{ "data": [ { "slug": "federal", "name": "United States (federal)", "abbreviation": "US", "kind": "federal", "summary": "Federal law sets the floor for every state: an FDA approved peptide (semaglutide, tirzepatide, tesamorelin, bremelanotide) can be prescribed and dispensed anywhere in the country, and a compounded peptide can only be made by a licensed pharmacy from a substance that is an approved drug component, has a USP or NF monograph, or appears on the FDA 503A bulk drug substances list. Peptides that FDA has placed in 503A Category 2, or that are still under review, are not eligible for pharmacy compounding, and \"research use only\" peptides sold for human use are unapproved drugs under the Federal Food, Drug, and Cosmetic Act. States can be stricter than this floor but not looser.", "telehealth": { "allowed": true, "notes": "There is no federal telehealth licensing law for non-controlled drugs: the prescriber must be licensed in the state where the patient is located, and each state sets its own rules for establishing the patient relationship. Federal telehealth restrictions come from the Controlled Substances Act (21 U.S.C. 829(e), the Ryan Haight Act) and DEA rules at 21 CFR 1300.04, which generally require an in-person evaluation before a controlled substance is prescribed by telemedicine unless a DEA exception or flexibility applies. None of the peptides in this database are federally scheduled controlled substances, so those rules do not apply to GLP-1 or compounded peptide prescriptions, but they do apply to anything else a telehealth clinic might co-prescribe.", "async_prescribing_allowed": null, "source_ids": [ "usc-829", "cfr-1300-04" ] }, "compounding": { "board_name": "FDA Center for Drug Evaluation and Research (federal oversight of 503A and 503B compounding)", "board_url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act", "follows_fda_503a_bulks": true, "notes": "Section 503A of the FD&C Act (21 U.S.C. 353a) exempts a compounded drug from new drug approval, labeling, and cGMP requirements only when it is made by a licensed pharmacist or physician for an identified patient on a valid prescription, and only from bulk substances that are components of approved drugs, have a USP or NF monograph, or appear on the 503A bulks list that FDA publishes by rule after Pharmacy Compounding Advisory Committee (PCAC) review. FDA also keeps an interim list of nominated substances: Category 1 (may be compounded while under review), Category 2 (significant safety risks identified, not eligible), and Category 3 (insufficient information). Section 503B outsourcing facilities can compound without patient specific prescriptions but face their own bulks list and cGMP requirements. State pharmacy boards license and inspect the pharmacies themselves; FDA policy and state licensure both have to be satisfied.", "source_ids": [ "fda-503a", "usc-353a", "fda-compounding-qa", "fda-category-2", "fr-2019-503a-bulks", "fda-503b", "fda-pcac" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Semaglutide and tirzepatide are FDA approved and available nationwide by prescription. Compounded copies were permitted only while the branded products were on the FDA drug shortage list. FDA declared the tirzepatide shortage resolved on October 2, 2024 and reaffirmed that decision on December 19, 2024 after reconsideration (503A grace period ended February 18, 2025; 503B ended March 19, 2025). FDA declared the semaglutide shortage resolved on February 21, 2025 (503A grace period ended April 22, 2025; 503B ended May 22, 2025). After those dates, a pharmacy may compound a GLP-1 only for a documented patient specific clinical need, such as an allergy to an excipient or a dose strength that is not commercially available, and FDA has warned about products made from salt forms and unapproved dosing. Manufacturer direct-to-consumer cash programs now supply branded vials and pens outside insurance. On April 30, 2026 FDA proposed not to include semaglutide, tirzepatide, or liraglutide on the 503B bulks list, after tentatively finding no clinical need for outsourcing facilities to compound them from bulk; that proposal was not final as of September 2026.", "source_ids": [ "fda-glp1-compounding", "fda-compounding-qa", "fr-2026-08552" ] }, "research_peptide_sales": { "notes": "Peptides labeled \"for research use only\" or \"not for human consumption\" are not exempt from federal drug law when they are marketed or sold for human use. Introducing an unapproved new drug into interstate commerce, or selling a misbranded drug, is a prohibited act under 21 U.S.C. 331 and the new drug approval requirement in 21 U.S.C. 355. FDA has issued warning letters to online sellers marketing peptides such as BPC-157 and other compounds with health claims, and FDA compounding risk alerts describe specific safety problems seen in unapproved peptide products. No state licenses these sellers as pharmacies.", "source_ids": [ "usc-331", "usc-355", "fda-warning-letters", "fda-risk-alerts" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "FDA approved (Ozempic, Rybelsus, Wegovy). Compounded semaglutide lost its shortage-based allowance on April 22, 2025 for 503A pharmacies and May 22, 2025 for 503B facilities. On April 30, 2026 FDA proposed not to include semaglutide on the 503B bulks list; that proposal was not final as of September 2026.", "source_ids": [ "fda-glp1-compounding", "fr-2026-08552" ] }, { "slug": "tirzepatide", "note": "FDA approved (Mounjaro, Zepbound). Compounded tirzepatide lost its shortage-based allowance on February 18, 2025 for 503A pharmacies and March 19, 2025 for 503B facilities. On April 30, 2026 FDA proposed not to include tirzepatide on the 503B bulks list; that proposal was not final as of September 2026.", "source_ids": [ "fda-glp1-compounding", "fr-2026-08552" ] }, { "slug": "bpc-157", "note": "Withdrawn from 503A Category 2 on April 15, 2026 and recommended for the 503A bulks list by PCAC on July 23 to 24, 2026. It is not on the 503A bulks list. PCAC's recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. It is not eligible for 503B outsourcing.", "source_ids": [ "fda-category-2", "fda-pcac", "fda-503a" ] }, { "slug": "ipamorelin", "note": "Placed in 503B Category 2 on September 29, 2023 alongside GHRP-2 and GHRP-6, so it cannot be compounded by outsourcing facilities.", "source_ids": [ "fda-category-2" ] } ], "faqs": [ { "q": "Can any US pharmacy legally compound a peptide?", "a": "Only a state-licensed pharmacy (503A) or an FDA-registered outsourcing facility (503B) can compound drugs, and only from bulk substances that are approved drug components, have a USP or NF monograph, or appear on the relevant FDA bulks list. A peptide that FDA has placed in Category 2 or that is still under review is not eligible, and states can add their own restrictions on top of the federal rule.", "source_ids": [ "fda-503a", "fda-category-2", "fda-compounding-qa" ] }, { "q": "Is compounded semaglutide or tirzepatide still legal in 2026?", "a": "Only in narrow circumstances. The shortage-based allowance ended in 2025 (tirzepatide first, then semaglutide), so a pharmacy may now compound a GLP-1 only when a specific patient needs something the approved product cannot provide, such as a different strength or an excipient-free formulation, and never as a routine copy of Wegovy or Zepbound.", "source_ids": [ "fda-glp1-compounding" ] }, { "q": "Does federal telehealth law stop a clinic from prescribing peptides online?", "a": "No. Federal telemedicine rules under the Controlled Substances Act only cover scheduled drugs, and the peptides in this database are not federally scheduled. What matters is the state where the patient is located: the prescriber must hold a license or telehealth registration there and follow that state's rules for establishing a patient relationship.", "source_ids": [ "usc-829", "cfr-1300-04" ] }, { "q": "Are \"research use only\" peptides legal to buy?", "a": "Selling them for human use is a violation of federal drug law: they are unapproved new drugs and, when sold with health claims, misbranded. FDA has issued warning letters to online peptide sellers. Buying them exposes you to products with no identity, purity, or sterility testing and no pharmacist oversight.", "source_ids": [ "usc-331", "usc-355", "fda-warning-letters" ] }, { "q": "What does the PCAC vote on BPC-157 and the other peptides actually change?", "a": "A PCAC recommendation is advisory. FDA still has