Key Takeaways
- A compounded medicine is mixed for you by a licensed pharmacy, at the strength and in the form your provider prescribes.
- Compounding exists because some people need a strength, a form or an ingredient change that no manufactured product offers.
- An FDA-approved product is one standard product made for everyone. A compounded preparation is made specifically for one person.
- Your pharmacy label lists your strength and directions.
If you've seen "compounded" on a prescription or a treatment page, you might wonder what it means. It's about how the medicine is made: prepared by a pharmacy for one person, rather than made the same way for everyone.
What Is Compounding?
It's when a pharmacy combines, mixes or alters ingredients to make a medicine for a specific person, as the FDA describes it.
Why It Exists
Because people's needs vary and manufactured products come in set forms. You might need a strength that isn't made, a liquid because you can't swallow a tablet, or a version without an ingredient that doesn't agree with you. Compounding fills the gap between what's manufactured and what you need.
How Is It Different From an FDA-Approved Product?
The difference is who the medicine is made for, and how it's checked before it reaches you.
An FDA-approved product is reviewed by the FDA before it's sold. The manufacturer submits trial data, and the FDA approves the product's labeling: what it treats, at what doses and with which warnings. Every batch made under that approval is the same product.
A compounded preparation is made by a licensed pharmacy for one person's prescription, at the strength and in the form your provider chooses. Compounded medicines aren't FDA-approved, and the FDA doesn't review them before they're marketed, so they don't come with approved labeling of their own.†
Both start with a prescription, and your provider can help you weigh which one fits your situation.
TWO ARRANGEMENTS
Made for everyone, or made for you.
| Manufactured | Compounded | |
|---|---|---|
| What it is | One standard product | Prepared for one person |
| Who checks it first | Reviewed by the FDA before it is sold | Reviewed by the prescriber and the pharmacist |
| Where instructions come from | Labeling set by the FDA | Your prescription and your own label |
A prescription either way.
How Do Your Provider and Pharmacy Work Together?
Your provider prescribes, and a licensed pharmacy prepares your medicine to that prescription. First, a provider licensed in your state reviews your health history and the medicines you take, and decides whether a compounded preparation fits. If it does, your provider writes your prescription, including the strength.
Your pharmacy label tells you what's in your medicine, at what strength, and how to take it. Follow those directions, and ask your provider or pharmacist about anything that's unclear. Because the pharmacy prepares it for your prescription, compounding can add time to delivery.
Before each refill, your provider reviews your care, and your care team is available between refills.
What Should You Ask?
Four questions are worth asking your provider or pharmacist.
- What's in it, and at what strength? Your prescription and pharmacy label tell you.
- Who prepares it? A licensed pharmacy, and your provider can tell you which one.
- What is it meant to help with? Your provider explains how it fits your goals and how your progress will be reviewed.
- Is there an FDA-approved option? For some medicines, there is. Your provider can tell you whether one exists for yours and how the two compare.
Safety Information for Your Medicine
Before prescribing, your provider checks the safety information on the FDA-approved label for the same active ingredient. Share your health history, the medicines you take and any side effects you notice. Check with your provider before changing how much you take or how often.
Our guides to compounded semaglutide and compounded tirzepatide cover side effects and who should be careful with those medicines.
Start With an Evaluation
Whether a compounded preparation fits you is a decision you make with a licensed provider who knows your history. When you're ready, the next step is an evaluation.
Frequently Asked Questions
Is a compounded medication safe?
It's prepared by a licensed pharmacy for you, on a prescription from a provider who has reviewed your health history. The reviewed safety information for its active ingredient comes from the approved product's label, and your provider weighs it before prescribing. Follow your prescription and pharmacy label, and tell your provider about any side effects.
Is compounded the same as generic?
No. A generic is approved in its own right, through an application showing it matches an approved reference product. A compounded preparation is made by a licensed pharmacy for one person's prescription, and it isn't a generic version of anything. LIV offers FDA-approved and compounded medicines: Ozempic and Zepbound from their manufacturers, and compounded semaglutide and tirzepatide mixed for you by a licensed pharmacy.
Why would a provider prescribe something compounded?
Because a manufactured product doesn't fit what you need. A different strength, a different form or leaving out an ingredient are all common reasons.
Why do compounded versions of some medicines come and go?
Federal law limits compounding a preparation that's essentially a copy of a commercially available product. That limit eases when the approved product is in shortage and returns when the shortage ends, so availability can change. Your provider can tell you what's available to you.
What does the boxed warning on Ozempic and Zepbound say?
The Ozempic label and the Zepbound label each carry a boxed warning about thyroid C-cell tumors. Semaglutide and tirzepatide caused these tumors in rodents; it isn't known whether they do in people. Neither is for anyone with a personal or family history of medullary thyroid cancer or MEN 2, or a serious allergy to the medicine. Compounded semaglutide and tirzepatide contain the same active ingredients, so your provider reviews this history before prescribing either form. The label notes that routine blood tests (calcitonin) or thyroid ultrasound are of uncertain value for catching these tumors early, so tell your provider about a lump in your neck, trouble swallowing, shortness of breath or hoarseness that doesn't go away.
References
U.S. Food and Drug Administration. (2026). Compounding and the FDA: Questions and answers. Read 2026-08-20. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
U.S. Food and Drug Administration. (n.d.). Compounded drug products that are essentially copies of a commercially available drug product under section 503A of the Federal Food, Drug, and Cosmetic Act: Guidance for industry. Read 2026-08-20. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/compounded-drug-products-are-essentially-copies-commercially-available-drug-product-under-section
Eli Lilly and Company. (2026). Zepbound (tirzepatide) injection: Prescribing information (revised 4/2026). DailyMed. Read 2026-08-20. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
Novo Nordisk Pharmaceutical Industries, LP. (2026). Ozempic (semaglutide) injection: Prescribing information (revised 5/2026). DailyMed. Read 2026-08-20. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
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