Novel Drug Delivery Forms in Compounding: The Complete 2026 Guide

Introduction: Why Drug Delivery Form Is as Important as the Drug Itself

The same active ingredient can succeed or fail based entirely on how it is delivered into the body. Absorption rate, bioavailability, and patient compliance all hinge on the dosage form. A perfectly prescribed medication is useless if a child spits it out, an elderly patient cannot swallow it, or the drug degrades before it reaches the bloodstream.

This reality is fueling remarkable growth in personalized medicine. The U.S. compounding pharmacy market was valued at approximately $6.98 billion in 2025 and is projected to reach $7.42 billion in 2026, climbing to $12.79 billion by 2035 at a CAGR of 6.24%, according to Towards Healthcare Research. That momentum reflects a healthcare system waking up to a simple truth: one size does not fit all.

Commercial manufacturers typically produce one or two standard forms of any given drug. Compounding pharmacies, by contrast, can engineer the delivery system itself to match a patient’s physiology, lifestyle, and clinical need. This guide explains each novel delivery form through three lenses: why it works pharmacokinetically, who it serves clinically, and how compounding pharmacies uniquely enable it.

Throughout, this article references the work of Nationwide Compounding Rx®, a PCAB-accredited, USP 800 compliant compounding pharmacy serving patients across 47 states plus Washington, D.C. From well-established transdermal gels to emerging 3D-printed orodispersible films and microneedle patches, here is the complete 2026 landscape.

Understanding the Pharmacokinetic Foundation: Why Delivery Form Matters

To understand novel delivery forms, a few concepts are essential. Bioavailability is the fraction of a drug that actually reaches systemic circulation. First-pass metabolism is the process by which the liver breaks down orally ingested drugs before they reach the bloodstream. Onset of action is how quickly a drug begins working.

Oral tablets and capsules, the commercial default, must survive gastric acid, enzymatic degradation, and extensive hepatic first-pass metabolism. This can reduce effective bioavailability dramatically. For some drugs, the majority of the dose is destroyed before it ever helps the patient.

Alternative routes of administration exist precisely to circumvent these barriers. Transdermal, sublingual, buccal, intranasal, rectal, vaginal, and subcutaneous routes each bypass the GI tract and liver to varying degrees. Choosing the right route can transform a marginally effective therapy into a reliable one.

Patient-specific variables matter enormously. Age, body composition, genetics, GI conditions, and concurrent medications all affect how a drug is absorbed and metabolized. The commercial one-size-fits-all form is simply inadequate for many patients. Pharmacogenomics adds another emerging layer: compounding pharmacists can use genetic and metabolic data to calculate optimal dosages and select the ideal delivery form for an individual.

Compounding pharmacies are uniquely positioned to act on this science. According to the APC 2025–2026 Snapshot, compounding pharmacies prepare approximately 100 unique formulations weekly, with pharmacists averaging 19 years of experience. That expertise and flexibility allow form to be matched to function.

Transdermal Delivery Systems: Bypassing First-Pass Metabolism Through the Skin

Transdermal drug delivery systems (TDDS) are formulations applied to the skin that allow active ingredients to permeate the stratum corneum and enter systemic circulation, completely bypassing hepatic first-pass metabolism.

The pharmacokinetic advantages are significant: more consistent plasma drug levels, reduced peak-and-trough fluctuations, lower systemic side effect burden, and improved patient compliance compared to oral dosing. Compounded transdermal forms span creams, gels, and ointments, each with distinct penetration profiles and clinical applications.

Compounded Transdermal Gels and Creams

Compounding pharmacies incorporate penetration enhancers such as DMSO, PLO gel base, and fatty acids to improve drug permeation through the skin barrier, a customization not available in commercial products. This unlocks a wide range of clinical uses:

• Hormone replacement therapy: estradiol, progesterone, and testosterone
• Pain management: ketamine, ketoprofen, and lidocaine combinations
• Dermatology: tretinoin, hydroquinone, and azelaic acid blends

These forms serve HRT patients who cannot tolerate oral hormones due to GI effects or clotting risk, pain patients seeking localized relief without systemic opioid exposure, and pediatric patients for whom topical application is the only feasible route. Nationwide Compounding Rx® offers transdermal creams, gels, and ointments as core components of its pain management and BHRT service lines. Non-sterile transdermal preparations fall under USP <795>, which introduced updated beyond-use dating and documentation standards effective November 2023.

