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Tel: 832-886-4296 Fax: 832-886-4298
ZarinaSpecialty & infusion
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Prescriber form

For prescribers sending a prescription to Zarina for a human patient. If you are a veterinarian, use the veterinarian form instead.

Sending a prescription

Fax
832-886-4298 — the usual route. Please send from the prescribing office.
E-prescribe
[TO CONFIRM: add your NCPDP / NPI number and the e-prescribing networks you are reachable on, so prescribers can find you in their EHR.]
Phone
832-886-4296 — for verbal orders where your state permits them, and for anything you would rather discuss with a pharmacist first.
Post
3425 Highway 6 South, Suite 110-B, Sugar Land, TX 77478

What to include

A compounded preparation is made to your order, so the order has to be specific:

  • Patient name, date of birth and address.
  • Active ingredient and strength, expressed the way you want it prepared — percentage, mg/mL, mg per capsule.
  • Dosage form — capsule, cream, solution, troche, suppository, and the base or vehicle if you have a preference.
  • Quantity and directions for use.
  • Refills, if any.
  • Your name, signature, NPI and DEA number where applicable.

If any of that is left open we will call you rather than assume. Telling us the clinical goal — a dose that is not made commercially, an excipient to avoid, a patient who cannot swallow — usually gets a better preparation than a formula alone.

Downloadable form

Editor: attach the PDF here.

Upload your prescriber order form to the Media Library and link it from this section. We have not generated one: a prescription form carries your pharmacy’s identifiers and licence details and should be the document your pharmacist already uses.

Before you write it

Call a pharmacist on 832-886-4296 if you want to check whether a formulation is achievable, stable, and what it will cost the patient. That conversation is free and it is usually shorter than a rewrite.

Compounded medications are not FDA-approved. The FDA does not verify the safety, effectiveness or quality of a compounded preparation before it is marketed. Preparations are dispensed only on a valid, patient-specific prescription.