Compounding
Elizabeth Briand
It may sound like something out of a futuristic film: Researchers used an automated compounding platform based on 3D printing to create pediatric corticosteroid formulations.
For the study, published in the June 9, 2025, issue of Pharmaceutics, pharmacists at St. Jude Children’s Research Hospital in Memphis prepared three personalized hydrocortisone dosage forms—3.2 mg gel tablets, 2.8 mg water-free troches, and 1.2 mg orodispersible films (ODF)—in a hospital pharmacy setting using a proprietary excipient base and standardized procedures. Testing showed that each of the formulations met pharmacopeial criteria for mass and content uniformity. The ODF and troche forms achieved rapid drug release standards, exceeding 75% within 5 minutes. The gel had a slower release—86% within 60 minutes.
Researchers concluded that “such systems can improve accuracy, minimize variability, and streamline the production of customized pediatric medications, particularly for drugs with poor palatability or narrow therapeutic windows.”
New approach to compounding
“I think the technology could improve dosing accuracy and precision compared to traditional compounding or extemporaneous preparation,” said lead study author Brooke Bernhardt, PharmD, chief pharmacy officer at St. Jude Children’s Research Hospital. “ I also think it has great potential to improve patient medication adherence by enabling tailoring of the formulation.”
Adherence could be supported by the ability of 3D printing to design doses in more appealing shapes and colors—something that could turn a child’s “no” into a “yes” when it comes to taking their medications.
Currently, as the study authors noted, there are limitations on commercially available formulations that can make it tricky to meet the unique needs of young patients. Manually compounding medications for pediatric patients is a labor-intensive process that may not be as consistent or accurate when it comes to dose.
Bernhardt and her team noted in their study that automated compounding systems offer better accuracy and reproducibility but that most of the advancements in this area have been in sterile compounding. Nonsterile compounding, however, has been slow to adapt to automation for a number of reasons, including the absence of standardized formulations and limited incentives for hospitals to invest in technologies that could support the work.
Bernhardt believes that the greatest benefit of nonsterile 3D-printing compounding technology is the potential to create more accurate dosing that meets the needs of patients.
“For compounding pharmacists, it is a new tool that can be used to offer greater flexibility in the types of therapies that can be offered,” she said.
Growing opportunities
Although the first 3D-printed medication was introduced in the United States nearly a decade ago, the practice has not gained as much traction here as it has in European hospitals, where Bernhardt first saw the technique used. In putting her study together, she found that many of the parts and excipients needed to run the machines used in Europe were not available in the United States.
“Europe is quite a bit ahead of us as it pertains to this field,” Bernhardt said. “And there is still a lot of work to be done to better understand exactly what can be done with this technology—safely and effectively. It will still take some time for it to be adopted as a more mainstream process in the U.S.”
Still, as the study suggested, the advantages of 3D printing in pediatric drug delivery are becoming increasingly apparent. Bernhardt and her team cite the examples of 3D-printed personalized medicines that have been effective in treating children with rare metabolic disorders as well as the ability of this technology to produce small or even single personalized doses for pediatric patients—ideal for hospitals or pharmacies requiring on-demand pediatric medicines.
“I envision this technology initially serving patients with complex, unique medical needs—pediatrics and geriatrics for sure,” Bernhardt said. “I think there is a lot of potential for compounding pharmacies to embrace this technology as well.” ■