Irsfeld Pharmacy

Steve Irsfeld, RPh, Owner and Pharmacist-in-Charge

For 44 years, Irsfeld Pharmacy PC has operated as a family-run pharmacy, but under the leadership of second-generation pharmacist Steve Irsfeld, the practice evolved far beyond a traditional dispensing model. At a time when healthcare is increasingly shaped by speed, volume, and automation, the company built its approach around staying involved with patients long after the prescription is filled.

That philosophy is visible in the pharmacy’s work with low-dose naltrexone (LDN), a therapy that supports patients with chronic pain, autoimmune conditions, inflammation, mental health and fertility-related care. After decades in retail pharmacy, Steve grew frustrated with high-volume dispensing models that left little room for patient interaction or follow-up.

“I’ve always wanted to have the ability to spend time with patients,” he says. “With the traditional pharmacy model with high volume and low reimbursement, that just wasn’t really possible.”

Over nearly two decades, Steve helped the pharmacy transition from insurance-heavy retail workflows toward a consultative compounding practice. Additional training through the American Academy of Anti-Aging Medicine expanded the company’s approach, giving patients access to compounded therapies, supplements, and longer consultations tailored to individual treatment needs.

Steve describes LDN as “a Swiss army knife” because of its wide-ranging applications, but he is equally candid about the patience required for the therapy to work successfully. Most patients begin at 0.5 milligrams and gradually increase dosage within a carefully monitored range, typically stabilizing somewhere between 0.5 and 4.5 milligrams. Instead of pursuing rapid symptom suppression, the pharmacy focuses on gradual dose adjustment, close monitoring, and helps patients stay with the therapy long enough to experience meaningful improvement.

“The medication matters, but maintaining contact with the patient is what allows the therapy to succeed,” he says.

Rather than immediately treating side effects as failure, the pharmacy uses them to identify a patient’s optimal therapeutic range. Steve compares the process to bringing patients “to the edge of the cliff,” maximizing benefit without pushing them beyond what their systems can tolerate.

Every patient begins with an in-depth consultation covering dosing, expectations, side effects, surgery considerations, alcohol use, and other treatment nuances. Patients then enroll in a structured follow-up program supported through the Keap CRM system, allowing pharmacists to build the long-term monitoring system Steve had envisioned for years.

Patients receive scheduled symptom-tracking check-ins and rate 25 indicators over time, giving pharmacists longitudinal data to guide dose adjustments, troubleshoot side effects, and intervene early when problems arise. Patients are also encouraged to remain in direct contact with the pharmacy throughout treatment.

The same flexibility extends into the pharmacy’s compounding practices. For highly sensitive patients, formulations may be adapted around ingredient tolerances using alternatives such as rice flour, almond flour, or tapioca instead of standard fillers.

The pharmacy measures success less by symptom scores alone than by what patients can reclaim in daily life. A fibromyalgia patient who was bedridden regained enough function to return to part-time work after starting therapy. Another family saw dramatic behavioral and communication improvements in their autistic son within weeks of treatment. Fertility patients who struggled to conceive returned with pregnancy news that staff members celebrated together. For many patients, the therapy also remains relatively affordable compared to more intensive chronic-care interventions.

As demand for compounded LDN grew, the pharmacy invested in tablet-press technology capable of producing highly precise doses at a scale traditional capsule compounding could not match. The system improved dosing precision to within roughly one to two percent accuracy while allowing the company to expand without compromising treatment consistency.

Founded by Steve’s father, Jim Irsfeld, more than four decades ago, the pharmacy is now preparing to welcome a third generation as Molly Irsfeld, PharmD, joins the practice. Long employee tenures continue to reinforce the company’s family-oriented culture and relationship-driven approach to care. Its combination of individualized compounding, structured follow-up, patient education, and scalable precision has recently earned recognition as a Top Low Dose Naltrexone Pain Management Service.

More importantly, the recognition reflects a healthcare model built around something increasingly difficult to sustain in modern medicine: remaining part of a patient’s care long after the prescription leaves the counter.