Yes, you can easily tell if a pharmacy is a compounding pharmacy by looking for specific signs and asking the right questions. A compounding pharmacy makes custom medications from scratch instead of just filling bottles with ready-made pills. According to the National Center for Biotechnology Information, compounded medicines represent up to 3% of all pharmaceutical prescriptions, and there are clear ways to spot these special pharmacies.
This guide will help you recognize compounding pharmacies, understand what makes them different, and know what questions to ask to make sure you find a quality one.
What Makes a Compounding Pharmacy Different
The Main Difference
Any pharmacy that provides medications that are not commercially available and prepares them onsite to meet your specific needs is a compounding pharmacy. Regular pharmacies mostly count pills from big bottles into smaller bottles. Compounding pharmacies actually mix ingredients together like a recipe.
Think of it this way: regular pharmacies are like a grocery store that sells pre-made meals. Compounding pharmacies are like a restaurant kitchen that makes meals from scratch based on what you need.
How Many Are There
According to the American Pharmacists Association, there are about 56,000 community-based or retail pharmacies in the United States. Of these, about 7,500 are compounding pharmacies. That means only about 1 in 7 pharmacies does serious compounding work.
Clear Signs a Pharmacy Does Compounding
Look for These Physical Signs
Special Equipment
- Clean rooms with special air filters
- Mixing equipment like mortars and pestles
- Scales for measuring tiny amounts
- Capsule-making machines
- Cream and ointment bases on shelves
Different Layout
- A separate work area behind the counter
- Signs about custom medications
- Areas that look like a small lab
Check Their Services
Website Clues
- Lists services like “custom dosing” or “personalized medications”
- Mentions veterinary compounding
- Talks about hormone therapy
- Shows pictures of mixing equipment
Marketing Materials
- Brochures about custom medications
- Information about removing allergens from drugs
- Services for kids who can’t swallow pills
Look at What They Stock
Special Ingredients
- Raw chemical powders
- Empty capsules in different sizes
- Flavoring agents (like cherry or vanilla)
- Special cream bases
- Sterile water and mixing solutions
Regular pharmacies don’t usually have these items sitting around.
Questions to Ask Any Pharmacy
Basic Questions
“Do you do compounding here?” This is the most direct question. They should give you a clear yes or no.
“What types of compounding do you offer?” Some pharmacies only do simple mixing. Others can make complex sterile injections.
“Do you make medications for my specific condition?” Not all compounding pharmacies make every type of medication.
Quality Questions
What training do your pharmacists have? (Ideally, you want a pharmacy where the pharmacists are board-certified sterile compounding pharmacists, or BCSCPs.)
“Are you PCAB accredited?” Ideally, your pharmacy will be accredited by the Pharmacy Compounding Accreditation Board (PCAB), which is considered the gold standard for compounding pharmacies.
“Does a third-party lab test your medications?” This shows they care about quality control.
“Are you licensed to ship to my state?” Important if you’re ordering from far away.
Red Flags to Watch Out For
Signs of Poor Quality
No Special Training If the pharmacist can’t tell you about their compounding training, be careful.
Dirty Work Areas Compounding requires very clean conditions. If you can see the work area and it looks messy, that’s a problem.
No Testing Good compounding pharmacies test their products. If they say they don’t, find another pharmacy.
Pushy Sales You should also be wary of buying compounded drugs online, whether it’s through an online pharmacy or a telehealth platform. Be extra careful of places that push expensive treatments without your doctor’s input.
Online Pharmacy Warnings
The FDA warns that consumers who purchase compounded drugs online, such as through online pharmacies and telehealth platforms, may not know the identity of the compounder that produced the drug. Always make sure you know who’s actually making your medication.
Types of Compounding Services
Non-Sterile Compounding
What They Make:
- Custom-strength pills
- Flavored liquid medicines for kids
- Pain creams and gels
- Hormone creams
- Pet medications with special flavors
Where It’s Done: Most regular compounding pharmacies can do this type of work.
Sterile Compounding
What They Make:
- IV medications
- Injections
- Eye drops
- Spinal injections
Special Requirements: These drugs are injected into your tissue or blood or put into your eyes. They need to be made in a sterile environment to reduce the risk of contamination.
This type requires special clean rooms and extra training.
Professional Certifications to Look For
PCAB Accreditation
According to the US Pharmacist publication, the Pharmacy Compounding Accreditation Board (PCAB®) was established in 2007 by eight of the nation’s leading pharmacy organizations. Only about 8% of pharmacies in the U.S. have achieved it.
