What Is a Nuclear Pharmacy and Why Do They Exist?

Radiation is a type of energy that has both an electric and magnetic field. It may seem scary, but radiation is actually a normal part of your everyday life. It can come from your cellphone or while flying in an airplane. Thankfully, small amounts of radiation usually don't cause short-term health effects. 

And radiation is not only found in everyday objects. It can also be used for medical purposes. Healthcare providers rely on a unique type of pharmacy to prepare radioactive medications. These are called nuclear pharmacies. 

Here, we’ll learn about nuclear pharmacies — what they are, how their medications diagnose and treat health conditions, and how your nuclear pharmacist differs from other pharmacists.

What is a nuclear pharmacy?

A nuclear pharmacy is a specific type of pharmacy. It’s different from a standard community, hospital, or long-term care pharmacy. Nuclear pharmacies prepare and dispense radioactive medications. Many hospital departments and clinics use them to diagnose or treat health conditions. 

Medications prepared by a nuclear pharmacy are also called radiopharmaceuticals. Radiopharmaceuticals combine a radioactive atom with another chemical. This allows a radioactive medication to travel to specific areas in the body. When it arrives at its destination in the body, it can serve as a diagnostic tool or treatment option. 

What types of medications are involved?

As mentioned, radioactive medications are used for both diagnosis and treatment.

Diagnostic medications can check how well a certain part of your body is working. In medical imaging, they provide a view inside your body. They release energy that’s detected by special cameras. Your healthcare team can then view the images made from those cameras. 

Radiopharmaceuticals are a type of tracer (tracker) when used for diagnosing medical conditions. Tracers can be injected into your body, you could swallow them, or you could breathe them in. 

For instance, HIDA scans use radiation to diagnose gallbladder problems, such as gallstones. In this test, radioactive tracers show how your organs are working. Tracers are also used for positron emission tomography (PET) scans. PET scans can detect certain cancers or heart diseases.

Separately, some radiopharmaceuticals can treat certain health conditions. 

For example, they can treat cancer by releasing energy like alpha and beta particles. A radioactive medication finds and attaches to cancer cells. Radiation damages DNA in cancer cells and prevents them from multiplying.

Another common radiopharmaceutical used for treatment is radioactive iodine (I-131). I-131 treats hyperthyroidism (overactive thyroid) or thyroid cancer. I-131 enters your thyroid and releases energy that destroys thyroid cells. 

How does a nuclear pharmacy compare to a hospital or retail pharmacy?

Most nuclear pharmacies have little direct contact with the general public. They do, however, work closely with healthcare providers. Generally these pharmacies dispense radiopharmaceuticals to hospitals and clinics. 

Nuclear pharmacies can also contribute to research and drug discovery within a hospital.

Are radioactive medications dangerous?

Not necessarily, especially with safeguards that are set in place. 

Radiation is often important in diagnosing and treating different diseases. The benefits of these procedures generally outweigh their risks. Nuclear medicine has existed for decades with no known long-term side effects.

Plus, the FDA approves radiopharmaceuticals before they’re given to you. The FDA oversees all radiation-emitting products and procedures. This includes x-rays and computed tomography (CT) scans. Most nuclear medicines use as little radiation as possible to diagnose or treat health conditions. 

That being said, the risk of radioactive medications still varies for everyone. This depends on the person’s risk factors, such as their age and medical history. 

Safety precautions are also in place to help reduce radiation exposure to other people. After receiving radiation therapy, you can minimize exposure to others with these tips:

1. Maintain distance: Radiation exposure decreases the further you are away from others.

2. Be mindful of time: Radiation exposure decreases when you spend less time near others.

3. Maintain hygiene: Proper hygiene, such as washing your hands, reduces the amount of radiation on surfaces around you.

Your healthcare provider may recommend stricter precautions to lower exposure. For example, the Society of Nuclear Medicine and Molecular Imaging has guidelines to lower I-131 exposure. People usually follow these precautions during the first week after therapy. Discuss with your healthcare provider about the best ways to stay safe.

Is nuclear pharmacy safe?

Due to the risk of radiation exposure, radioactive medications need special handling procedures. 

The U.S. Nuclear Regulatory Commission (NRC) oversees the proper use of radiopharmaceuticals. This ensures the safety of medication recipients, healthcare providers, the public, and the environment. 

Different precautions are in place to protect nuclear pharmacists and pharmacy technicians. Nuclear pharmacy workers are well-trained in radiation safety. 

For instance, pharmacy staff use protective shielding while compounding (preparing) medications. Lead or tungsten is often used to contain and shield the radioactive materials. Nuclear pharmacists follow specific guidelines to safely prepare medications for patients.

What does a nuclear pharmacist do?

Nuclear pharmacists specialize in preparing, compounding, and dispensing radiopharmaceuticals. They also inform other healthcare professionals on how to use these drugs safely. 

What kind of training does a nuclear pharmacist need?

After becoming a licensed pharmacist, they must also complete Authorized Nuclear Pharmacist (ANP) training. This is needed to work as a nuclear pharmacist. This program provides specialized training to:

• Prepare sterile compounds

• Handle radioactive materials

• Prepare shipments of radioactive materials

• Follow federal and state regulations

Licensed pharmacists must meet the following additional criteria to become an ANP: 

• Graduate from an accredited pharmacy school

• Complete at least 4,000 hours of training in nuclear pharmacy

• Pass an examination in nuclear pharmacy or complete 700 hours in a training program 

Nuclear pharmacy was the first Board of Pharmacy Specialties (BPS) certification to be developed. A pharmacist with BPS certification is able to work as a recognized specialized pharmacy professional. Although not required, pharmacists can become certified as Board Certified Nuclear Pharmacists (BCNP). 

How long does it take to become a nuclear pharmacist?

Pharmacy school often takes 4 years to complete after going through college. Some schools offer accelerated programs lasting 5 years total after high school. After graduation, new graduates take exams to become licensed pharmacists. 

After licensure, pharmacists must complete 4,000 hours of nuclear pharmacy training. This equals about 500 eight-hour training shifts. Only 2,000 of these hours can come from your academic training. This usually takes 1 to 2 years to complete.

Some pharmacy schools also offer specific training in nuclear pharmacy. Purdue University offers a program that provides more than 200 hours of training. The American Pharmacists Association also offers different resources including certification information.

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Written by:

Kevin Le, PharmD, BCPS, BCPPS

Kevin Le, PharmD, BCPS, BCPPS is a clinical pharmacy specialist in solid organ transplant at Ann & Robert H. Lurie Children’s Hospital of Chicago. He has been working as a pediatric pharmacist since 2016.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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