome. “If you stop taking your Lipitor for five days, nothing bad is going to happen,” he adds.

We are always available at the pharmacy to answer your questions and help you get well and stay well. Call us or visit us anytime. Stay safe.

01/03/2022

We perform two COVID tests in the pharmacy. A serology test that uses antibodies, and an Antigen Test. Antigen Test can detect and provide results within 3 days of being infected and is a nose swab test.

A serology test, or blood test, usually only tests for IgG which only shows positive after 7-days of being infected and is only valid for past infections.

The manufacturer we use mainly and most new Serology (Blood tests) now also test for IgM antibodies. What that means is that these tests can detect if you are positive or negative COVID infection AFTER three (3) days of being exposed to COVID.

This information is available on line if you search for COVID IgG and IgM test. If you only search for Serology test then you are only reading about IgG positive results. If you have questions please feel free to call us at 832-861-0081.

Hope this helps you understand the tests.

11/24/2021

We have adult and children COVID vaccines available. No appointment needed

09/01/2021

We are looking to hire a pharmacy technician that enjoys dealing with customers with a smile, and a genuine desire to provide great care to our patients. We prefer compounding experience but will train the right person who is a good fit in our customer care team. If interested, or know someone who might be interested then give us a call at 832-861-0081 or send resume to info@jeffstopcarerx.com. We are at 4901 FM 2920 rd @ Rhodes, right next to Bluewater Seafood

08/25/2021

Deliver prescriptions to patients home. Daily between 1-6:30 Monday through Friday.