Advanced Transdermal Carriers: Liposomal and Nanoencapsulation Systems

Liposomal delivery uses lipid bilayer vesicles to encapsulate hydrophilic or lipophilic drug molecules, dramatically improving skin penetration, solubility, and bioavailability compared to conventional creams. Nanotechnology has produced several next-generation variants: ethosomes (ethanol-enriched, highly deformable vesicles for deeper penetration), transfersomes (ultra-deformable carriers that squeeze through skin pores), niosomes (non-ionic surfactant vesicles), and pharmacosomes (drug-lipid conjugates), according to research published in MedComm: Biomaterials and Applications.

Nanoencapsulation packages active ingredients within nanocapsules (10 to 1000 nm) that protect the drug from degradation, control release rate, and enable targeted delivery. These systems are especially valuable for poorly water-soluble drugs, peptides, and hormones that conventional creams cannot deliver efficiently. While primarily found in research and 503B outsourcing contexts today, they represent the trajectory of compounding innovation.

Sublingual and Buccal Delivery Systems: Speed and Bioavailability Through the Oral Mucosa

Sublingual (under the tongue) and buccal (between cheek and gum) delivery routes carry drugs through the highly vascularized oral mucosa directly into systemic circulation, bypassing first-pass hepatic metabolism. The advantages include rapid onset (often within minutes), higher bioavailability than equivalent oral doses, reduced inter-patient variability, and avoidance of GI degradation. Compounded forms include troches, lozenges, sublingual tablets, solutions, and drops.

Troches and Lozenges

Troches are slow-dissolving lozenges held in the mouth that release drug into the oral mucosa over 15 to 30 minutes, combining mucosal absorption with some GI absorption as the troche dissolves. They are widely used for BHRT (estradiol, progesterone, testosterone, and DHEA combinations in a single troche), pain management, and sleep or anxiety formulations.

A key advantage is combination therapy: a single compounded troche can deliver two or more hormones simultaneously, reducing pill burden and improving adherence, a capability unavailable in commercial products. One limitation is that troches contain oils and can melt in high heat, requiring temperature-controlled shipping. Nationwide Compounding Rx® lists troches as a core dosage form, particularly for BHRT patients.

Sublingual Tablets and Solutions

Sublingual tablets differ from troches in important ways: they dissolve rapidly (within seconds to a few minutes), are not oil-based, do not melt under heat, and have no special shipping requirements, a practical advantage for nationwide distribution.

Sublingual solutions and drops are liquid formulations administered under the tongue, offering precise dose titration and rapid absorption. These are especially useful for pediatric patients, geriatric patients with swallowing difficulties, and patients requiring fine dose adjustments based on lab results, aligning directly with Nationwide Compounding Rx®’s patient-by-patient customization philosophy.

Orodispersible Films (ODFs): The Next Generation of Oral Mucosal Delivery

Orodispersible films are thin polymeric strips (typically 2 to 8 cm²) that dissolve or disintegrate rapidly in the oral cavity within seconds to a few minutes, without requiring water. Depending on formulation design, they can deliver drug via sublingual or buccal absorption (bypassing first-pass metabolism) or via swallowing the dissolved film for GI absorption.

The advantages over conventional oral forms are compelling: no swallowing required, faster onset, improved bioavailability, discreet administration, no risk of choking, and excellent compliance. A 2025 peer-reviewed study from St. Jude Children’s Research Hospital and CurifyLabs, published in Pharmaceutics, demonstrated that automated 3D printing produced pediatric hydrocortisone ODFs meeting all pharmacopeial criteria for mass and content uniformity, proving clinical-grade precision.