to publish a proposed and then a final rule adding a substance to the 503A bulks list. Until then the recommended peptides are no longer in Category 2 but are not on the 503A bulks list either, so a 503A pharmacy has no federal basis to compound them from bulk. State boards cannot authorize what federal law does not.", "source_ids": [ "fda-pcac", "fda-category-2", "fr-2019-503a-bulks", "fda-503a" ] } ], "sources": [ { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "usc-353a", "type": "other", "title": "21 U.S.C. 353a, Pharmacy compounding (Office of the Law Revision Counsel)", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section353a&num=0&edition=prelim" }, { "id": "fda-compounding-qa", "type": "fda", "title": "FDA: Compounding and the FDA, questions and answers", "url": "https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fr-2019-503a-bulks", "type": "federal_register", "title": "Federal Register: List of bulk drug substances that can be used to compound drug products in accordance with section 503A (final rule, February 19, 2019)", "url": "https://www.federalregister.gov/documents/2019/02/19/2019-02785/list-of-bulk-drug-substances-that-can-be-used-to-compound-drug-products-in-accordance-with-section-503a-of-the-federal-food-drug-and-cosmetic-act", "year": 2019 }, { "id": "fda-503b", "type": "fda", "title": "FDA: Information for outsourcing facilities (section 503B)", "url": "https://www.fda.gov/drugs/human-drug-compounding/information-outsourcing-facilities" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-829", "type": "other", "title": "21 U.S.C. 829, Prescriptions (including subsection (e) on controlled substances dispensed by means of the Internet)", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section829&num=0&edition=prelim" }, { "id": "cfr-1300-04", "type": "other", "title": "21 CFR 1300.04, Definitions relating to the dispensing of controlled substances by means of the Internet (practice of telemedicine)", "url": "https://www.ecfr.gov/current/title-21/chapter-II/part-1300/section-1300.04" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "usc-355", "type": "other", "title": "21 U.S.C. 355, New drugs", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section355&num=0&edition=prelim" }, { "id": "fda-warning-letters", "type": "fda", "title": "FDA: Warning letters (searchable database)", "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/compliance-actions-and-activities/warning-letters" }, { "id": "fda-risk-alerts", "type": "fda", "title": "FDA: Compounding risk alerts", "url": "https://www.fda.gov/drugs/human-drug-compounding/compounding-risk-alerts" }, { "id": "fr-2026-08552", "type": "federal_register", "title": "Federal Register 2026-08552: List of Bulk Drug Substances for Which There Is a Clinical Need Under Section 503B (proposed May 1, 2026; comments extended to July 30, 2026)", "url": "https://www.federalregister.gov/documents/2026/05/01/2026-08552/list-of-bulk-drug-substances-for-which-there-is-a-clinical-need-under-section-503b-of-the-federal", "year": 2026 } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "alabama", "name": "Alabama", "abbreviation": "AL", "kind": "state", "summary": "Yes, with conditions. An Alabama resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Alabama-licensed physician, including through telehealth under the 2022 telehealth statute (Code of Alabama sections 34-24-701 through 34-24-707), and can obtain a compounded peptide only when it is eligible under federal 503A rules and dispensed by an Alabama-permitted pharmacy or a nonresident pharmacy registered with the Alabama State Board of Pharmacy. Alabama physicians must see a telehealth patient in person after four telehealth visits for the same unresolved condition in 12 months, and the Board of Pharmacy has taken a public position against semaglutide salt forms in compounding.", "telehealth": { "allowed": true, "notes": "Act 2022-302, codified at Code of Alabama sections 34-24-701 through 34-24-707, replaced Alabama's older special purpose license regime. A physician must hold an Alabama license (or a license through the Interstate Medical Licensure Compact) to treat an Alabama patient by telehealth; there is no out-of-state registration pathway for non-Alabama physicians. A physician may prescribe non-controlled drugs by telehealth without a prior in-person visit if the standard of care is met, but if the same physician or practice group treats the same patient by telehealth more than four times in 12 months for the same unresolved condition, the patient must be seen in person within 12 months or referred to a physician who can see them in person. Controlled substances require a prior in-person visit within 12 months and a real-time encounter. The statute defines telehealth to include both synchronous and asynchronous (store-and-forward) technology, so a non-controlled peptide prescription can lawfully follow an asynchronous evaluation if the physician documents an adequate evaluation; the Board of Medical Examiners implements the act in rule chapter 540-X-24.", "async_prescribing_allowed": true, "source_ids": [ "al-34-24-703", "al-bme-telemedicine", "imlc-states" ] }, "compounding": { "board_name": "Alabama State Board of Pharmacy", "board_url": "https://albop.com/", "follows_fda_503a_bulks": true, "notes": "The Alabama State Board of Pharmacy regulates pharmacies under the Alabama Pharmacy Practice Act (Code of Alabama Title 34, Chapter 23) and Administrative Code chapter 680-X-2. Alabama has no state bulks list; a peptide may be compounded only if it is an approved drug component, has a USP or NF monograph, or appears on the FDA 503A bulks list. Any pharmacy located outside Alabama that ships, mails, or delivers prescription drugs to an Alabama patient must hold a nonresident (mail order) permit from the Board under rule 680-X-2-.07 and Code sections 34-23-30 and 34-23-31, and must designate an Alabama agent for service of process. The Board has issued a public statement on compounded semaglutide that rejects the use of semaglutide salt forms (sodium and acetate) because they are not the active ingredient in the approved product. Injectable peptides are sterile parenteral products, which Board rule 680-X-2-.19 (Parenteral Sterile Therapy) governs: a pharmacy compounding parenteral products must be certified by the Board as a parenteral sterile compounding pharmacy. Board rule 680-X-2-.43 (Requirements for Compounding) requires every compounding pharmacy to follow current USP-NF standards.", "source_ids": [ "al-board", "al-680-x-2-07", "al-680-x-2-19", "al-680-x-2-43", "al-board-rules", "al-semaglutide-ruling", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to the federal exception for documented patient-specific needs since the FDA shortage declarations ended in 2025, and Alabama is one of the states whose Board of Pharmacy publicly warned pharmacies about semaglutide copies and salt forms. The Board of Medical Examiners has also published fraud alerts about counterfeit Ozempic and unlicensed sellers.", "source_ids": [ "fda-glp1-compounding", "al-semaglutide-ruling", "al-bme-fraud-alert", "al-680-x-2-07" ] }, "research_peptide_sales": { "notes": "Selling prescription drugs to Alabama consumers requires a Board of Pharmacy permit, and \"research use only\" peptides sold for human injection are unapproved new drugs under 21 U.S.C. 331 and 355 regardless of labeling. The Alabama Board of Medical Examiners has warned the public about unlicensed sellers of semaglutide and tirzepatide, and these products are not dispensed by a pharmacist and carry no Alabama consumer protections. In 2026 the Board of Medical Examiners issued a notice that no physician may compound, administer, or dispense a non-FDA-approved or research-grade peptide or delegate that to a CRNP, CNM, or PA, and that physicians must buy all prescription products, drugs, and ingredients from entities permitted by the Alabama State Board of Pharmacy. No research-grade peptide is on any approved CRNP, CNM, or PA formulary, and a patient consent form does not remove the provider's liability.", "source_ids": [ "al-board", "al-bme-fraud-alert", "usc-331", "al-bme-research-peptide-notice" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded from any Alabama pharmacy by prescription, including telehealth prescriptions under sections 34-24-701 through 34-24-707. The Alabama State Board of Pharmacy has stated that compounding with semaglutide sodium