Many medications that are either unavailable in standard pharmacies due to an FDA-declared shortage, or prohibitively costly, may be obtained in generic form by specialized “compounding pharmacies” as prescribed by a licensed healthcare professional. In this article, we’ll explore what compounded medications are, how they work, the benefits and risks, and why they play an increasingly important role in modern healthcare.
What Are Compounded Medications?
Compounded medications are prescriptions that are prepared by a licensed pharmacist and customized to meet the specific needs of an individual patient. Unlike mass-produced drugs manufactured in large batches by pharmaceutical companies, compounded medications are made in smaller quantities and adjusted on a case-by-case basis.
This process may involve changing the strength of a medication, combining more than one active ingredient into a single dosage, or altering the form of the medication—for example, turning a pill into a liquid for someone who has difficulty swallowing. Compounding can also remove certain inactive ingredients, such as dyes, preservatives, or fillers, which may cause allergic reactions or sensitivities in some patients.
While compounded medications are not necessary for every situation, they can provide important alternatives when commercially available drugs do not meet a patient’s needs. For example, they may be useful when a standard medication is discontinued, temporarily unavailable, or only offered in a dosage form that is not practical for the individual.
Compounded medications are regulated by state boards of pharmacy and must be prepared according to established safety and quality standards. This ensures that patients receive prescriptions that are both reliable and effective when traditional, mass-produced options are not suitable.
Examples of Some Commonly Compounded Medications
Examples of compounded medications include:
- Ketamine: Ketamine is a 50:50 (“racemic”) mix of “right-handed” arketamine and “left-handed” Esketamine isomers. As discussed in other “deep dives” on the Sterling website, racemic ketamine is a 75-year old well-known generic long out of patent. The process for creating pure Esketamine has recently been patented and therefore is not available as a generic. But the ar- and es isomers are clinically little different and racemic ketamine has long been used successfully off label as a treatment for depression. This form of ketamine is available from a number of compounding pharmacies across the country at a reasonable cost.
- Semaglutide: The branded, under-patent version of Ozempic and Wegovy is very costly out of pocket and for many people not covered adequately by insurance. However semaglutide is (as the ending ”…tide” suggests) a so-called peptide—a short string of amino acids. Peptides may not be patented, however, the delivery system and dosing can be. Semaglutide mixed with vitamin B is widely available for research purposes only (as a generic) but also from select manufacturers for clinical use. It may therefore be ordered from certain compounding pharmacies.
- Tirzepatide: is the generic name for Mounjaro and Zepbound, another peptide also available in compounded form.
Compounding pharmacies create custom formulations of medications based on prescriptions from healthcare providers. The process and sources for acquiring the raw materials needed for compounding might not be explicitly detailed in public domains due to regulatory and proprietary reasons.
Compounding pharmacies are expected to source pharmaceutical-grade ingredients from reputable suppliers to ensure the safety and efficacy of compounded medications. They must comply with regulatory guidelines set by bodies such as the FDA in the United States and similar agencies worldwide, ensuring the quality and safety of compounded medications.
Conclusion: Understanding Compounded Medications
Compounded medications can provide a safe and effective way to tailor prescriptions to meet unique patient needs. While not always necessary, they can be invaluable when standard, mass-produced medications aren’t available or just aren’t the right fit. Understanding how compounded medications work—and when they may be beneficial—empowers patients to make informed choices about their care.
If you’d like to learn more about whether medications could support your mental health treatment plan, the team at Sterling Institute in Danbury, Connecticut is here to help. We also offer telehealth services in New York and Florida, making expert psychiatric care accessible no matter where you are.
