What is a compounding pharmacy?
Compounding pharmacies have been around in the United States since the 1700s, however back then it was called an apothecary. Before modern times, medications were compounded because there was no mass production of common doses. The FDA now defines a compounding pharmacy as a pharmacy that will combine, mix, or alter ingredients to create medications tailored to the specific needs of a patient. Some patients need customized medication because of intolerance/adverse effects, allergies to a filler, or need a medication in a liquid instead of a tablet. These medications are carefully and safely made in specific rooms with specific procedures to ensure they are safe and effective to take.
Benefits to compounding pharmacies vs regular retail
Compounding medications used to be the foundation of pharmacy which caused pharmacists to take on a professional status role4. Naturally, the process of compounding needed to become faster and more efficient to meet the needs of the entire population. This had a negative impact on compounding pharmacy because there was less of a need for a unique medication dose. The emergence of large retail pharmacy chains has started to shift the public’s perception of a compounding pharmacist away from a vital professional role in health care. However, surviving compounding pharmacies have slowed this progression by bringing back personalized patient care and hopefully convincing people that compounding pharmacies are still just as vital to the health care field as they originally were4. Moving away from simply ordering a medication and distributing it to the masses can help foster a collaborative team of health care professionals to make the patient experience even better, we call this the triad relationship between the patient, prescriber, and pharmacists. Having something wrong with a patient’s medication can be frustrating but in a compounding pharmacy, the patient can ask the compounding pharmacist to call their providers office, which leads to discussion with the provider, and coming to a joint conclusion to either increase or reduce a dose.
Changing the dosage form of a medication is another major role of compounding pharmacies. For example, the drug metformin is usually given as a tablet to help manage type two diabetes mellitus. This medication often comes with gastrointestinal side effects such as constipation and diarrhea. These side effects can be managed through dose changes, but some patients will still experience them. Compounding metformin into a cream would solve this issue. The metformin would be absorbed through the skin and therefore would not affect the gastrointestinal system, and the dose of the cream would be a lot smaller because the drug no longer goes through first pass metabolism. This can be done with other medications to try and solve the issue of side effects. As mentioned before, compounding pharmacies can make a medication with a specific dose for a patient, making it a lot easier to find correct doses for patients. These pharmacies have more time to follow up with each person to make sure the medication is being tolerated. If the medication is not tolerated the compounding pharmacist can offer advice on how to change the dose of the medication to specifically meet the needs of the patient. This is not common in large retail pharmacy chains because of two main reasons: there simply is not enough time to follow up, and there are not enough strengths for a medication to match a single patient’s needs. Compounding solves both of those issues by talking with the patients more often and for as long as needed
At a compounding pharmacy, the process of getting a patient their medication is a little different than at a retail pharmacy. First a prescription will be called, faxed, or brought into the pharmacy. The prescription will be typed, and a label will be created from the master formula document. This formula and calculated numbers will be verified by a pharmacist to ensure the medication meets the exact specifications of the prescriber. The formula and label will then be given to the compounding technician to create the medication from scratch. After the medication is made, it is packaged up, verified by the pharmacist, and the patient is notified that it is ready for pick up. Because of these extra and time-consuming steps, receiving a medication from a compounding pharmacy can take longer to receive than at a retail pharmacy.
The Arizona State Board of Pharmacy requires that all compounding pharmacies be compliant with three major guidelines/organizations: the FDA, Arizona Board of Pharmacy, and United States Pharmacopeia (USP). The FDA gives us definitions and guidelines for the safety of drugs. The Arizona Board of Pharmacy makes sure the pharmacy is adhering to best practices and pharmacy law. Lastly, USP sets guidelines for how to keep the staff, drug, and environment safe when compounding.
How is Prescott Compounding Pharmacy different from other compounding pharmacies?
Prescott Compounding Pharmacy puts patients first. Here, we will call to let the patient know their medication is ready for pick up to give the patient ample time to get to the pharmacy. An important aspect of patient satisfaction is accommodating emergency fills. To efficiently do this, we will compound certain urgent medications so that when the patient has a prescription called in, we have some on hand to fill it faster. Another unique aspect of Prescott Compounding Pharmacy is trying to reach the prescribing physician three separate times for refills once the patient has asked us to. We try our best to make sure that the patient will get a new prescription once they don’t have any refills remaining, so that patients are not without their medication. Prescott compounding pharmacy is the only compounding pharmacy in the Prescott area, but customer service is a top priority to us, and it keeps us competitive with other pharmacies in Arizona.
The medications made at Prescott Compounding Pharmacy unfortunately cannot be run through insurance, but we have many ways to lower the financial burden on our patients. We can print out a universal insurance claim form for patients to send to their insurance company for reimbursement. Patients can request this with every prescription they get from us. Another way to help patient expenses is by offering discounts on certain medications. Patient can often save money by filling larger quantities of their medication, i.e., a 60 or 90 day supply. This doesn’t apply to every medication and every fill, but we try to give discounts when appropriate.
The pharmacists at Prescott Compounding Pharmacy have received the same formal education as every other practicing pharmacist however, our pharmacists have done over 20 hours of specialized training for topics including compounding for animals, bio-identical hormone replacement therapy, and over-the-counter CBD supplements to better serve the community. They use this training and knowledge to counsel patients on the many medications that we carry in these categories. Our pharmacists are also passionate about the next generation of pharmacists. They are also preceptors for pharmacy schools at multiple colleges including the University of Arizona, Midwestern University, and the University of Hawaii. Students from these colleges are welcome at Prescott Compounding Pharmacy where they will learn how to successfully operate a compounding pharmacy and continue the traditional methods of pharmacy.
By: Alyx Meilinger, Pharm. D. Student, University of Arizona c/o 2026
Edited by: Jimmy Stevens, Pharm. D.
- (n.d.).Frequently Asked Questions About Compounding Pharmacy . Compounding Faqs. https://www.pharmacist.com/Practice/Patient-Care-Services/Compounding/Compounding-FAQs
- Carvalho, M., & Almeida, I. F. (2022, August 31).The role of pharmaceutical compounding in promoting medication adherence. Pharmaceuticals (Basel, Switzerland). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503326/
- Center for Drug Evaluation and Research. (n.d.).Compounding and the FDA: Q & A. U.S. Food and Drug Administration. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
- Giam, J. A., McLachlan, A. J., & Krass, I. (2011, March 30).Community Pharmacy Compounding–impact on professional status – International Journal of Clinical Pharmacy. SpringerLink. Epub 2011. PMID: 21448656 https://link.springer.com/article/10.1007/s11096-011-9496-z