or semaglutide acetate is not acceptable, and compounded semaglutide base is limited to the federal patient-specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "al-semaglutide-ruling", "fda-glp1-compounding", "al-34-24-703" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Alabama through telehealth without an in-person visit?", "a": "Yes. Under Code of Alabama sections 34-24-701 through 34-24-707, an Alabama-licensed physician can evaluate you and prescribe a non-controlled drug such as semaglutide or tirzepatide by telehealth if the standard of care is met. If the same physician treats you by telehealth more than four times in 12 months for the same unresolved condition, you must be seen in person within 12 months or referred for in-person care.", "source_ids": [ "al-34-24-703", "al-bme-telemedicine" ] }, { "q": "Can an out-of-state telehealth doctor treat me in Alabama?", "a": "Only if that physician holds an Alabama medical license, including a license issued through the Interstate Medical Licensure Compact. Alabama's 2022 telehealth act repealed the old special purpose license and did not create a registration pathway for physicians licensed only in other states. Check the physician on the Board of Medical Examiners license lookup before paying.", "source_ids": [ "al-34-24-703", "al-bme-telemedicine", "imlc-states" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Alabama?", "a": "Only in limited, patient-specific cases. The federal shortage allowances ended in 2025, and the Alabama State Board of Pharmacy has publicly stated that semaglutide sodium and acetate salts are not acceptable starting materials. A pharmacy compounding GLP-1 copies routinely is exposed to both FDA action and Board discipline.", "source_ids": [ "fda-glp1-compounding", "al-semaglutide-ruling" ] }, { "q": "How do I check whether a mail-order pharmacy can ship compounded peptides to Alabama?", "a": "Search the Alabama State Board of Pharmacy license verification for the pharmacy. Rule 680-X-2-.07 bars a nonresident pharmacy from shipping prescription drugs to an Alabama patient unless it is registered with the Board, and the pharmacy must also hold a valid permit in its home state. If it is not listed, the shipment is unlawful in Alabama.", "source_ids": [ "al-680-x-2-07", "al-board" ] }, { "q": "Can an Alabama pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac", "al-board" ] }, { "q": "Is it legal to buy research peptides online and ship them to Alabama?", "a": "No. Peptides sold \"for research use only\" but marketed for injection are unapproved new drugs under federal law, anyone distributing prescription drugs into Alabama needs a Board of Pharmacy permit, and the Board of Medical Examiners has warned about unlicensed sellers of semaglutide and tirzepatide.", "source_ids": [ "usc-331", "al-bme-fraud-alert", "al-board" ] } ], "sources": [ { "id": "al-board", "type": "other", "title": "Alabama State Board of Pharmacy", "url": "https://albop.com/" }, { "id": "al-board-rules", "type": "other", "title": "Alabama State Board of Pharmacy: statutes and rules (Title 34, Chapter 23 and Administrative Code chapter 680-X-2)", "url": "https://albop.com/statutes-rules/" }, { "id": "al-680-x-2-07", "type": "other", "title": "Alabama Administrative Code rule 680-X-2-.07, Mail order prescriptions (nonresident pharmacy registration)", "url": "https://www.law.cornell.edu/regulations/alabama/Ala-Admin-Code-r-680-X-2-.07" }, { "id": "al-680-x-2-19", "type": "other", "title": "Alabama Administrative Code rule 680-X-2-.19, Parenteral Sterile Therapy (last amended May 15, 2025), accessed 2026-09-22", "url": "https://www.law.cornell.edu/regulations/alabama/Ala-Admin-Code-r-680-X-2-.19" }, { "id": "al-680-x-2-43", "type": "other", "title": "Alabama Administrative Code rule 680-X-2-.43, Requirements for Compounding (USP-NF standards), accessed 2026-09-22", "url": "https://www.law.cornell.edu/regulations/alabama/Ala-Admin-Code-r-680-X-2-.43" }, { "id": "al-34-24-703", "type": "other", "title": "Code of Alabama section 34-24-703, Duties of physicians providing telehealth medical services (Act 2022-302)", "url": "https://law.justia.com/codes/alabama/title-34/chapter-24/article-12/section-34-24-703/" }, { "id": "al-bme-telemedicine", "type": "other", "title": "Alabama Board of Medical Examiners: telemedicine and telehealth licensing", "url": "https://www.albme.gov/resources/licensees/telemedicine/" }, { "id": "al-semaglutide-ruling", "type": "other", "title": "Alabama State Board of Pharmacy position on compounded semaglutide (salt forms), hosted by the Board of Medical Examiners", "url": "https://www.albme.gov/uploads/pdfs/BOPSemaglutide.DeclaratoryRuling_.pdf" }, { "id": "al-bme-fraud-alert", "type": "other", "title": "Alabama Board of Medical Examiners: fraudulent activity alert on Ozempic, semaglutide, and tirzepatide", "url": "https://www.albme.gov/press-release/fraudulent-activity-alert-ozempic-semaglutide-tirzepatide" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" }, { "id": "al-bme-research-peptide-notice", "type": "other", "title": "Alabama Board of Medical Examiners: Official Notice Concerning the Prescribing of Non-FDA Approved (Research-Grade) Peptides", "url": "https://www.albme.gov/press-release/board-issues-official-notice-concerning-the-prescribing-of-non-fda-approved-research-grade-peptides" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "alaska", "name": "Alaska", "abbreviation": "AK", "kind": "state", "summary": "Yes. An Alaska resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Alaska-licensed provider, including by telehealth under AS 08.64.364 (physicians) and the 2022 cross-profession telehealth statute AS 08.01.085, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy holding an Alaska pharmacy license. Since November 2023 every out-of-state pharmacy shipping into Alaska must hold a full Alaska pharmacy license under AS 08.80.157 rather than the old nonresident registration, and telehealth businesses must be on the state Telemedicine Business Registry.", "telehealth": { "allowed": true, "notes": "AS 08.64.364 allows an Alaska-licensed physician to prescribe, dispense, or administer a prescription drug without conducting a physical examination if the physician or a similar practitioner is available for follow-up care and the standard of care is met; the 2016 amendments (SB 74) removed the earlier requirement that the physician be physically located in Alaska. HB 265 (2022) added AS 08.01.085, which lets any Alaska-licensed health care provider deliver telehealth to a patient in Alaska, and the Division of Corporations, Business and Professional Licensing publishes telehealth guidance for each board. Providers must hold an Alaska license (there is no out-of-state registration exception for physicians), and any business delivering distance health care to Alaska patients must register on the Telemedicine Business Registry. Physicians and physician assistants may prescribe controlled substances by telehealth if they comply with AS 08.64.364 and federal law. The statutes do not require a real-time video encounter for non-controlled drugs, so asynchronous evaluation followed by a prescription is not prohibited as long as the documented evaluation meets the standard of care.", "async_prescribing_allowed": true, "source_ids": [ "ak-08-64-364", "ak-telehealth-info" ] }, "compounding": { "board_name": "Alaska Board of Pharmacy", "board_url": "https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofPharmacy.aspx", "follows_fda_503a_bulks": true, "notes": "The Alaska Board of Pharmacy regulates pharmacy practice under AS 08.80 and 12 AAC 52; rule 12 AAC 52.440 requires a pharmacy or pharmacist that compounds to follow the Board's \"Compounding Practices\" guidelines pamphlet dated February 2008, which the rule incorporates by reference, and rule 12 AAC 52.430 requires a pharmacy that prepares or dispenses sterile pharmaceuticals (which includes injectable peptides) to adhere to the accepted standard of care. Alaska has no state bulks list, so peptide eligibility follows the federal 503A framework. Since November 27, 2023, the nonresident registration statute (AS 08.80.158) has been repealed and every pharmacy shipping prescription drugs into Alaska, wherever located, must hold an Alaska pharmacy license under AS 08.80.157 with a licensed pharmacist-in-charge. A telehealth prescription filled by an out-of-state pharmacy that has not obtained the Alaska