ODFs serve pediatric patients (no swallowing required, can be flavored), geriatric patients (dysphagia, polypharmacy), psychiatric patients (compliance monitoring), and patients with nausea who cannot retain tablets. Notably, 3D printing enables multilayer ODFs that can segregate incompatible drugs within a single film, a significant innovation for combination therapy that connects directly to Nationwide Compounding Rx®’s pediatric compounding service line.

Nasal Spray Compounding: A Direct Route to Systemic and CNS Delivery

The nasal mucosa is highly vascularized and offers direct access to systemic circulation. The olfactory region also provides a unique pathway to the central nervous system via the olfactory nerve, bypassing the blood-brain barrier. This makes intranasal delivery rapid, non-invasive, and capable of CNS-targeted delivery.

Compounded nasal sprays support peptide therapies (oxytocin, BPC-157, PT-141), hormone delivery (progesterone, estradiol), CNS medications (ketamine, naloxone), migraine treatments, and allergy formulations. Commercial nasal spray options are limited because most peptides and hormones are not available in intranasal form and individual dosing requirements vary widely, creating a clear role for compounding.

Peptide compounding has been a dynamic area in 2025 and 2026. The FDA Pharmacy Compounding Advisory Committee met on July 23–24, 2026 to discuss reclassifying certain therapeutic peptides back to Category 1 on the 503A Bulks List, a development with meaningful implications for nasal spray compounding.

Suppositories: Rectal and Vaginal Routes for Targeted and Systemic Delivery

Compounded suppositories are solid dosage forms designed to melt or dissolve at body temperature after insertion, releasing drug for local or systemic absorption. Rectal suppositories partially bypass hepatic first-pass metabolism because the inferior and middle rectal veins drain directly into systemic circulation, making them useful when oral administration is not feasible due to nausea, vomiting, unconsciousness, or pediatric non-compliance. Vaginal suppositories deliver drug directly to vaginal and uterine tissue with minimal systemic exposure, ideal for localized hormone therapy, antifungal treatment, and pelvic floor conditions.

Clinical applications include BHRT (vaginal progesterone and estriol suppositories), pain management, anti-nausea medications, and pediatric fever management when oral dosing is refused. Compounded BHRT progesterone exists in at least 13 different dosage forms, including suppositories, compared to only 4 FDA-approved forms, according to the NCBI Bookshelf. Nationwide Compounding Rx® lists suppositories as an available dosage form supporting its customized hormone therapy service line, prepared in compliance with USP <795>.

Hormone Pellet Implants: Subcutaneous Sustained-Release Delivery

Hormone pellet implants are small cylindrical pellets (typically 3 to 9 mm) compounded from crystalline hormone such as estradiol or testosterone, inserted subcutaneously (usually in the hip or buttock) via a minor in-office procedure. They dissolve slowly over 3 to 5 months, releasing hormone at a steady, physiologic rate that mirrors the body’s natural secretion pattern, eliminating the peaks and troughs associated with creams, injections, or oral dosing.

The advantages include consistent hormone levels, no daily administration burden, improved compliance, and customization to individual lab results. Pellets are uniquely a compounding product because they are not commercially manufactured in the breadth of strengths required for individualized dosing. This aligns with Nationwide Compounding Rx®’s BHRT philosophy of adjusting medications each refill based on lab results. Insertion is performed by the prescribing provider; the pharmacy’s role is precision manufacturing to exact strength and size specifications.

Oral Liquids and Suspensions: Flexible Dosing for Pediatric and Geriatric Patients

Compounded oral liquids and suspensions dissolve (solution) or disperse (suspension) the drug in a vehicle, often with flavoring agents and stabilizers. Many patients, particularly children and the elderly, cannot swallow tablets or capsules. Liquid forms allow precise dose titration, easy administration, and improved palatability through flavoring. Oral liquids generally have faster onset than solid oral forms, though suspensions require proper shaking to ensure dose uniformity.

