Ad astra per aspera: astropharmacy – overcoming terrestrial boundaries

Astropharmacy is a growing field at the intersection of space medicine, pharmaceutical sciences, and biomanufacturing, addressing challenges in drug stability, production, and administration in space. As long-duration space travel advances, the need for sustainable pharmaceutical solutions becomes critical due to microgravity, radiation, limited storage, and resupply constraints. Pharmacists may play a role in space missions, but studies suggest challenges in integrating them due to crew role limitations. Proposed training models, like the PAR framework, emphasize microgravity simulations and crisis management, but lack real world validation. Drug stability is a major concern, with research showing 40% of ISS medications losing potency within a year due to radiation and storage limitations. Biomanufacturing offers potential solutions, with studies demonstrating microbial synthesis and cell-free protein production of drugs. However, real microgravity testing is needed to ensure efficiency and consistency. Advances in AI-driven pharmacotherapy and automated medication management could enhance astronaut care, but require adaptation for space environments. Future research must prioritize in-orbit validation of drug stability, biomanufacturing feasibility, and AI-driven pharmacokinetics. Standardized training programs for space pharmacists and improved drug formulations resistant to radiation should be developed. Addressing these challenges is fundamental for ensuring effective healthcare in deep-space missions, supporting astronaut health, and enabling sustainable exploration beyond Earth.