What is Compounding and What Can Bremo Do for You ?

Bremo Pharmacy has offered professional compounding for over three decades. We strive to create innovative ways for you and your family to take medications. Bremo offers a wide range of personalized compounding medications for you and your whole family, including your four-legged friends! You may have many questions about compounding. For example, what exactly is compounding and why do pharmacies do it? How is it done and why does the process take longer than a regular prescription? Before drug manufacturing became the norm, compounding was a common practice among pharmacies. The modern age of compounding began in the 18th century when pharmacist extracted pure drugs like morphine from natural products like opium. With the entrance of manufacturing of medications, compounding pharmacies became more rare.

What is prescription compounding?
Prescription compounding is the process of combining multiple ingredients according to a unique recipe that combines, mixes, or alters ingredients in order to meet a patient’s needs. This can be done by adding flavors, changing the dosage form it is in, combining multiple medications together, or making it without certain ingredients that someone is allergic to. Compounding also allows for personalized medications for people and pets by changing dosage forms and formulations to make medications easier for patients to take.

Does Bremo compound?
Bremo Pharmacy is a full-service pharmacy for both compounded and non-compounded prescriptions. This is one of the many services that make Bremo Pharmacy special and unique. Compounding is not a service offered at every community pharmacy due to the necessary training and equipment required to properly make compounds. In order to become a compounding pharmacy, there is an extensive list of training, facility, and quality regulations that must be met. This is to ensure the final product is properly made and safe to use.
Bremo Pharmacy volunteered to become accredited through Pharmacy Compounding Accreditation Board (PCAB®) to prove that we follow the highest standards of quality and safety when we “compound” prescription medications. As a PCAB accredited pharmacy, Bremo Pharmacy puts quality first. We make sure that our compounded products meet the highest standards.
In our new state of the art compounding lab we are well equipped to take care of all your compounding needs for both non-sterile, hazardous, and non-hazardous compounds. Our new lab separates hazardous compounds such as methimazole, hydroxyurea or bioidentical hormone replacement from non-hazardous compounds. The hazardous compounding lab refreshes the air 12 times per hour and continuously draws the air up and out of the room to protect the employees and avoid cross-contamination. This ensures that compounds made at Bremo are safe for our
patients as well as, ensuring our pharmacists and technicians are safe in the preparation process.

Laws and Regulation


To understand compounding and the basis of what pharmacies are allowed to make, you have to know that there are three governing organizations that set these standards for pharmacies. The first organization is the United States Pharmacopeia (also referred to as USP). USP defines standards for compounding as well as the environmental and safety measures. These standards are then enforced by the Virginia Board of Pharmacy. The state board makes sure that pharmacies are practicing correctly by inspecting compounding pharmacies. USP outlines these standards for compounding through USP <795>, <797> and <800>. These chapters include ways to avoid contamination and provide guidance for compounding in a clean environment. It also outlines how to handle potentially hazardous medications and the type of facility requirements they need to be prepared in. USP guidelines are the minimum standard of compounding practice and must be followed by any pharmacy that compounds medications. USP <800> is the most recent chapter, and it adds new requirements for pharmacy facilities. Lastly, there is the Drug Enforcement Administration (DEA) which oversees controlled substances. Controlled substance medication can also be used in compounding.

Bremo pharmacy continues to stay informed about changes in compounding
practices to provide patients with the best possible services.

What can you have compounded?
Compounded drugs may be used when an FDA-approved medication is unsuitable for a patient’s needs, such as when a person has an allergy to an ingredient in a commercially available medication, requires a custom dose, different dosage form, or special method of delivery. If you have a prescription for a product that is not already available, it can be compounded. For example, atenolol is only available from the manufacturer as a tablet. If you or your pet were to need it as a liquid, we could make it here at Bremo because the liquid is not commercially available.
We can also compound discontinued medications, medications no longer made by the manufacturer, and not available on the market. This product can be compounded as long as it was not discontinued due to any safety concerns. Another reason we can make a commercially available product is if the available product has any “inactive ingredients” that a patient may be allergic to. A common example of this would be dye allergies. In this case, we are able to compound this product without that ingredient.

Bremo Pharmacy is able to customize medications to fit anyone’s needs, including changing the flavor. With a few exceptions most medications can be made into different forms, different dose or method of delivery, free from allergens and intolerances to meet an individual’s needs. We recently made many updates to our pharmacy, allowing us to expand our compounding services.

Please join us Friday, December 13th at
Bremo Pharmacy (2024 Staples Mill Rd) from
11:30am to 1:30pm to see our transformation and innovative compounding lab.
RSVP to Karen at Karen.Nemetz@bremorx.com or call (804)288-8361 ext. 130.
Come see what Bremo can do for you!

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