license is being dispensed unlawfully. The Alaska Administrative Code text of 12 AAC 52.440 published by the Alaska Legislature, checked 2026-09-22, still incorporates the February 2008 pamphlet, so the rule has not been rewritten since the 2023 licensing changes.", "source_ids": [ "ak-board", "ak-board-regs", "ak-12-aac-52-440", "ak-aac-52-430-440", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because Alaska now requires a full pharmacy license for any out-of-state pharmacy, Alaska patients using telehealth GLP-1 programs should confirm the dispensing pharmacy appears in the Division's professional license search as an Alaska-licensed pharmacy.", "source_ids": [ "fda-glp1-compounding", "ak-board-regs", "ak-board" ] }, "research_peptide_sales": { "notes": "Any entity distributing prescription drugs into Alaska must be licensed by the Board of Pharmacy under AS 08.80.157, and peptides sold \"for research use only\" but marketed for human injection are unapproved new drugs under 21 U.S.C. 331 regardless of labeling. These products are not dispensed by a pharmacist, are not covered by Alaska's Telemedicine Business Registry protections, and carry no state consumer safeguards.", "source_ids": [ "ak-board-regs", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Alaska through telehealth without a physical exam?", "a": "Yes. AS 08.64.364 lets an Alaska-licensed physician prescribe a drug without a physical examination if follow-up care is available and the standard of care is met, and AS 08.01.085 extends telehealth authority to other Alaska-licensed providers. Semaglutide and tirzepatide are not controlled substances, so no additional in-person requirement applies.", "source_ids": [ "ak-08-64-364", "ak-telehealth-info" ] }, { "q": "Does an out-of-state telehealth clinic need an Alaska license to treat me?", "a": "Yes. The provider must hold an Alaska license from the relevant board, and the business must be listed on Alaska's Telemedicine Business Registry. Alaska does not offer a telehealth-only registration for physicians licensed elsewhere.", "source_ids": [ "ak-telehealth-info", "ak-08-64-364" ] }, { "q": "Can a mail-order pharmacy in another state ship compounded peptides to Alaska?", "a": "Only if it holds an Alaska pharmacy license. Since November 27, 2023, the nonresident registration under AS 08.80.158 no longer exists and all pharmacies serving Alaska patients are licensed under AS 08.80.157 with an Alaska-registered pharmacist-in-charge. Search the Division's professional license database before ordering.", "source_ids": [ "ak-board-regs", "ak-board" ] }, { "q": "Can an Alaska pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "ak-12-aac-52-440", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ak-board", "type": "other", "title": "Alaska Board of Pharmacy (Division of Corporations, Business and Professional Licensing)", "url": "https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofPharmacy.aspx" }, { "id": "ak-board-regs", "type": "other", "title": "Alaska Board of Pharmacy: statutes and regulations (AS 08.80 and 12 AAC 52, including the 2023 pharmacy licensing changes)", "url": "https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofPharmacy/StatutesRegulations.aspx" }, { "id": "ak-12-aac-52-440", "type": "other", "title": "12 AAC 52.440, Guidelines relating to compounding practices", "url": "https://www.law.cornell.edu/regulations/alaska/12-AAC-52.440" }, { "id": "ak-aac-52-430-440", "type": "other", "title": "Alaska Legislature, Alaska Administrative Code: 12 AAC 52.430 (sterile pharmaceuticals) and 12 AAC 52.440 (compounding practices), accessed 2026-09-22", "url": "https://www.akleg.gov/basis/aac.asp?media=print&secStart=12.52.430&secEnd=12.52.440" }, { "id": "ak-08-64-364", "type": "other", "title": "Alaska Statutes AS 08.64.364, Prescribing without a physical examination (telehealth), as amended by SB 74 (2016)", "url": "https://www.akleg.gov/basis/statutes.asp#08.64.364" }, { "id": "ak-telehealth-info", "type": "other", "title": "Alaska Division of Corporations, Business and Professional Licensing: telehealth information and Telemedicine Business Registry (AS 08.01.085)", "url": "https://www.commerce.alaska.gov/web/cbpl/TelehealthInformation.aspx" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "arizona", "name": "Arizona", "abbreviation": "AZ", "kind": "state", "summary": "Yes. An Arizona resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Arizona-licensed provider or from an out-of-state provider registered under A.R.S. 36-3606, including by telehealth under A.R.S. 36-3601 through 36-3607 (HB 2454, 2021), and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by an Arizona-permitted pharmacy or a nonresident pharmacy holding an Arizona nonresident permit. Arizona is one of the more open telehealth states: the statute covers asynchronous care and lets qualifying out-of-state providers register instead of obtaining a full Arizona license.", "telehealth": { "allowed": true, "notes": "A.R.S. 36-3602 sets the telehealth standard of care (same as in-person, identity verification, documentation) and A.R.S. 36-3601 defines telehealth to include asynchronous store-and-forward and remote monitoring as well as real-time audio-visual and, with limits, audio-only. Under A.R.S. 36-3606 a health care provider licensed in another state may treat Arizona patients by telehealth after registering with the Arizona board that licenses comparable providers, provided the out-of-state license is unrestricted and the provider carries liability coverage and follows Arizona prescribing law. Prescribing by telehealth is permitted; controlled substance prescribing by telehealth is restricted (audio-only is not allowed for new controlled substance prescriptions, and registered providers must enroll in the prescription monitoring program). Peptides in this database are not controlled, so a non-controlled peptide prescription may follow an asynchronous evaluation if the provider documents an evaluation meeting the standard of care.", "async_prescribing_allowed": true, "source_ids": [ "az-36-3602", "az-36-3606" ] }, "compounding": { "board_name": "Arizona State Board of Pharmacy", "board_url": "https://pharmacy.az.gov/", "follows_fda_503a_bulks": true, "notes": "The Arizona State Board of Pharmacy regulates compounding through Administrative Code rule R4-23-410 (current good compounding practices) and R4-23-670 (sterile pharmaceutical products), both of which require compliance with applicable federal law, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Arizona has no state bulks list. A pharmacy located outside Arizona may not ship prescription-only drugs into the state without a Board-issued nonresident pharmacy permit under rule R4-23-607 and A.R.S. 32-1931, in addition to a valid permit in its home jurisdiction. The Board maintains a public license verification tool for both resident and nonresident pharmacies.", "source_ids": [ "az-board", "az-r4-23-410", "az-r4-23-607", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Arizona patients using telehealth GLP-1 programs should confirm that the prescriber is Arizona-licensed or registered under A.R.S. 36-3606 and that the dispensing pharmacy holds an Arizona nonresident permit.", "source_ids": [ "fda-glp1-compounding", "az-36-3606", "az-r4-23-607" ] }, "research_peptide_sales": { "notes": "A.R.S. 32-1931 and rule R4-23-607 prohibit a nonresident from selling or distributing prescription-only drugs into Arizona without a Board nonresident permit, and \"research use only\" peptides marketed for injection are unapproved new drugs under 21 U.S.C. 331 regardless of labeling.", "source_ids": [ "az-r4-23-607", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Arizona through telehealth without seeing a doctor in person?", "a": "Yes. A.R.S. 36-3602 holds telehealth to the same standard of care as in-person care and the definition of telehealth includes asynchronous store-and-forward, so an Arizona-licensed or Arizona-registered provider may evaluate you remotely and prescribe semaglutide or tirzepatide, which are not controlled substances.", "source_ids": [ "az-36-3602", "az-36-3606" ] }, { "q": "Can an out-of-state telehealth provider treat me in Arizona without an Arizona license?", "a": "Yes, if the provider has registered with the relevant Arizona licensing board under A.R.S. 36-3606, holds an unrestricted license in another state, carries liability coverage, and follows Arizona