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Commonly Compounded Medications for Oncology Patients If your healthcare provider has recommended a compounded medication as part of your oncology care, you may be researching the medications that compounding pharmacies commonly prepare. This page provides general information about several medications that Pharmacy Solutions frequently compounds for oncology patients when prescribed by a qualified healthcare provider.
The medications described on this page are FDA-approved for their original indications but have also appeared in published oncology research. Any use outside the original approved indication is considered off-label. Off-label prescribing is legal and common in medical practice, and the decision to prescribe any medication rests entirely with your healthcare provider based on their clinical judgment and review of available research.[1] Pharmacy Solutions does not recommend, promote or prescribe any medication. The pharmacy prepares compounded medications only when a licensed healthcare provider has issued a prescription.
What Off-Label Prescribing Means
When a healthcare provider prescribes a medication for a use other than its FDA-approved indication, this is called off-label prescribing. The FDA approves drugs for specific conditions based on clinical trial data. However, once a drug is approved, the FDA does not regulate how providers choose to prescribe it. Providers may prescribe off-label based on published research, clinical experience and their assessment of a patient’s individual situation.[1]
Off-label prescribing is particularly common in oncology. Many medications used in cancer care are prescribed for indications or in combinations that extend beyond their original FDA approval. This reflects the evolving nature of oncology research and the need for individualized care approaches.
Mebendazole
Original approved use
Mebendazole is an antiparasitic medication in the benzimidazole family. It has been used for decades to address helminthic (parasitic worm) infections and has an established safety profile from this use.[2]
Oncology research context
Mebendazole has been the subject of preclinical studies and a limited number of clinical investigations exploring its potential applications in oncology. Published research includes laboratory studies, animal models and early-phase human trials.[3][4] A phase 2a clinical study examining mebendazole in patients with advanced gastrointestinal cancer was published in 2021.[5] Research in this area is ongoing, and mebendazole has not been approved by the FDA for any oncology indication.
What Pharmacy Solutions can compound
When prescribed by a healthcare provider, Pharmacy Solutions can prepare mebendazole in customized strengths or formulations according to the provider’s specifications. Dosing for off-label use may differ from standard antiparasitic dosing, and your provider will determine the appropriate prescription based on your individual situation.
Ivermectin
Original approved use
Ivermectin is an antiparasitic medication with decades of safety data from its approved indications. It is used to address certain parasitic infections and has a well-characterized safety profile.[6]
Oncology research context
Ivermectin has appeared in published preclinical research examining potential mechanisms relevant to oncology.[7] This research is exploratory, conducted primarily in laboratory and animal models, and ivermectin has not been approved by the FDA for any oncology indication. Any use in this context is off-label and at the discretion of the prescribing provider.
What Pharmacy Solutions can compound
When prescribed by a healthcare provider, Pharmacy Solutions can prepare ivermectin in customized strengths or formulations according to the provider’s specifications.
Metformin
Original approved use
Metformin is a medication widely prescribed for the management of type 2 diabetes. It has been in clinical use for decades and has an extensive safety record.[8]
Oncology research context
Metformin has appeared in numerous published studies exploring potential associations between its use and oncology outcomes. Much of this research comes from epidemiological studies examining populations already taking metformin for diabetes.[9] Clinical trials investigating metformin in oncology contexts are ongoing. Metformin has not been approved by the FDA for any oncology indication, and any use in this context is off-label.
What Pharmacy Solutions can compound
When prescribed by a healthcare provider, Pharmacy Solutions can prepare metformin in customized strengths or formulations according to the provider’s specifications. This may be appropriate when a patient requires a dosage form or strength not commercially available.
Atorvastatin
Original approved use
Atorvastatin is a statin medication prescribed to help manage cholesterol levels. It is one of the most commonly prescribed medications in the United States and has an extensive safety profile from widespread clinical use.[10]
Oncology research context
Statins, including atorvastatin, have appeared in published research examining potential associations with oncology outcomes. Much of this research is epidemiological, with some preclinical studies exploring potential mechanisms.[11] Atorvastatin has not been approved by the FDA for any oncology indication, and any use in this context is off-label.
What Pharmacy Solutions can compound
When prescribed by a healthcare provider, Pharmacy Solutions can prepare atorvastatin in customized strengths or formulations according to the provider’s specifications.
