Compounding pharmacy is the process of mixing drugs by a pharmacist or physician to fulfill the unique needs of a patient. This is mostly done for necessary medical reasons, such as to change the solid form medication pill to a liquid, to avoid such ingredients that the patient is allergic to, or to obtain the exact dose needed. It may also be done for voluntary reasons, such as adding favorite flavors to a medication.

History

Before heavy production of medications became normal, compounding was a routine activity among pharmacists. There are very less community pharmacists who have experience with compounding techniques.

The art of pharmaceutical compounding has ancient roots. Hunter-gatherer societies had some knowledge of the remedial properties of the animals, plants, molds, fungus and bacteria as well as inorganic minerals within their environment. Ancient civilizations utilized pharmaceutical compounding for religion, grooming, keeping the healthy well, treating the ill and preparing the dead. The ancient compounders produced the first oils from plants and animals. They discovered poisons and the antidotes. They made ointments for wounded patients as well as perfumes for customers.

Uses

During research and development

Pharmaceutical compounding is a branch of pharmacy that plays the crucial role of drug development. Compounding pharmacists and medicinal chemists develop and test pharmaceutical formulations for new drugs so that the active ingredients are effective, stable, easy to use, and acceptable to patients.

In the community pharmacy

Physicians may prescribe an individually compounded medication for a patient with an unusual health need. This allows the physician to tailor a prescription to each individual. Compounding preparations are especially prevalent for:

•  Patients requiring limited dosage strengths, such as a very small dose for infants

•  Patients who need drugs that have been discontinued by pharmaceutical manufacturers because of low profitability

•  Children who want flavored additives in liquid drugs, usually so that the medication tastes like candy or fruit

•  Veterinary medicine, usually for a change in dose

Regulation

Compounding pharmacies are licensed and regulated like all other pharmacies.

Controversies

There was a controversy over who should regulate compounding pharmacies. The FDA is concerned that many large compounding pharmacies that are actually acting as large-scale manufacturers of new drugs, and therefore should be subject to normal pharmaceutical regulation. The FDA has repeatedly emphasized that all compounded drugs are new drugs and are thus illegal. Compounded medications are not new, unapproved drugs and pharmacies dispensing them act only under a doctor's prescription. To the extent that there are patient safety issues, state boards of pharmacy are well-equipped to deal with them.”