prescribing rules. Registered providers cannot open an Arizona office. Check the board's registration list before paying.", "source_ids": [ "az-36-3606" ] }, { "q": "How do I check whether a mail-order pharmacy can ship compounded peptides to Arizona?", "a": "Search the Arizona State Board of Pharmacy license verification for the pharmacy. Rule R4-23-607 and A.R.S. 32-1931 require a nonresident pharmacy permit before any prescription-only drug is shipped into Arizona. If the pharmacy is not listed, the shipment is unlawful.", "source_ids": [ "az-r4-23-607", "az-board" ] }, { "q": "Can an Arizona pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "az-r4-23-410", "fda-category-2", "fda-pcac" ] }, { "q": "Is it legal to buy research peptides online and ship them to Arizona?", "a": "No. Distributing prescription-only drugs into Arizona without a nonresident permit violates A.R.S. 32-1931, and \"research use only\" peptides sold for injection are unapproved drugs under federal law. They are not dispensed by a pharmacist.", "source_ids": [ "az-r4-23-607", "usc-331" ] } ], "sources": [ { "id": "az-board", "type": "other", "title": "Arizona State Board of Pharmacy", "url": "https://pharmacy.az.gov/" }, { "id": "az-r4-23-410", "type": "other", "title": "Arizona Administrative Code R4-23-410, Current good compounding practices", "url": "https://www.law.cornell.edu/regulations/arizona/Ariz-Admin-Code-SS-R4-23-410" }, { "id": "az-r4-23-607", "type": "other", "title": "Arizona Administrative Code R4-23-607, Nonresident permits (implementing A.R.S. 32-1931)", "url": "https://www.law.cornell.edu/regulations/arizona/Ariz-Admin-Code-SS-R4-23-607" }, { "id": "az-36-3602", "type": "other", "title": "Arizona Revised Statutes 36-3602, Telehealth; standard of care; requirements", "url": "https://www.azleg.gov/ars/36/03602.htm" }, { "id": "az-36-3606", "type": "other", "title": "Arizona Revised Statutes 36-3606, Interstate telehealth services; registration; requirements", "url": "https://www.azleg.gov/ars/36/03606.htm" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "arkansas", "name": "Arkansas", "abbreviation": "AR", "kind": "state", "summary": "Yes, with a stricter first-visit rule than most states. An Arkansas resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Arkansas-licensed provider, including by telemedicine under the Arkansas Telemedicine Act (Ark. Code 17-80-401 through 17-80-407), but a new telemedicine patient relationship cannot rest on an internet questionnaire, email, text message, or patient-generated history alone; it needs an in-person exam, an existing relationship, referral, or coverage arrangement, or an evaluation by an Arkansas-licensed provider who has the patient's health record and uses appropriate technology, which for non-controlled drugs can include the telephone. Compounded peptides are available only when eligible under federal 503A rules and dispensed by an Arkansas-licensed pharmacy; an out-of-state pharmacy shipping into Arkansas must hold an Arkansas pharmacy license and keep an Arkansas-licensed pharmacist on staff as pharmacist in charge.", "telehealth": { "allowed": true, "notes": "The Arkansas Telemedicine Act (Ark. Code 17-80-401 through 17-80-407, amended by Acts 767, 829, and 1112 of 2021) defines telemedicine to include store-and-forward technology and remote patient monitoring, and section 17-80-403 bars a distant-site professional from using telemedicine with an Arkansas patient unless a professional relationship exists. Section 17-80-402(4) lists the ways that relationship can exist: a prior in-person exam, personal knowledge through an ongoing relationship, treatment in consultation with or on referral from a professional who has a relationship with the patient, an on-call or cross-coverage arrangement, circumstances defined by Arkansas State Medical Board rule, or, added in 2021, an Arkansas-licensed professional who has access to the patient's health record and uses any technology the professional deems appropriate, including the telephone, to diagnose, treat, and if clinically appropriate prescribe a noncontrolled drug. The same subdivision says a health record may be created with the use of telemedicine if the professional meets the in-person standard of care, and the Medical Board's rule (17 CAR 140-202(b)(8)) mirrors this, so the 2021 amendments did broaden relationship formation: a telephone or video evaluation that builds a proper health record can support a first non-controlled prescription. Section 17-80-403(c) still excludes a relationship established only by an internet questionnaire, email, patient-generated medical history, text messaging, fax, or any combination of them, and the Medical Board's telemedicine rule (17 CAR 140-3201) adds that a patient completing a medical history online and forwarding it is not sufficient and does not count as store-and-forward, so a first GLP-1 or compounded peptide prescription cannot lawfully follow a questionnaire-only asynchronous intake. Once the relationship exists, follow-up care may use asynchronous tools if the standard of care is met. Section 17-80-404 and 17 CAR 140-3201 require the treating professional to be licensed in Arkansas.", "async_prescribing_allowed": false, "source_ids": [ "ar-17-80-403", "ar-17-80-402", "ar-17-80-404", "ar-car-140-202", "ar-car-140-3201" ] }, "compounding": { "board_name": "Arkansas State Board of Pharmacy", "board_url": "https://healthy.arkansas.gov/boards-commissions/boards/pharmacy-arkansas-state-board/", "follows_fda_503a_bulks": true, "notes": "The Arkansas State Board of Pharmacy regulates compounding under the Pharmacy Practice Act (Ark. Code Title 17, Chapter 92) and its compounding rule, now codified in the Code of Arkansas Rules as 17 CAR 160-2201 (Standards for compounding and dispensing compounded products, as amended effective June 29, 2026). That rule requires compounding pharmacies to comply with section 503A of the federal Food, Drug, and Cosmetic Act and the USP chapters on compounding numbered below 1000, generally prohibits compounding a drug that is commercially available or essentially a copy of an FDA approved product unless the prescriber documents a patient-specific medical need or the product is documented as unavailable, and requires a pharmacist in charge who oversees sterile compounding to keep written sterile procedures and certify Board-approved sterile training for pharmacists and technicians. Arkansas has no state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Arkansas is unusual in its nonresident rule: Ark. Code 17-92-401 requires any pharmacy outside the state that routinely ships dispensed legend drugs into Arkansas to hold an Arkansas pharmacy license, follow Arkansas law for the Arkansas part of its operation, keep an Arkansas-licensed pharmacist on staff as pharmacist in charge, and register an Arkansas agent for service of process.", "source_ids": [ "ar-board", "ar-160-2201", "ar-17-92-401", "ar-out-of-state-rule", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to documented patient-specific needs after the FDA shortage allowances ended in 2025, and Arkansas's own compounding regulation separately bars routine copies of commercially available drugs. Because Arkansas law does not let an online questionnaire alone establish the patient relationship, Arkansas patients should expect a live evaluation (in person, by video, or by telephone backed by a health record) before a first GLP-1 prescription, and should confirm the dispensing pharmacy holds an Arkansas license with an Arkansas-licensed pharmacist in charge.", "source_ids": [ "fda-glp1-compounding", "ar-160-2201", "ar-17-80-403", "ar-17-92-401" ] }, "research_peptide_sales": { "notes": "Only Arkansas-licensed pharmacies may dispense prescription drugs to Arkansas patients, including out-of-state pharmacies licensed under Ark. Code 17-92-401. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling, are not dispensed by a pharmacist, and carry no Arkansas licensing protections. The Arkansas Food, Drug, and Cosmetic Act (Ark. Code 20-56-201 and following) has no separate new-drug approval section, so the unapproved-drug prohibition comes from federal law; the state act does prohibit selling a misbranded drug (Ark. Code 20-56-215) and treats a drug as misbranded unless its labeling bears adequate directions for use and adequate warnings (Ark. Code 20-56-211).", "source_ids": [ "ar-17-92-401", "usc-331", "ar-20-56-211", "ar-20-56-215" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription. A first prescription by telemedicine requires a professional relationship under Ark. Code 17-80-402 and 17-80-403, such as an in-person exam, an existing relationship or referral, or an evaluation by an Arkansas-licensed provider with access to the patient's health record (telephone allowed for non-controlled drugs); a questionnaire alone does not qualify. