Pharmacy compounding is the art and science of preparing custom medications for patients. Compounding practice dates back to the origins of pharmacy; yet its presence has changed over the years. In the 1930s and 1940s, approximately 60 percent of all medications were compounded. With the advent of drug manufacturing in the 1950s and 1960s. compounding rapidly declined. The pharmacist’s role as a preparer of medications quickly changed to that of dispenser of manufactured dosage forms.
However, over the last two decades, compounding has experienced a resurgence as people began to feel modern medicine is less able to meet their personal needs as they research their own health and wellness. Add to that, technology, innovative techniques and research that have allowed pharmacists the ability to create customized dosage forms and strengths necessary to meet specific needs.
There are several reasons why pharmacists compound prescription medications. Many patients are allergic to preservatives or dyes found in mass manufactured medications, or they are sensitive to standard drug strengths. It may be that a medication is not made commercially in the strength the patient needs. Perhaps the patient has difficulty swallowing and must have a suspension or syrup made that is not commercially available. Or perhaps our patient is of the furry kind, and they will take their medication only if it is beef flavored – unless it is a ferret, then we’ve found they prefer tooty-fruity.
With a physician’s consent, a compounding pharmacist can fine-tune the strength of a medication, alter its form to make it easier for the patient to ingest, add flavor to make it more palatable, or create a product free from the offending allergen.
Another option is the ability to prepare the medication in a unique delivery system or device, such as sublingual troche or lozenge, a lollipop, or a transdermal gel or cream that can be absorbed through the skin. For patients who have difficulty swallowing a tablet or capsule, a compounding pharmacist can make a liquid suspension instead.