It is the second and final Sebadoh album to feature drummer Bob Fay, who replaced founding member Eric Gaffney in 1994.

The album cover features a photograph of a pharmacy in Cashel, Ireland, taken by band member Jason Loewenstein on tour.

[11] As with its predecessor, Bakesale, the songwriting on Harmacy was handled primarily by Loewenstein and founding member Lou Barlow, with Fay contributing the lone track, "Sforzando!

[12] Like Bakesale, the album was a "(relatively) polished production",[13] and featured pervasive use of electric guitars and longer song structures, marking a clear departure from the band's lo-fi, often acoustic earlier albums like their release, Sebadoh III (1991).

Released in the wake of Barlow's Top 40 hit, "Natural One", with his band The Folk Implosion, Harmacy became Sebadoh's first charting album in the U.S., expanding on the success of Bakesale,[13] and yielding the Modern Rock Tracks hit, "Ocean".

Club wrote that Harmacy "doesn't have Bakesale's considerable staying power as a whole, but the strong balance of soft pop songs ("Too Pure", "Perfect Way", the elegant pop ballad "Willing to Wait") and abrasively punky rock songs ("Love To Fight", "Mind Reader", "Can't Give Up") still holds together somehow.