The History of Pharmaceutical Compounding

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The History of Compounding Pharmacies

Standard pharmaceutical medications may not provide a solution suitable for your needs, as everyone is unique and reacts differently to certain medications. Fortunately, you do not have to stick to one medication that isn’t as effective as it could be, as pharmaceutical compounding enables a pharmacy to develop medications with multiple benefits that work for you without the harmful side effects. For those who are unable to visit a retail pharmacy and receive effective medication to treat a condition, a compounded medication could be a viable solution.

Pharmacies like Compounding Pharmacy of America offer specialized compounding services to provide a custom solution to your health needs. For example, if you have a condition that doesn’t improve with one medication because the side effects are too severe, we can develop another form of the same medication that can treat your issue. If you are unable to take medications orally, or you have a large number of medications to take, we can alter the formulation or combine several medications to make taking your prescription more safe and convenient.

While we take pride in our compounding services, we are not the first pharmacy to undertake the practice of mixing components to create a compounded medication. How and when did this practice begin, and when did compounding pharmacies emerge? Here is a look at the history and evolution of compounding, as well as how the practices have changed due to new technologies, manufacturing processes, and a variety of other elements.

What Are Compounded Medications and Compounding Pharmacies?

Compounding pharmacies are pharmacies responsible for developing specific medications for patients that the patient would not be able to obtain otherwise. These medications are known as compounded medications, and they are made by mixing various pharmaceutical ingredients to craft a custom drug the patient can take more easily, at a custom dose, or along with other medications. Some of the most popular compounded medications include chrysin, hydrocortisone, tramadol, and prednisone.

Compounding Pharmacy of America, as well as other compounding pharmacies, work closely with patients to ensure their health needs are met. When everyday medication you can find in retail isn’t effective or your condition is severe, we can develop custom solutions that are meant to address your needs.

Medications are often compounded to:

  • Reformulate to eliminate an unnecessary ingredient that causes side effects (i.e. an allergen, dyes, etc.)
  • allergen, dyes, etc.)
    Change the consistency of the drug (i.e. liquids for people who cannot swallow pills or topicals for people who cannot take injections)
  • Change the dosage from the standard FDA dose
  • To combine multiple drugs for people with an excessive amount of medications to take
  • To add a flavoring to make the medication more appealing to children or pets,
    And more.

Though it may not be widely known, this practice is nothing new. In fact, compounding has existed for thousands of years.

The Early Days of Compounding Medication

Early Days of Compounding

The history of compounding medications dates back more than a thousand years. The first known case of prescriptions being recorded was in roughly 2400 BCE. A clay tablet from this era describes various salves, washes, and other items.

Claudius Galen, a Greek physician who improved the use of drugs and science in therapeutics between 130 and 200 CE, is credited for being the first person to mix multiple drugs to help a patient. Interestingly, a compounded medication was recorded in the Sushrata Samhita, which is a Sanskrit text that is considered one of the three foundational texts of Indian medicine. This text dates back to the 6th century BCE, meaning we’ve spent more than 2,000 years mixing various ingredients to make compounded medications to treat illnesses or other conditions.

Around the 9th century, physicians such as Al-Razi and Abu al-Qasim al-Zahrawi experimented with compounded medications. Because of their efforts, Baghdad was a central area for compounding pharmacists to practice and improve their work. People in this era used plants as healing agents, which would eventually lead to the creation of medicine. While this was effective at the time, a lack of modern technology prevented substantial progress from being made in this field.

Pharmacy in the Western World

However, pharmacies began to open up anyway, with the first US pharmacy opening in 1720. Considered more of an apothecary at the time than a pharmacy, it was opened by Christopher Marshall, an Irish immigrant. One of the pharmacy’s highlights was its provision of medicine to troops battling in the Revolutionary War, which began more than 50 years after the company opened.

In 1821, the first US pharmacy school, the Philadelphia College of Pharmacy, allowed students to practice pharmacy and earn degrees in the field. This would become a requirement for pharmacists starting in 1932. Because pharmacies in the early days compounded medications frequently, this was the first compound pharmacy, as well as the first educational system, to practice this form of healthcare.

The First Need for Regulation

The 19th century is when we began to see a sudden shift in how pharmacy was regulated. The United States Pharmacopeia (USP), created in 1820 by 11 physicians, was designed to protect patients if they became sick or injured due to poor quality or inconsistent medication. There was concern over the concept of public health, and this organization was determined to protect the public from potentially dangerous medicines. Their efforts were effective, as Congress would later pass laws such as the Drug Importation Act to protect the public.

The Need for Compounding Pharmacies Increases

As time progressed, researchers learned much more about medications and how they react with the body. That’s a chief reason that, in the 1800s, people began to acknowledge the difference between a pharmacist and a physician. The physician prescribed the medication, whereas the pharmacist would be in charge of creating the medication and ensuring it exerted the best possible effects on the body.

Once the early 20th century arrived, most, if not all, medications were made via pharmaceutical compounding. At that time, medications weren’t mass-produced as single, uniform doses like they are today. People would report to their physician, who would then prescribe a medication to meet their specific needs.

