Medication Dosage Forms: Creams, Liquids, Capsules and Other Compounded Options

One of the most practical reasons a prescriber may consider compounding is dosage-form customization. A patient may need a prescription in a form that differs from an available manufactured product. The exact option depends on the drug, route, prescription, patient needs, formulation science, and pharmacy capabilities.

Why dosage form matters

A dosage form is the physical form in which a medication is prepared and used. Tablets, capsules, liquids, creams, gels, ointments, and other preparations can behave differently and are not automatically interchangeable.

When a provider requests a different dosage form, the pharmacist has to determine whether that form is appropriate for the active ingredient and intended route of administration.

Oral liquids

A liquid may be considered when a patient cannot appropriately use a tablet or capsule and the prescription can be prepared as a suitable liquid formulation. FDA specifically identifies inability to swallow a tablet or capsule as one example of why a patient may need a compounded drug.

Liquids may require specific storage, measuring, or shaking instructions. Patients should follow the label and use the measuring device recommended by the pharmacy.

Capsules

A compounded capsule may be used when a patient-specific prescribed strength is appropriate and the formulation can be prepared in capsule form. The prescriber determines the intended dose; the pharmacy evaluates whether the requested capsule can be compounded.

Patients should not open, divide, or otherwise alter a compounded capsule unless the pharmacist or prescriber specifically instructs them to do so.

Creams, gels, ointments and other topicals

Topical dosage forms may be used for prescriptions intended for application to the skin or another specified site. The active ingredient, base, concentration, application site, and directions all matter to the formulation.

A pharmacist may need to clarify the requested vehicle or concentration with the prescriber before preparation.

Flavors and easier-to-take preparations

For suitable prescriptions, flavor may sometimes be adjusted to make an oral preparation easier for a patient to take. Flavoring does not change the prescribed dose or make the medication optional; patients still need to follow the directions on the prescription.

Not every drug or dosage form can be flavored or changed, so the pharmacy has to review the specific prescription first.

The right form is prescription-specific

There is no universally 'best' compounded dosage form. The appropriate choice depends on the medication, patient, intended route, prescription, and formulation requirements.

Related Lone Star Chemist resources

Flavored & Easier-to-Take Medications Explore patient-specific dosage-form and flavor options.

Customized Medications Learn about customized strengths and dosage forms.

Compounding Education Center Read more educational pharmacy content.

Patient Resources Review practical prescription guidance.

Important compounding information

Compounded medications are not FDA-approved. FDA does not review compounded drugs before marketing for safety, effectiveness, or quality. Compounding is used for individual patient needs when appropriate, and availability depends on the prescription, clinical appropriateness, ingredient eligibility and availability, pharmacy capabilities, and applicable law.

For federal information, see FDA's Compounding and the FDA: Questions and Answers.