Pharmaceutical profile and prescribing practices in compounding pharmacies in Brazil: a cross-sectional study

The industrialization expanded drug access but standardized formulations often fail to meet individual clinical specificities. Compounding pharmacies fill this gap by providing personalized therapies. In Brazil, although Federal Pharmacy Council Resolutions grant pharmacists the autonomy to prescribe over-the-counter drugs and compounded formulations, this clinical practice faces legal instability and structural challenges. This study aimed to outline the profile of pharmacists and analyze the clinical practice of pharmaceutical prescribing in compounding pharmacies across Brazil.

This is a quantitative, descriptive, and cross-sectional study conducted through an online survey covering all 27 federal units in Brazil. The questionnaire was distributed between May and December of 2024 via institutional channels and professional social networks. The sample consisted of 186 licensed pharmacists working in the compounding sector. Data collection addressed personal and professional information, prescription practices, and the management of self-limiting health problems.

The sample was predominantly female (78.5%), with a high concentration in the Southeast region (35%). While 73.1% of participants perform pharmaceutical prescribing, only 43.4% document these prescriptions according to regulatory requirements. Furthermore, 44.3% of participants reported never having taken training courses related to prescribing. The most frequently managed health demands included mild insomnia (86.6%), weight loss (84.4%), and anxiety (83.9%). Herbal medicines were the most prescribed class (87.7%), with Passiflora incarnata (64.8%) being the most common active ingredient. Major barriers to prescribing included a lack of time (67.6%), absence of financial incentives (36.3%), and inadequate infrastructure (32.4%). Most professionals (61.8%) provide prescribing services free of charge.

Pharmacists in Brazilian compounding pharmacies actively perform clinical prescribing, primarily managing self-limiting conditions with herbal and nutritional therapies. However, a significant gap persists between practice and formalization, characterized by low documentation rates, lack of infrastructure privacy, and training deficiencies. Addressing these regulatory, educational, and structural limitations is critical to ensuring patient safety, establishing clinical governance, and consolidating the role of the compounding pharmacist in the healthcare system.