Compounding Pharmacy


A compounding pharmacy plays a crucial role in the at-home administration of therapeutic ketamine by preparing customized formulations, ensuring the appropriate dosage, and providing guidance on proper usage. Although ketamine is primarily known as an anesthetic, it has been increasingly used for treating mental illnesses such as depression and post-traumatic stress disorder (PTSD).

The role of a compounding pharmacy in at-home routes of administration of therapeutic ketamine can be explained as follows:

  1. Customized formulations: Ketamine is available in various forms, such as intravenous (IV) infusion, intramuscular (IM) injection, nasal spray, and oral formulations. A compounding pharmacy can create customized formulations tailored to the patient’s needs, considering the required dosage, administration route, and any potential allergies or sensitivities.
  2. Ensuring appropriate dosage: The dosage of ketamine for therapeutic purposes can vary based on the condition being treated, the patient’s medical history, and their response to the medication. A compounding pharmacy can accurately measure and prepare the correct dosage, ensuring the patient receives effective and safe treatment.
  3. Guiding proper usage: The compounding pharmacy can instruct patients and caregivers on the correct administration method, storage, and medication handling. This is particularly important for at-home administration, where the patient or caregiver may be responsible for administering the ketamine.
  4. Monitoring and adjusting treatment: A compounding pharmacy may work closely with the patient’s healthcare provider to monitor the patient’s response to the treatment and make any necessary adjustments to the dosage or formulation. This allows for a more personalized approach to therapy and can improve treatment outcomes.
  5. Compliance with regulations: Compounding pharmacies must follow strict guidelines and regulations to ensure the safety, quality, and efficacy of the medications they prepare. This includes adhering to Good Compounding Practices (GCP) and other relevant standards.

It is essential for patients receiving at-home therapeutic ketamine to work closely with their healthcare provider and compounding pharmacy to ensure they receive the most appropriate and effective treatment. This collaboration can help optimize the patient’s response to ketamine therapy and minimize potential side effects.


Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., … & Nemeroff, C. B. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399-405. Link: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2605202

Wilkinson, S. T., Ballard, E. D., Bloch, M. H., Mathew, S. J., Murrough, J. W., Feder, A., … & Sanacora, G. (2018). The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis. American Journal of Psychiatry, 175(2), 150-158. Link: https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2017.17040472

Xu, Y., Hackett, M., Carter, G., Loo, C., Gálvez, V., Glozier, N., … & Glue, P. (2016). Effects of low-dose and very low-dose ketamine among patients with major depression: a systematic review and meta-analysis. International Journal of Neuropsychopharmacology, 19(4), pyv124. Link: https://academic.oup.com/ijnp/article/19/4/pyv124/2599526


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