What Is a Compounding Pharmacy? (And Are Your Drugs Coming From There?)

Hospitals may be administering non-FDA-approved drugs

As the cases of deadly fungal meningitis continue to grow -- so far claiming 15 lives in 15 states -- a spotlight is being cast on the compounding pharmacy that made the contaminated steroid shots responsible for the infections. Everyone has the same question: What the heck is a compounding pharmacy?

Up until the 1950s, all pharmacies were compounding pharmacies, meaning your drugs were mixed for you right there behind the counter. Now, prescription drugs are mass-produced by drug companies. But the contaminated steroid injections were produced at The New England Compounding Center in Framingham, Mass. (The FDA is investigating two other drugs made at the center for a possible link to other fungal infections).

Today, compounding pharmacies are a niche practice where druggists custom-mix prescriptions for patients who have special needs. If a person is allergic to an ingredient in their prescription, for instance, the pharmacist can reformulate it without that allergen. If a person can’t swallow a pill, the druggist may create a dissolvable strip or patch instead.

But drugs made at compounding pharmacies are not FDA-approved, meaning they haven't been verified for safety or effectiveness. However, experts say that these pharmacies dp fulfill an important need when performing as they’re supposed to -- using FDA-approved drugs to make a medication for a specific patient, based on a doctor’s prescription. Unfortunately, some compounding pharmacies, like the one in Massachusetts, have begun to act more like manufacturing companies, creating drugs in bulk for mass distribution to clinics and hospitals.

If your doctor writes one of these customized prescriptions for you, you’ll have to pick it up at a special pharmacy, so chances are good you’ll know you’re getting a compounded drug. Medications that are administered in a hospital or under your doctor’s care, however, could come from a compounding pharmacy. According to The New York Times, most hospitals have their own compounding pharmacy on-site and they also may receive drugs from an independent one.

Injected drugs, like the painkillers involved in this meningitis outbreak, pose a greater risk of contamination than pills. To protect themselves, patients need to ask their physicians where their drugs come from. If they are compounded, find out whether or not all work is done on-site at the hospital’s own pharmacy.

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