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "ar-17-80-402", "ar-17-80-403", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to documented patient-specific needs since the 503A grace period ended February 18, 2025, and an out-of-state pharmacy shipping it to Arkansas must hold an Arkansas license with an Arkansas-licensed pharmacist in charge.", "source_ids": [ "fda-glp1-compounding", "ar-17-92-401" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Arkansas from an online questionnaire alone?", "a": "No. The Arkansas Telemedicine Act requires a professional relationship before telemedicine care and says an internet questionnaire, email, text message, or patient-generated medical history alone does not create one. For a new patient the relationship can come from an in-person exam, a referral from a professional who knows you, or an evaluation by an Arkansas-licensed provider who has your health record and uses appropriate technology, which for non-controlled drugs such as GLP-1s can include a telephone call. After the relationship exists, follow-up can be asynchronous.", "source_ids": [ "ar-17-80-402", "ar-17-80-403", "ar-car-140-202" ] }, { "q": "Does a telehealth prescriber need an Arkansas license?", "a": "Yes. Ark. Code 17-80-404 requires a professional treating a patient located in Arkansas through telemedicine to be fully licensed in Arkansas. Check the prescriber on the Arkansas State Medical Board license lookup before paying.", "source_ids": [ "ar-17-80-404" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Arkansas?", "a": "An Arkansas pharmacy license. Ark. Code 17-92-401 also requires the pharmacy to keep an Arkansas-licensed pharmacist on staff as pharmacist in charge for its Arkansas business and to register an Arkansas agent for service of process. If the pharmacy is not in the Board of Pharmacy license lookup, the shipment is not lawful.", "source_ids": [ "ar-17-92-401", "ar-out-of-state-rule", "ar-board" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Arkansas?", "a": "Only in limited, patient-specific cases. The federal shortage allowances ended in 2025, and Arkansas's compounding regulation generally bars compounding copies of commercially available drugs unless the prescriber documents a patient-specific medical need.", "source_ids": [ "fda-glp1-compounding", "ar-160-2201" ] }, { "q": "Can an Arkansas pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac", "ar-160-2201" ] } ], "sources": [ { "id": "ar-board", "type": "other", "title": "Arkansas State Board of Pharmacy", "url": "https://healthy.arkansas.gov/boards-commissions/boards/pharmacy-arkansas-state-board/" }, { "id": "ar-17-80-402", "type": "other", "title": "Arkansas Code 17-80-402, Telemedicine Act definitions (professional relationship, store-and-forward)", "url": "https://law.justia.com/codes/arkansas/title-17/subtitle-3/chapter-80/subchapter-4/section-17-80-402/" }, { "id": "ar-17-80-403", "type": "other", "title": "Arkansas Code 17-80-403, Establishment of professional relationship", "url": "https://law.justia.com/codes/arkansas/title-17/subtitle-3/chapter-80/subchapter-4/section-17-80-403/" }, { "id": "ar-17-80-404", "type": "other", "title": "Arkansas Code 17-80-404, Appropriate use of telemedicine", "url": "https://law.justia.com/codes/arkansas/title-17/subtitle-3/chapter-80/subchapter-4/section-17-80-404/" }, { "id": "ar-17-92-401", "type": "other", "title": "Arkansas Code 17-92-401, Applicability to out-of-state operations (pharmacies)", "url": "https://law.justia.com/codes/arkansas/title-17/subtitle-3/chapter-92/subchapter-4/section-17-92-401/" }, { "id": "ar-out-of-state-rule", "type": "other", "title": "Code of Arkansas Rules 17 CAR 160-1401, Out-of-state pharmacy regulation", "url": "https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=17&chapterID=174&subChapterID=217&partID=770&subPartID=5555§ionID=36104" }, { "id": "ar-160-2201", "type": "other", "title": "Code of Arkansas Rules 17 CAR 160-2201, Standards for compounding and dispensing compounded products (Ark. R. 2026-88, effective June 29, 2026), accessed 2026-09-22", "url": "https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=17&chapterID=174&subChapterID=217&partID=770&subPartID=5563§ionID=36139" }, { "id": "ar-car-140-202", "type": "other", "title": "Code of Arkansas Rules 17 CAR 140-202, Arkansas State Medical Board: minimum standards for establishing patient/provider relationships (paragraph (b)(8)), accessed 2026-09-22", "url": "https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=17&chapterID=173&subChapterID=216&partID=1045&subPartID=5581§ionID=36256" }, { "id": "ar-car-140-3201", "type": "other", "title": "Code of Arkansas Rules 17 CAR 140-3201, Arkansas State Medical Board: requirements for services provided using telemedicine, accessed 2026-09-22", "url": "https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=17&chapterID=173&subChapterID=216&partID=1045&subPartID=5611§ionID=36366" }, { "id": "ar-20-56-211", "type": "other", "title": "Arkansas Code 20-56-211, Misbranded drug or device (Food, Drug, and Cosmetic Act), accessed 2026-09-22", "url": "https://law.justia.com/codes/arkansas/title-20/subtitle-4/chapter-56/subchapter-2/section-20-56-211/" }, { "id": "ar-20-56-215", "type": "other", "title": "Arkansas Code 20-56-215, Prohibited acts (Food, Drug, and Cosmetic Act), accessed 2026-09-22", "url": "https://law.justia.com/codes/arkansas/title-20/subtitle-4/chapter-56/subchapter-2/section-20-56-215/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "california", "name": "California", "abbreviation": "CA", "kind": "state", "summary": "Yes. A California resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a California-licensed prescriber, including by asynchronous telehealth: Business and Professions Code section 2242 says an appropriate prior exam does not require a synchronous interaction and can be done through a questionnaire if the standard of care is met. Compounded peptides are harder to get in California than in most states, because the California State Board of Pharmacy's rewritten compounding regulations (16 CCR 1735 and 1736 series, 2025) define \"essentially a copy\" more strictly than federal law, and any out-of-state pharmacy shipping sterile compounded injectables into California needs both a nonresident pharmacy license and a nonresident sterile compounding license.", "telehealth": { "allowed": true, "notes": "Business and Professions Code section 2290.5 defines telehealth to include synchronous interactions and asynchronous store and forward transfers, requires the provider to obtain and document verbal or written consent to telehealth, and applies the same standard of care as in-person practice. Section 2242 makes it unprofessional conduct to prescribe a dangerous drug without an appropriate prior examination and medical indication, but expressly states that the exam does not require a synchronous interaction and can be achieved through telehealth, including a self-screening tool or questionnaire, if the licensee complies with the standard of care. The prescriber must hold a California license; California does not offer an out-of-state telehealth registration for physicians. Peptides in this database are not controlled substances, so federal Ryan Haight limits do not apply to them.", "async_prescribing_allowed": true, "source_ids": [ "ca-bpc-2290-5", "ca-bpc-2242", "ca-mbc" ] }, "compounding": { "board_name": "California State Board of Pharmacy", "board_url": "https://www.pharmacy.ca.gov/", "follows_fda_503a_bulks": true, "notes": "The California State Board of Pharmacy regulates compounding under the Pharmacy Law (Business and Professions Code section 4000 and following) and Title 16 of the California Code of Regulations, sections 1735 (nonsterile) and 1736 (sterile) series, which the Board comprehensively rewrote in 2025 to align with USP chapters 795 and 797. California follows the federal 503A bulks framework for which substances may be compounded, but sets a stricter standard on copies: under 16 CCR 1735.1 