Flavor customization is a direct compliance tool. Nationwide Compounding Rx® offers eight flavoring options: banana crème, cherry, grape, peppermint, raspberry, strawberry, tutti frutti, and vanilla butternut. Applications include pediatric antibiotics, anticonvulsants, and hormones in custom strengths; geriatric polypharmacy simplification; feeding-tube patients; and dysphagia. Notably, more than half of compounding pharmacies reported compounding copies of FDA-approved drugs during active shortages, and oral liquids are frequently among those shortage-driven compounds.

Capsules with Enhanced Delivery: Beyond the Standard Oral Solid

While compounded capsules resemble commercial ones, they enable custom drug combinations, precise strengths unavailable commercially, allergen-free formulations, and modified-release profiles. Compounding pharmacies can formulate sustained-release or delayed-release capsule contents using pharmaceutical polymers and excipients, extending drug action and reducing dosing frequency.

A single compounded capsule can contain two or more active pharmaceutical ingredients in exact ratios, reducing pill burden for complex conditions. Nationwide Compounding Rx® can eliminate common allergens such as lactose, dyes, gluten, and sugar, a critical capability for patients with multiple sensitivities. Applications include BHRT combinations, multi-modal analgesia, thyroid therapy (T3/T4 in exact ratios), and weight management. When commercial manufacturers discontinue low-profit drugs, compounding pharmacies can continue producing them in capsule form for dependent patients.

Gummies and Chewable Forms: Compliance-Driven Innovation

Compounded gummies are gelatin or pectin-based chewable formulations that incorporate active ingredients in a palatable, familiar format. They dramatically improve compliance in pediatric patients who refuse tablets, capsules, or unpleasant liquids, addressing one of the most persistent challenges in pediatric pharmacotherapy.

Adult applications are expanding to include patients with swallowing difficulties, cognitive impairments, or strong aversions to conventional forms. Because gummies are chewed and swallowed, absorption follows oral GI kinetics, and formulation must ensure dose uniformity throughout the matrix. Nationwide Compounding Rx® specifically lists gummies as suited for pediatric dosing, prepared under USP <795> standards for content uniformity, stability, and appropriate beyond-use dating.

Microneedle Patches: The Frontier of Minimally Invasive Transdermal Delivery

Microneedle (MN) patches are arrays of microscale needles (typically 25 to 2000 µm) that painlessly penetrate the stratum corneum to deliver drugs into the viable epidermis or dermis, bypassing the primary skin barrier without reaching nerve endings. This overcomes the central limitation of conventional patches, enabling delivery of larger molecules such as peptides, proteins, and vaccines.

According to research on microneedle technologies for drug delivery, there are four main types: solid (coat-and-poke), hollow (infuse through channels), dissolving (polymer needles that dissolve in skin), and coated. Emerging applications include peptide delivery (GLP-1 analogs, BPC-157), hormone therapy, psychedelic-assisted therapy, and vaccines. The FDA’s July 2026 discussion on reclassifying peptides for 503A compounding could significantly expand microneedle patch compounding. Currently, this technology remains primarily in research, 503B outsourcing, and specialized clinical settings, but it represents a near-term frontier.

3D Printing in Compounding Pharmacy: Precision Manufacturing for Personalized Dosage Forms

Pharmaceutical 3D printing (additive manufacturing) is moving from research feasibility to clinical practice. It enables on-demand production of dosage forms with precise, patient-specific drug content, geometry, and release profiles, including gel tablets, troches, ODFs, and multilayer forms that segregate incompatible drugs.

The landmark 2025 St. Jude and CurifyLabs study produced three pediatric hydrocortisone dosage forms (gel tablets, water-free troches, and orodispersible films), all meeting pharmacopeial criteria. In January 2026, CurifyLabs launched the PharmaPrinter Aurum, a next-generation printer up to nine times faster than manual compounding. The 3D printed drugs market is projected to grow from $435.8 million in 2026 to $1.1 billion by 2036 at a CAGR of 9.8%, signaling that mainstream adoption is approaching. A 2026 Drug Delivery and Translational Research paper documents 3D printing spreading across hospital point-of-care, community-pharmacy compounding, and industrial production, with bioequivalence demonstrated in healthy adults.

