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How Does Drug Compounding Work? 

May 30, 2023

Drug compounding represents a fundamental aspect of pharmacy. It is a process that has been used for many years in medication to create different dosages. However, in the modern age, this practice has taken on a specialized role within the pharmaceutical industry, customizing medications to meet specific patient needs that off-the-shelf pharmaceutical products cannot fulfil.  

This article will explain how drug compounding works and its importance. 

What Is Drug Compounding? 

Drug compounding combines, mixes, or alters ingredients to create a medication tailored to a patient’s needs. This may include changing the form of the medication from a solid to a liquid, or creating novel dosage forms that are easier to administer or more effective for the patient’s specific condition. Compounding also allows patients with allergies or intolerances to receive medications that do not contain specific allergens. 

A licensed pharmacist or a physician can perform compounding in a state-licensed pharmacy or a registered 503B compounding facility. This is a type of facility that complies with specific regulations and standards set by the Food and Drug Administration (FDA) for large-scale compounding. The pharmacist should be knowledgeable about the science and practice of compounding and follow applicable laws and regulations governing compounding practices in their state. 

Applications Of Drug Compounding

Drug compounding is particularly useful in a variety of specific scenarios. In pediatrics, it caters to children’s needs by creating palatable flavors and suitable dosages. For the elderly, it eases medication intake by converting hard-to-swallow pills into liquid forms. It also addresses the needs of patients with rare diseases by creating custom medications when commercial ones fall short.

Additionally, it ensures safety for patients with allergies by excluding allergenic substances from their medications.

The Drug Compounding Process 

The drug compounding process involves multiple stages, each integral to ensuring the final medication is effective, safe, and ideally suited to the patient’s needs. Here are the steps: 

  1. Identifying The Need For A Compounded Medication 

The drug compounding process starts when a need for a specific, personalized medication arises. This could be due to various reasons, such as a patient being allergic to a commercially available drug ingredient, a discontinued or temporarily unavailable medication, or the need for a unique dosage or form of medication that isn’t commercially available. The patient’s physician or healthcare provider identifies this need and decides that a compounded medication is the best solution for the patient. 

  1. Prescription And Formulation 

Once the need is identified, the physician or healthcare provider writes a prescription detailing the ingredients and dosage needed for the patient. The prescription is then sent to the compounding pharmacist. Utilizing their specialized training, the compounding pharmacist formulates a plan for creating the medication. This formulation outlines the quantities of each ingredient needed and the compounding method. 

  1. Creation Of The Compounded Medication 

The compounding pharmacist begins creating the medication following the prescription and formulation plan. This process involves accurately measuring and mixing the necessary ingredients. The process can be simple, involving only a few steps, or more complex, requiring advanced techniques and equipment, depending on the compounded medication.  

  1. Quality Control And Testing 

After compounding the medication, it must pass stringent quality control measures. This might involve physical and chemical testing, such as testing for the correct dosage and consistency and ensuring the medication is contaminant-free. These rigorous standards are in place to ensure that the compounded medication is safe, effective, and meets the standards of potency and purity. 

  1. Dispensing And Follow-up 

After approval of the medication, it can be dispensed to the patient. The pharmacist will give the patient detailed instructions on properly using and storing the medication. Following this, there will typically be a follow-up with the pharmacist or the prescribing healthcare provider to ensure the medication is working as expected and to monitor for any side effects or complications. 

Importance Of Drug Compounding 

Drug compounding offers patients and healthcare providers a variety of benefits. Some of the benefits include:  

  • Access Discontinued Drugs 

Drug compounding offers a valuable solution when a patient requires a drug that has been discontinued or is temporarily unavailable. In such cases, the compounded equivalent can provide the necessary treatment. Compounding pharmacists have access to quality pharmaceutical ingredients allowing them to recreate essential medicines that are otherwise inaccessible. 

Furthermore, compounding pharmacies are essential in maintaining treatment continuity during drug shortages. They can produce and provide critically needed medications for patients, ensuring that treatment protocols can proceed without interruption. 

  • Adjust Dosages 

Another significant benefit of drug compounding is the ability to customize the dosage of a medication. Commercially available medications often come in standardized doses, which may only suit some. Compounding can provide a solution for those who need a dose that isn’t readily available. 

Patients with unique dosage needs, like children, the elderly, or those with specific health conditions, benefit enormously from this aspect of compounding. Pharmacists can tailor-make medications with the exact dose required, avoiding the need for patients to split or combine pills, thereby ensuring optimal treatment efficacy. 

  • Address Allergies 

Drug compounding also helps patients with allergies to certain ingredients commonly found in commercial drugs. Some patients may be allergic to dyes, lactose, gluten, or preservatives in standard medications, causing adverse reactions when taken. 

In these situations, compounding pharmacists can create personalized medications, excluding these allergenic substances. This ability to customize ingredients in a medication ensures that patients with allergies can still receive the treatment they need without the risk of allergic reactions. 


Drug compounding plays a vital role in modern healthcare, providing custom medications for unique patient needs and ensuring better outcomes. It’s a reliable alternative when commercial drugs are unavailable. For further insights into drug compounding, consider resources from health organizations or contact a local compounding pharmacy. Stay informed about this evolving field for your healthcare needs.