What PCAB Checks:
- Only chemicals from highly reliable suppliers are used
- Pharmacists and technicians receive regular, specialized training
- Facility must meet design and other related standards to help ensure the area is clear and free of contamination
Board Certified Sterile Compounding Pharmacist (BCSCP)
According to the Board of Pharmacy Specialties, if an applicant achieves a passing score on the Compounded Sterile Preparations Pharmacy certification examination, they may use the designation Board-Certified Sterile Compounding Pharmacist, or BCSCP.
This certification means the pharmacist has special training in making sterile medications safely.
When You Might Need a Compounding Pharmacy
Common Reasons
Custom Dosing Your doctor prescribes a strength that doesn’t come ready-made.
Different Forms A person who cannot swallow a pill may require a pharmacy to provide the drug as a liquid.
Allergy Issues The need to remove allergens such as lactose or gluten from your medication.
Drug Shortages Recently, for example, shortages of popular weight loss drugs such as tirzepatide (Zepbound) and semaglutide led people to compounding pharmacies.
For Kids and Pets
Children’s Needs
- Liquid versions of adult pills
- Better-tasting medicine
- Smaller doses based on weight
Pet Medications
- Fish or chicken flavored pills
- Doses sized for tiny or huge animals
- Forms that are easier to give
How to Find a Quality Compounding Pharmacy
Use Professional Directories
You can find compounding pharmacies near you on the Alliance for Pharmacy Compounding website. This is a trusted industry organization.
Other Good Resources:
- State pharmacy board websites
- Your doctor’s recommendations
- PCAB accredited pharmacy lists
Get Referrals
Ask Your Doctor Your doctor may already use a compounding pharmacy with other patients and may be able to refer you to one they know is reliable.
Ask Other Patients People with similar conditions often know good compounding pharmacies.
Check with Specialists Doctors who treat hormone problems, pain conditions, or work with kids often know the best compounding pharmacies.
Understanding the Risks
What Could Go Wrong
Quality Issues Because compounded medications don’t have to go through the FDA’s approval process, their strength and quality might not be consistent.
Contamination Risk Since compounding pharmacies themselves aren’t FDA-regulated, there’s also a greater risk of drug contamination.
Dosing Mistakes There are reports of patients mistakenly giving themselves 20 times the appropriate dose when instructions aren’t clear.
How to Stay Safe
Work with Your Doctor Never use a compounding pharmacy without your doctor’s knowledge and prescription.
Choose Accredited Pharmacies Stick with PCAB-accredited pharmacies when possible.
Ask Questions Don’t be shy about asking how they ensure quality and safety.
Follow Instructions Carefully Compounded medications often have different instructions than regular pills.
Cost Considerations
How Prices Compare
Historically, compounded drugs have been more expensive than regular medications. This is because they’re made one at a time instead of in huge batches.
Insurance Coverage Many insurance plans cover compounding, but they might require:
- Prior approval from your doctor
- Proof that regular medications won’t work
- Higher co-pays than regular drugs
When They’re Cheaper Sometimes compounded versions cost less, especially during drug shortages when brand-name drugs are hard to find.
Working with VillageRx for Compounding Needs
If you’re in the Glen Ellyn area and need compounding services, VillageRx offers personalized medication solutions. Our experienced pharmacists can help with custom dosing, allergy-friendly formulations, and specialized medications for your unique needs.
We also provide specialized compounding for various conditions including pain management creams, oral capsules, and even veterinary medications for your pets.
Common Misconceptions
What People Get Wrong
“All Pharmacies Do Compounding” Not true. Most regular pharmacies only do very basic mixing.
“Compounded Drugs Are Experimental” Wrong. They use the same FDA-approved ingredients as regular drugs, just mixed differently.
“Compounding Is New” Actually, compounding has been around for a long time. This was how most medicines were made before the era of FDA approval and mass pharmaceutical manufacturing.
“Online Is Always Cheaper” Be careful. Cheap online compounding can be dangerous if quality controls aren’t in place.
Final Thoughts
Knowing if a pharmacy does compounding is pretty straightforward once you know what to look for. The key signs are special equipment, custom medication services, and trained pharmacists with compounding certifications like BCSCP or PCAB accreditation.
Always ask direct questions about their training, testing, and accreditation. Don’t be afraid to visit the pharmacy in person to see their setup. A good compounding pharmacy will be happy to show you their quality measures and explain their process.
Remember that compounded medications can be life-changing for people who need custom solutions, but they do require more care in choosing the right pharmacy. Take your time to find a quality provider who puts safety first.
If you need help finding a compounding pharmacy or have questions about custom medications, talk to your doctor or contact a trusted local pharmacy that offers these services. The extra effort to find the right compounding pharmacy is worth it for your health and safety.