Automation, Robotics, and AI: How Technology Elevates Novel Dosage Form Quality

Automation is transforming compounding quality and safety. Robotic systems at UCSF Medical Center have prepared 350,000 medication doses without a single error, and automated compounding software has doubled output to 14,000 doses per year without additional staff. Modern automation can produce up to 1,000 weight-controlled doses per hour.

AI applications now include automated dose verification, preparation error detection, correct labeling in sterile environments, and pharmacogenomic-guided precision dosing that analyzes genetics, BMI, and metabolism. Producing consistent ODFs, liposomal formulations, or microneedle patches requires precision that manual compounding alone cannot reliably achieve at scale. Nationwide Compounding Rx®’s commitment to modern, high-tech technologies, combined with USP 800 compliance and PCAB accreditation, provides the quality infrastructure within which these advanced methods can be safely deployed. Its 1 to 2 business day turnaround demonstrates that technology investment supports both quality and speed.

Novel Dosage Forms by Patient Population: Matching the Form to the Person

The most clinically meaningful way to understand novel dosage forms is to map them to the populations they serve, because the right form depends entirely on the patient’s age, condition, physiology, and lifestyle.

Pediatric Patients

Children cannot swallow most commercial tablets, and many drugs lack pediatric-appropriate strengths. Best-suited forms include flavored oral liquids, gummies, orodispersible films, and 3D-printed gel tablets. The 2025 St. Jude and CurifyLabs study of pediatric hydrocortisone ODFs and troches is a landmark example. Nationwide Compounding Rx®’s pediatric line offers flavored liquids, gummies, and custom-strength formulations with eight flavors to maximize compliance.

Geriatric Patients

Dysphagia, polypharmacy, cognitive impairment, and altered pharmacokinetics define geriatric challenges. ODFs, sublingual solutions, transdermal gels, and gummies eliminate the swallowing requirement. Combination therapy consolidates multiple medications into a single form, reducing pill burden. Reduced hepatic function makes first-pass-bypassing routes especially advantageous, and allergen-free formulations address common sensitivities.

Hormone Replacement Therapy (HRT) Patients

HRT is the fastest-growing therapeutic application in compounding, driven by demand for customized hormone type, dosage, and delivery. Compounded progesterone exists in at least 13 dosage forms versus 4 FDA-approved forms. Best-suited forms include transdermal creams and gels, troches, sublingual tablets, vaginal suppositories, and pellet implants. Nationwide Compounding Rx® adjusts BHRT medications each refill based on lab results. Notably, estriol cream and pellets containing estradiol or progesterone exist only as compounded preparations.

Pain Management Patients

Systemic oral pain medications carry risks of addiction, nausea, dizziness, and sedation. Transdermal gels and creams deliver ketamine, ketoprofen, lidocaine, or combinations directly to the pain site with minimal systemic absorption. Sublingual solutions offer rapid onset for breakthrough pain, and suppositories serve patients who cannot take oral medications. A single transdermal gel can combine an NSAID, a local anesthetic, and a muscle relaxant. Nationwide Compounding Rx®’s pain service focuses on topical formulations that minimize systemic side effects.

Dermatology Patients

Commercial dermatology products may contain irritants, allergens, or inappropriate concentrations. Customized creams, gels, and ointments with precise active ingredient concentrations, plus liposomal carriers for enhanced penetration, address these limitations. Nationwide Compounding Rx® treats rosacea, acne, aging, scarring, stretch marks, dark spots, eczema, psoriasis, and atopic dermatitis, with vehicle customization and allergen-free options for sensitive skin.

The Regulatory Landscape Shaping Novel Compounded Dosage Forms in 2026

Two categories govern compounding. 503A pharmacies compound for individual patient prescriptions, the traditional model. 503B outsourcing facilities compound in larger batches without patient-specific prescriptions, under FDA oversight similar to manufacturers.

