What is compounding? A guide to compounded medicines in Australia

The short version

Compounding is when a pharmacist prepares a medicine for one specific patient, following a prescriber's instructions, because a commercially manufactured product that meets that patient's needs isn't available. It's one of the oldest parts of pharmacy — before mass-produced medicines, every medicine was compounded — and it still has an important place today.

When is compounding used?

Compounding is appropriate when there is no suitable commercially available product. Common reasons a prescriber might choose a compounded medicine include:

• A different strength — the commercial product only comes in doses that don't suit the patient (very common in paediatrics and for tapering).
• A different form — a patient can't swallow tablets and needs a liquid, or a topical preparation is preferred over an oral one.
• An allergy or intolerance — to a dye, preservative, lactose, gluten or other excipient in the commercial product.
• A combination — several active ingredients prepared together in one preparation, where that's clinically appropriate.
• A discontinued or unavailable medicine — including during manufacturer shortages.
• Flavouring or palatability — particularly for children and animals.

When compounding is not used

Australian pharmacies can only compound when there is no appropriate commercially available product. A compounded medicine isn't a "custom version" of something you can already buy — if a suitable registered product exists, that is what should be supplied. This is a legal requirement, and it's why every request to CustomDose is assessed by a pharmacist before anything is made.

Compounded medicines are also not evaluated by the Therapeutic Goods Administration (TGA) for quality, safety and efficacy the way registered medicines are. That doesn't mean they're unsafe — it means the responsibility for their appropriateness sits with the prescriber and the compounding pharmacist, which is exactly why the assessment step matters.

Who can prescribe a compounded medicine?

For prescription-only medicines, a compounded medicine needs a valid prescription from a registered prescriber — a doctor, nurse practitioner, dentist or veterinarian, depending on the medicine and patient. Some non-prescription preparations (for example certain nutritional supplements or skin preparations) can be requested directly, but a pharmacist still assesses whether compounding is appropriate.

How is compounding regulated?

In Australia compounding is governed by:

• The Pharmacy Board of Australia's Guidelines on compounding of medicines, which set out how pharmacists must assess each request (patient factors, the formulation, premises and equipment, personnel competence, and regulatory/counselling requirements), document it, and prepare the medicine.
• State and territory poisons legislation, which covers who can prescribe and supply which medicines.
• The TGA's framework, which exempts pharmacist-compounded medicines for individual patients from registration but sets limits — including advertising restrictions, which is why you won't see prescription compounded medicines advertised or priced on our public pages.

What happens when you request a compounded medicine at CustomDose

1. You upload your prescription (or build a personalised supplement request).
2. A registered pharmacist reviews it against the guidelines above.
3. If it's appropriate, you receive a secure payment link; if not, we'll tell you why and, where possible, suggest a suitable alternative.
4. Once paid, the medicine is prepared and dispatched (or ready for collection), with counselling information.

You're always free to have your prescription dispensed at any pharmacy of your choice.