Doxycycline
Original approved use
Doxycycline is a broad-spectrum antibiotic in the tetracycline class. It has been used for decades to address bacterial infections and certain other conditions, with a well-established safety profile.[12]
Oncology research context
Doxycycline has appeared in published preclinical research exploring potential mechanisms relevant to oncology.[13] This research is exploratory, and doxycycline has not been approved by the FDA for any oncology indication. Any use in this context is off-label and at the discretion of the prescribing provider.
What Pharmacy Solutions can compound
When prescribed by a healthcare provider, Pharmacy Solutions can prepare doxycycline in customized strengths or formulations according to the provider’s specifications.
The COC Protocol
Some healthcare providers prescribe combinations of repurposed medications as part of an individualized approach to oncology care. One such approach, developed by Care Oncology Clinic, is known as the COC Protocol. This protocol involves the use of metformin, atorvastatin, doxycycline and mebendazole in combination.[14]
Pharmacy Solutions can compound medications prescribed as part of the COC Protocol or similar approaches when a qualified healthcare provider issues a prescription. The pharmacy does not recommend or promote any specific protocol. All care decisions are made by the prescribing provider based on their assessment of the patient’s individual situation.
If you are interested in learning more about the COC Protocol, speak with your healthcare provider or contact Care Oncology Clinic directly for information about their services.
Quality and Safety Standards
All compounding at Pharmacy Solutions is performed under strict quality protocols. The pharmacy holds PCAB accreditation in both sterile and non-sterile compounding, placing it among fewer than 2% of compounding pharmacies nationwide with this dual accreditation.[15] Pharmacy Solutions is USP <800> compliant for the safe handling of hazardous drugs, sources all ingredients from FDA-registered facilities and tests all finished products through an independent third-party laboratory. These standards apply to all medications compounded at Pharmacy Solutions, including those prepared for oncology patients.
Working With Your Healthcare Provider
The medications described on this page are compounded by Pharmacy Solutions only when prescribed by a licensed healthcare provider. If you are interested in exploring whether any of these medications might be appropriate for your situation, the first step is a conversation with your oncology team or healthcare provider.
Your provider can review the available research, assess your individual circumstances and determine whether any particular medication or approach is appropriate for you. When your provider issues a prescription, Pharmacy Solutions can prepare the medication according to their specifications.
If you have questions about the compounding process or need assistance connecting with a provider, click Ask a Pharmacist or contact Pharmacy Solutions directly.
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Frequently Asked Questions About Oncology Medications
What medications does Pharmacy Solutions compound for oncology patients?
Pharmacy Solutions compounds a variety of medications for oncology patients when prescribed by a healthcare provider. Common examples include mebendazole, ivermectin, metformin, atorvastatin and doxycycline. The pharmacy prepares medications according to the prescriber’s specifications and does not recommend or promote any specific medication.
Are these medications FDA-approved for cancer?
The medications described on this page are FDA-approved for their original indications but have not been approved by the FDA for any oncology indication. Any use in oncology is considered off-label, meaning the prescribing provider is relying on their clinical judgment and review of available research rather than an FDA-approved indication.
What is the COC Protocol?
The COC Protocol is an approach developed by Care Oncology Clinic that involves the use of metformin, atorvastatin, doxycycline and mebendazole in combination. Pharmacy Solutions can compound medications prescribed as part of this protocol when a healthcare provider issues a prescription. The pharmacy does not recommend or promote the protocol itself.
Do I need a prescription to get these medications?
Yes. Pharmacy Solutions compounds medications only when a licensed healthcare provider has issued a valid prescription. The pharmacy cannot dispense prescription medications without a prescriber’s order.
Can Pharmacy Solutions help me find a provider?
If you need assistance connecting with a healthcare provider who is familiar with compounded medications or repurposed drug protocols, click Ask a Pharmacist or contact Pharmacy Solutions directly. The pharmacy can provide information about the process and may be able to assist with provider connections.
What quality standards does Pharmacy Solutions follow?
Pharmacy Solutions is PCAB accredited in both sterile and non-sterile compounding, is USP <800> compliant for the handling of hazardous drugs, sources all ingredients from FDA-registered facilities and tests all finished products through an independent third-party laboratory.
How is compounding different from commercial medications?
Compounding allows a pharmacy to prepare medications in customized strengths, formulations or dosage forms based on a prescriber’s specifications. This may be appropriate when a patient requires a dosage not commercially available, needs a medication without certain inactive ingredients, or requires an alternative dosage form such as a liquid or topical preparation.
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