and 1736.1 a compounded drug is essentially a copy of a commercially available product unless a change for an identified patient produces a clinically significant difference that the pharmacist verifies and documents, and the California rule does not treat a different strength or route alone as enough. Out-of-state pharmacies shipping into California must hold a nonresident pharmacy license under section 4112, and those shipping sterile compounded products (which includes injectable peptides) also need a nonresident sterile compounding license under section 4127.2. The Board's approved-regulations page lists the rewrite as one package (Compounded Drug Preparations: repeal and replacement of 16 CCR 1735 and following, new articles 1736, 1737, and 1738), adopted by the Board March 26, 2025, approved by the Office of Administrative Law June 19, 2025, and effective October 1, 2025; the page shows no separate earlier effective date for the essentially-a-copy provisions.", "source_ids": [ "ca-board", "ca-laws-regs", "ca-copy-rules", "ca-approved-regs", "ca-compounding-policy", "ca-bpc-4112", "ca-bpc-4127-2", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Branded Wegovy, Zepbound, Ozempic, and Mounjaro are available from California pharmacies, and California's asynchronous telehealth rules make branded prescriptions easy to obtain remotely. Compounded semaglutide and tirzepatide are more restricted in California than federal law alone requires: beyond the end of the FDA shortage allowances in 2025, California pharmacists must document a clinically significant difference for the individual patient before compounding a GLP-1 that matches a commercial product, and a lower price is not a qualifying reason. The Board's rules allow shortage-based compounding again only if the drug returns to the FDA or ASHP shortage list.", "source_ids": [ "fda-glp1-compounding", "ca-copy-rules", "ca-bpc-2242" ] }, "research_peptide_sales": { "notes": "California's Sherman Food, Drug, and Cosmetic Law bars selling, delivering, or giving away any new drug in California unless it has federal approval or a California approval (Health and Safety Code section 111550). \"Research use only\" peptides sold for human use are unapproved new drugs under both the Sherman Law and federal law, and only licensed pharmacies may dispense prescription drugs to California patients.", "source_ids": [ "ca-hsc-111550", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including after an asynchronous questionnaire-based telehealth exam under Business and Professions Code section 2242. Compounded semaglutide requires a documented clinically significant difference for the patient under California's 2025 essentially-a-copy rules, a stricter bar than the federal patient-specific exception.", "source_ids": [ "ca-bpc-2242", "ca-copy-rules", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide faces the same California clinically significant difference requirement, and any compounded vial shipped from outside California must come from a pharmacy holding a nonresident sterile compounding license under section 4127.2.", "source_ids": [ "ca-copy-rules", "ca-bpc-4127-2" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. California pharmacies apply the federal bulks test plus the Board's rewritten compounding standards, and the Board has not issued a BPC-157 specific rule.", "source_ids": [ "fda-category-2", "fda-pcac", "ca-laws-regs" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in California through an online questionnaire?", "a": "Yes, if the prescriber meets the standard of care. California Business and Professions Code section 2242 says an appropriate prior exam does not require a synchronous interaction and can be done through telehealth, including a self-screening tool or questionnaire. The prescriber must be California-licensed and must document your consent to telehealth under section 2290.5.", "source_ids": [ "ca-bpc-2242", "ca-bpc-2290-5" ] }, { "q": "Why is compounded semaglutide harder to get in California than in other states?", "a": "California's 2025 compounding regulations treat a compounded drug as essentially a copy of a commercial product unless a change made for you produces a clinically significant difference that the pharmacist verifies and documents. That is stricter than the federal standard, and price is not a valid reason.", "source_ids": [ "ca-copy-rules", "fda-glp1-compounding" ] }, { "q": "What licenses does an out-of-state pharmacy need to ship injectable peptides to California?", "a": "Two. It needs a nonresident pharmacy license under Business and Professions Code section 4112, and because injectable peptides are sterile compounded products it also needs a nonresident sterile compounding license under section 4127.2. Verify both on the Board of Pharmacy license lookup.", "source_ids": [ "ca-bpc-4112", "ca-bpc-4127-2", "ca-board" ] }, { "q": "Can a California pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac", "ca-laws-regs" ] }, { "q": "Is it legal to buy research peptides online in California?", "a": "Not for human use. Health and Safety Code section 111550 bars selling or delivering an unapproved new drug in California, and research-labeled peptides sold for injection are unapproved new drugs under both state and federal law.", "source_ids": [ "ca-hsc-111550", "usc-331" ] } ], "sources": [ { "id": "ca-board", "type": "other", "title": "California State Board of Pharmacy", "url": "https://www.pharmacy.ca.gov/" }, { "id": "ca-laws-regs", "type": "other", "title": "California State Board of Pharmacy: laws and regulations (Pharmacy Law and 16 CCR compounding sections)", "url": "https://www.pharmacy.ca.gov/laws_regs/index.shtml" }, { "id": "ca-copy-rules", "type": "other", "title": "California Board of Pharmacy: regulation text, compounding in licensed pharmacies (16 CCR 1735 and following, including the essentially-a-copy definition)", "url": "https://www.pharmacy.ca.gov/laws_regs/1735_pt_24.pdf" }, { "id": "ca-approved-regs", "type": "other", "title": "California State Board of Pharmacy: approved regulations (Compounded Drug Preparations, effective October 1, 2025; OAL approval June 19, 2025), accessed 2026-09-22", "url": "https://www.pharmacy.ca.gov/laws_regs/approved_regs.shtml" }, { "id": "ca-compounding-policy", "type": "other", "title": "California State Board of Pharmacy: compounding policy statement (June 19, 2025 notice of approval, regulations effective October 1, 2025), accessed 2026-09-22", "url": "https://www.pharmacy.ca.gov/about/compounding_policy.pdf" }, { "id": "ca-bpc-2290-5", "type": "other", "title": "California Business and Professions Code section 2290.5, Telehealth", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=2290.5." }, { "id": "ca-bpc-2242", "type": "other", "title": "California Business and Professions Code section 2242, Prescribing without an appropriate prior examination", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=2242." }, { "id": "ca-bpc-4112", "type": "other", "title": "California Business and Professions Code section 4112, Nonresident pharmacy license", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=4112." }, { "id": "ca-bpc-4127-2", "type": "other", "title": "California Business and Professions Code section 4127.2, Nonresident sterile compounding pharmacy license", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=4127.2." }, { "id": "ca-hsc-111550", "type": "other", "title": "California Health and Safety Code section 111550, New drugs (Sherman Food, Drug, and Cosmetic Law)", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=111550." }, { "id": "ca-mbc", "type": "other", "title": "Medical Board of California", "url": "https://www.mbc.ca.gov/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "colorado", "name": "Colorado", "abbreviation": "CO", "kind": "state", "summary": "Yes. A Colorado resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Colorado-licensed provider, including by telehealth, because Colorado law treats telehealth as the practice of medicine where the patient is located (C.R.S. 12-240-107) and the Colorado Medical Board allows a provider-patient relationship to be formed through telehealth under its telehealth policies. