To become a drug, a pharmacologically active compound must be prepared in a specific form. This form must be robust during manufacturing, packaging, storage and transport, and must administer the correct dose to the patient. To successfully prepare a drug form, manufacturers must often produce solid samples with a controlled crystal structure and a specific particle size and shape. To further complicate matters, these drug particles are often constituents of a multi-component composite. The present review summarizes how extreme pressure and temperature conditions help achieve this highly tuned material.