Compounding FAQ

The National Institute for Occupational Safety and Health (NIOSH) publishes a List of Antioneoplastic and Other Hazardous Drugs in Healthcare Settings.

On November 1, 2022, United States Pharmacopeia (USP) published revisions to their pharmaceutical compounding standards chapter 795 (nonsterile preparations) and 797 (sterile preparations) with an anticipated implementation date of November 1, 2023, for both.

The following presentation is a broad comparison of the major differences between the currently implemented guidelines and the 2022 revisions. The presentation is not meant to be a comprehensive guide for implementation for the revisions.

USP 797 and 795 presentation

The amendments to 201 KAR 2:076 became effective on October 25, 2023. The amendments reflect the adoption by the Board of the 2022 revisions for USP 797 and USP 795 standards and include USP 800 as it relates to compounding.

Highlights of the regulation include:

  • The addition of the Designated Person (definition and responsibilities).
  • Definitions for “essential copy of a commercially available drug product" and “hazardous drug" and rules regarding both terms.
  • The addition of a flavoring will not be considered compounding if the additive is non-expired, inert, nonallergenic, produces no effect other than the instillation or modification of flavor and is not greater than five (5) percent of the drug product's total volume.
  • The dispensing of compounded preparations for veterinary use shall follow the requirements of 201 KAR 2:311.
  • Verification of a compounded preparation shall be completed by a pharmacist after the preparation of the compound and prior to dispensing to the patient.
  • Enforcement Discretion: Effective January 1, 2026 the board shall enforce the 2022 revisions. Until January 1, 2026 the board shall enforce the 2014 revision of USP 795 and the 2008 revision of USP 797, and the board shall not enforce USP 800.

Until January 1, 2026 at the request of a permit holder the board may inspect pursuant to the 2022 revision standards.

Compounding a commercially available product is allowable only in certain narrow circumstances, as described in the 2025 Update​.  

The Board is charged with protecting the public. Therefore, compounding semaglutide or tirzepatide drug products in a way that fails to conform with governing law may lead to enforcement action by the Food and Drug Administration and the Kentucky Board of Pharmacy.

Pharmacies should also be aware that pharmaceutical manufacturers may initiate legal proceedings against prescribers and compounders to combat illegal semaglutide or tirzepatide drug product compounding.​

201 KAR 2:076​ governs the preparation of compounded drug products. Compounding is also governed by the federal Drug Quality and Security Act and by applicable United States Pharmacopeia chapter standards, which are incorporated as a matter of federal and state law.

​201 KAR 2: 311 

The FDA’s most current statement of regulatory policy governing veterinary compounding may be found here: FDA Regulation of Animal Drugs. Included in the resources at this link is FDA’s final Guidance for Industry #256, Compounding Animal Drugs from Bulk Drug Substances.

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