Updated USP <795> and <797> standards, official since November 1, 2023, introduced stricter beyond-use dating based on dosage form, expanded facility and personnel requirements, and enhanced documentation. USP <800>, met by Nationwide Compounding Rx®’s facility, governs hazardous drug handling and eliminates cross-contamination risk, critical for potent hormones. The FDA advisory committee meeting of July 23–24, 2026 addressed reclassifying therapeutic peptides back to Category 1, with implications for nasal and microneedle peptide compounding. Meanwhile, legislative developments would narrow copy compounding and expand oversight. Drug shortages remain a powerful driver, with more than half of pharmacies compounding FDA-approved copies during active shortages. PCAB accreditation provides third-party validation of compliance, a quality signal for prescribers and patients.

How Compounding Pharmacies Differ From Commercial Manufacturers: The Novel Form Advantage

Commercial manufacturers produce standardized drugs at scale for the broadest population. Compounding pharmacies engineer individualized formulations for specific patients whose needs fall outside that standard. FDA approval requires a fixed formulation, strength, and dosage form; changes demand new approval, making rapid customization impossible for manufacturers.

A compounding pharmacist, by contrast, can change the delivery form, adjust the strength, eliminate allergens, add flavoring, combine multiple APIs, and select the optimal vehicle within a single prescription cycle. When manufacturers discontinue low-profit drugs, compounders continue producing them in whatever form a patient requires. Combination therapy allows multiple APIs in a single novel form, reducing pill burden. Nationwide Compounding Rx®’s 1 to 2 business day turnaround and same-day pickup contrast sharply with the months-long timelines of commercial development, and its reach across 47 states plus Washington, D.C. combines geographic scale with patient-specific customization.

Conclusion: The Right Form for the Right Patient

Novel drug delivery forms in compounding are not merely alternative packaging. They are pharmacokinetically engineered solutions that determine whether a drug reaches its target effectively, safely, and in a form the patient will actually use. This guide has covered the full spectrum: transdermal gels and liposomal carriers, sublingual troches, orodispersible films, nasal sprays, suppositories, hormone pellets, microneedle patches, and 3D-printed dosage forms, each serving distinct clinical needs.

The market’s projected growth to $12.79 billion by 2035 reflects a healthcare system increasingly recognizing that personalized medicine requires personalized delivery. The best dosage form is always the one that matches the individual patient’s physiology, lifestyle, and clinical condition, a determination requiring the expertise, flexibility, and accreditation of a qualified compounding pharmacy. With PCAB accreditation, USP 800 compliance, 40 years of combined staff experience, and a full spectrum of novel forms, Nationwide Compounding Rx® is equipped to serve patients who need more than commercial manufacturing can provide. Its core philosophy, “We do not believe in a one size fits all approach,” is not just a value proposition but a pharmacokinetic and clinical reality.

Ready to Explore a Novel Delivery Form for Your Patient or Prescription?

For healthcare providers: Contact Nationwide Compounding Rx® to discuss which novel dosage form best serves your patient’s specific clinical needs. The pharmacy operates on a collaborative, provider-partnership model designed to support prescribing decisions.

For patients: If you are struggling with a commercial medication’s form, strength, or ingredients, ask your prescriber about compounded alternatives and request that your prescription be sent to Nationwide Compounding Rx®.

Contact information:

• Phone: 480-499-8379
• Toll-Free: 1-833-650-9836
• Website: www.NationwideCompounding.com
• Turnaround: 1 to 2 business days

Nationwide Compounding Rx® serves patients across 47 states plus Washington, D.C., with same-day pickup available for some medications at its Scottsdale, AZ location for local patients. As a PCAB-accredited, USP 800 compliant pharmacy sourcing only from FDA-inspected vendors, it delivers quality and safety that prescribers and patients can rely on. Explore the BHRT, pain management, pediatric compounding, and dermatology service pages for deeper information on novel forms relevant to your specialty or condition.