Filling Your Prescription Medications Effectively and Conveniently

Compounding Services: An Overview

22 June 2023

Janet Phillips

Sometimes a patient's medical needs cannot be met by the standard, commercially produced medications stocked in most pharmacies. A compounding pharmacy can create customized formulations to meet the specifications of individual patients when the standard formulation of a drug is not safe or effective.

Why Compounding? 

Patients benefit from compounding because the customized medication is better suited to treating their condition than the standard formulation. Some ingredients, routes of administration, or dosages of standard formulations can harm certain patients. Compounding improves the efficacy and/or eliminates unsafe effects of a commercially prepared drug. Patients are more likely to take medication as directed if it is easy to take and does not make them ill. 

How Does It Work?

First, the pharmacist receives a prescription from the patient's health care provider to begin the compounding order. The prescription delineates the particular ingredients, formulation, or dosage the patient requires. Then the pharmacist uses these instructions to prepare a customized medication for the patient.

Who Does It Help? 

Compounding helps patients who do not tolerate the standard commercial formulation of a drug due to reactions with the inactive ingredients, severe side effects, inability to take a drug in its standard route of administration, or when a commercially prepared drug is unavailable.  

How Can Medication Be Customized?

Pharmacists who provide compounding services use prescribed active ingredients combined with the appropriate inactive ingredients to produce medications in liquid, capsule, ointment, or cream form. These specialized preparations address patient needs such as:

• Allergen-free alternatives to dyes, preservatives, binders, and other inactive ingredients
• Liquids or chewables for patients who have trouble swallowing pills
• Non-standard dosage amounts, when the mass-produced dosages are not well-tolerated
• Flavor enhancement to make oral medications more palatable, especially for children or pets
• Alternatives to oral formulations that cause severe upset stomach or vomiting
• Discontinued drugs or formulations that are in short supply
• Formulations that are more patient-friendly, such as a smooth cream instead of a sticky gel or smaller capsules instead of large pills

Who Can Compound Medications?

Pharmacists learn how to compound medications during their education and professional training. They use specialized tools such as mortars and pestles, graduated cylinders, balances, spatulas, and mixing slabs to prepare customized formulations as specified by the prescriber. A licensed physician or a pharmacy technician—under the supervision of a pharmacist—may also compound medications.

Where Can I Get Compounded Medications?

Compounding is available in both retail pharmacies and clinical settings, such as hospitals. However, only a small portion of pharmacies in the community specialize in compounding services. Oral and topical formulations are prepared using nonsterile compounding methods. Injectable formulations and eye medications must be prepared in a clean room using sterile compounding techniques.

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