The Need for Additional Regulations

The Industrial Revolution paved the way for pharmaceutical companies to create medications to help their patients. Due to how often new technologies were being developed, medicines could be more easily manufactured while keeping costs low. In the 1870s, trademark and patent laws were passed that allowed pharmacies to advertise their medications. Unfortunately, there were some eventual complications with this process, as anything could be advertised and sold without proving its efficacy.

In 1906, the Pure Food and Drug Act was passed, which prevented contaminated and mislabeled medications from being sold in interstate commerce. This law later became replaced by the Food, Drug, and Cosmetic Act of 1938, which required drug manufacturers to prove that their drugs were safe and effective before they were allowed to distribute and market them.

The Rise of Mass Manufacturing

1950s Pharmacy

Because medications weren’t frequently made and the focus was treating each patient individually, pharmacists continued to make compounded medications one at a time. While some could be given to anyone, many were created with a single patient’s set of needs and symptoms in mind. These medications also took more time to manufacture compared to those created today — that is, until the early 1950s. Around this time, the number of prescriptions that required compounded medications dropped to 25 percent, then under five percent in 1960.

At this time in history, compounding pharmacies began to struggle, as mass-produced medications could be manufactured much more quickly and given to many more people. For example, people with a heart condition could rely on a popular mass-produced drug to manage their condition and expect the same drug every time. Some drugs that may have been considered compounded medications before were being mass-produced without the need for compounding.

This was also around the time when insurance companies got involved with this new trend, as their involvement reduced the need to reimburse pharmacists for compounding medications. You may think the history of compounding would have ended with the rise of this increased manufacturing, but the medications themselves were still being made at compounding pharmacies. Fortunately, it soon became clear that there would always be a need for compounding pharmacies.

The Advantage of Compounding Pharmacies

Compounding pharmacies encountered a difficult situation when commercial drug manufacturers got involved, and the idea of a specialized compounder faded from the forefront. However, commercial manufacturing was not the end of compounding pharmacies, mainly due to the disadvantages of this new practice.

Compounding pharmacies are efficient at creating precise, custom medications that address each individual’s needs. When a drug is mass-produced, it may become more readily available for people with the same condition, but the drug will not be suitable for all. For example, the standard format of a drug may cause negative side effects in some people that make daily life a challenge, and compounding pharmacies can address the issue. When people began to notice how effective compounding pharmacies are at developing customized drugs for each individual, they became more valuable than ever before.

Compounding Pharmacies and Medications Today

We’re seeing a resurgence of custom-made medications and compounding pharmacies that primarily make these types of medications. As long as there are individuals with unique medication needs, the compounding pharmaceutical industry will have clients they can help. Large chain pharmacies may have become the norm due to the development of mass production, but if an individual needs a specific formulation of a medication that isn’t sold in large quantities, a compounding pharmacy is the answer.

The Future of Compound Pharmacy

Future of a Compound Pharmacy

Compounded medications continue to be necessary to help patients with health problems that are challenging to address with standard medications. However, there are certain challenges compounding pharmacies are still working to resolve. For example, some healthcare practices refuse to use compounded medications unless they have strict rulings from the Food and Drug Administration (FDA).

Another hurdle the pharmacy industry must continually overcome is pharmacies that fail to meet regulations or create a drug that poses a health risk. In 2012, for instance, a meningitis outbreak occurred that was traced back to the New England Compounding Center (NECC). This was due to unsanitary facility conditions that caused the drugs to become contaminated. Fortunately, industry standouts like Compounding Pharmacy of America take pride in not only meeting but exceeding FDA standards and offering safe, high-quality medications for those who need them.

While there have been setbacks and challenges to overcome, this has not eliminated the importance of compounding pharmacies. Today, thousands of patients in the US require compounded medications to manage their health. The more we learn about how the body responds to medications and the more we perform research on compounded medications themselves, the more good the compounding pharmacy industry can do.

Need More Information? Contact Compounding Pharmacy of America

Contact the Compound Pharmacy of America

When a patient heads to a healthcare facility for treatment, no matter what their condition is, they expect to be prescribed a solution that either resolves or helps manage the issue. Often, this means unique, compounded prescriptions for patients with sensitivities, exceptional needs, and more.

Our team at the Compounding Pharmacy of America knows how important your medication is to achieve a healthy and fulfilling life. Compounded medications may be what you need to treat your health condition and get back to living your best life. If you’d like to learn more about our compounding services or our online shop, browse our blog or contact us today.

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About Matt Poteet, Pharm.D.

Chief Operating Officer, The Compounding Pharmacy of America Matthew Poteet, Pharm.D. graduated with Honors from Lee University with a Bachelors of Science in Biological Science. After his undergraduate training, he completed the Doctor of Pharmacy program at Mercer University Southern School of Pharmacy, graduating in 2004. Dr. Poteet has spent much of his pharmacy career on staff at two of the most prestigious academic teaching hospitals in the Southeast; Emory University in Atlanta and Vanderbilt University Medical Center in Nashville. At these institutions he received extensive experience and training in sterile products compounding. He returned home to East Tennessee in 2010, where he has held the position of Pharmacy Director at two sterile products pharmacies in Knoxville. Matthew lives in Knoxville with his wife, Chris. Dr. Poteet is Tennessee’s first Board Certified Anti-Aging Pharmacist by the American Academy of Anti-Aging Medicine. Read More About Matthew Poteet, PharmD