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Colorado prescription drug outlet or a nonresident prescription drug outlet registered with the Colorado State Board of Pharmacy under C.R.S. 12-280-133, which must supply a recent inspection report from its home-state board or a national pharmacy verification program and may ship compounded drugs into Colorado only on patient-specific prescriptions.", "telehealth": { "allowed": true, "notes": "C.R.S. 12-240-107 includes telemedicine in the definition of the practice of medicine, and the practice occurs where the patient is located, so the prescriber needs a Colorado license (Colorado participates in the Interstate Medical Licensure Compact, which is one route to that license). The Colorado Medical Board's published policies (Policy 40-03 on the provider-patient relationship, revised 2015, and Policy 40-27, guidelines for the appropriate use of telehealth technologies, issued 2015 and revised December 18, 2020 and August 19, 2021) say a provider-patient relationship may be established through telehealth whether or not there has been an in-person encounter, as long as it conforms to generally accepted standards of practice, the provider verifies the patient's identity and location, discloses the provider's identity and credentials, and obtains appropriate informed consent. Policy 40-27 defines telehealth to include store-and-forward transfers, requires an appropriate medical evaluation and review of relevant clinical history before any prescription, holds online prescribing to in-person standards, and states that treatment, including a prescription, based solely on an online questionnaire does not constitute an acceptable standard of care. The policies do not require a real-time video visit, so a first non-controlled prescription may follow an asynchronous evaluation that meets that standard, but a questionnaire-only intake does not.", "async_prescribing_allowed": true, "source_ids": [ "co-12-240-107", "co-medical-board", "co-telehealth-policy", "imlc-states" ] }, "compounding": { "board_name": "Colorado State Board of Pharmacy (Division of Professions and Occupations)", "board_url": "https://dpo.colorado.gov/Pharmacy", "follows_fda_503a_bulks": true, "notes": "The Colorado State Board of Pharmacy regulates compounding under the Pharmacy Practice Act (C.R.S. Title 12, Article 280, including section 12-280-120 on compounding and dispensing) and Board rules at 3 CCR 719-1. Colorado has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Under C.R.S. 12-280-133, a prescription drug outlet outside Colorado that ships, mails, or delivers drugs into Colorado is a nonresident prescription drug outlet and must register with the Board, disclose its officers and the pharmacists dispensing to Colorado residents, keep its home-state license valid, and submit its most recent home-state inspection report. Board Rule 5.00.15 accepts an inspection by the home-state board or by a national pharmacy verification program dated within the previous two years and requires an affidavit that the outlet will not ship drugs into Colorado without a patient-specific prescription; an annual third-party inspection is required only for the separate case of distributing compounded products to Colorado veterinarians (Rule 21.00.20). Compounding standards are in Rule 21.00.00 of 3 CCR 719-1, and Rule 21.20.00 (Compounding of Sterile Products) with Rules 21.21.00 and 21.22.00 governs sterile preparations such as injectable peptides. The Board has a permanent rulemaking hearing set for October 1, 2026 on proposed revisions to its compounding rules to align them with recent FDA guidance.", "source_ids": [ "co-board", "co-12-280-133", "co-12-280-120", "co-3ccr719-1", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Colorado patients using a telehealth GLP-1 program should confirm the prescriber holds a Colorado license and that an out-of-state dispensing pharmacy appears as a registered nonresident prescription drug outlet. The Board of Pharmacy rules (3 CCR 719-1) contain no GLP-1-specific provision, and a 2026 bill to regulate the marketing and distribution of compounded GLP-1 weight-loss medication (SB26-066) was postponed indefinitely in a House committee on May 5, 2026 and did not become law, so federal compounding limits and the general Colorado rules apply.", "source_ids": [ "fda-glp1-compounding", "fda-glp1-clarifies", "co-12-280-133", "co-3ccr719-1", "co-sb26-066" ] }, "research_peptide_sales": { "notes": "Only registered prescription drug outlets, including registered nonresident outlets, may dispense prescription drugs to Colorado patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling and are not dispensed by a pharmacist. Colorado law also bars the sale directly: C.R.S. 12-280-131 says no person shall sell, deliver, offer for sale, hold for sale, or give away any new drug not authorized to move in interstate commerce under federal law, with an exception only for drugs intended solely for investigational use by qualified experts and plainly labeled for investigational use only.", "source_ids": [ "co-12-280-133", "co-12-280-131", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telehealth from a Colorado-licensed provider under the Medical Board's telehealth policies. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "co-telehealth-policy", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can a telehealth provider prescribe me a GLP-1 in Colorado without an in-person visit?", "a": "Yes, if the provider holds a Colorado license and establishes a provider-patient relationship that meets generally accepted standards of practice. Colorado treats telemedicine as practicing medicine where the patient is located, and the Colorado Medical Board's telehealth policies allow the relationship to be formed through telehealth with appropriate informed consent.", "source_ids": [ "co-12-240-107", "co-telehealth-policy" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Colorado?", "a": "Registration as a nonresident prescription drug outlet with the Colorado State Board of Pharmacy under C.R.S. 12-280-133. The outlet must submit a recent inspection report from its home-state board or a national pharmacy verification program, keep its home-state license valid, and ship compounded drugs into Colorado only on patient-specific prescriptions, so check the Division of Professions and Occupations license lookup before ordering.", "source_ids": [ "co-12-280-133", "co-3ccr719-1", "co-board" ] }, { "q": "What Colorado-specific rules apply to GLP-1 programs?", "a": "Colorado patients using a telehealth GLP-1 program should confirm the prescriber holds a Colorado license and that an out-of-state dispensing pharmacy appears as a registered nonresident prescription drug outlet. Colorado has no GLP-1-specific pharmacy rule; a 2026 bill aimed at compounded GLP-1 weight-loss medication (SB26-066) did not become law.", "source_ids": [ "fda-glp1-compounding", "fda-glp1-clarifies", "co-12-280-133", "co-sb26-066" ] }, { "q": "Can a Colorado pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac", "co-12-280-120" ] } ], "sources": [ { "id": "co-board", "type": "other", "title": "Colorado State Board of Pharmacy, Division of Professions and Occupations", "url": "https://dpo.colorado.gov/Pharmacy" }, { "id": "co-medical-board", "type": "other", "title": "Colorado Medical Board, Division of Professions and Occupations", "url": "https://dpo.colorado.gov/Medical" }, { "id": "co-telehealth-policy", "type": "other", "title": "Colorado Medical Board Policies (Policy 40-03 provider-patient relationship; Policy 40-27 telehealth guidelines, revised August 19, 2021), linked from the Board homepage, accessed 2026-09-22", "url": "https://drive.google.com/file/d/1qxCbRZQ6zMLdr5imKx06-ucLbsTkCZXE/view" }, { "id": "co-12-240-107", "type": "other", "title": "C.R.S. 12-240-107, Practice of medicine defined (includes telemedicine)", "url": "https://colorado.public.law/statutes/crs_12-240-107" }, { "id": "co-12-280-133", "type": "other", "title": "C.R.S. 12-280-133, Nonresident prescription drug outlet, registration, accessed 2026-09-22", "url": "https://colorado.public.law/statutes/crs_12-280-133" }, { "id": "co-12-280-131", "type": "other", "title": "C.R.S. 12-280-131, New drugs, when sales permissible, accessed 2026-09-22", "url": "https://colorado.public.law/statutes/crs_12-280-131" }, { "id": "co-3ccr719-1", "type": "other", "title": "Colorado Secretary of State, Code of Colorado Regulations 3 CCR 719-1, State Board of Pharmacy Rules (current version effective August 21, 2026; Rules 5.00.15, 21.00.00, 21.20.00), accessed 2026-09-22", "url": "https://www.coloradosos.gov/CCR/GenerateRulePdf.do?ruleVersionId=12670&fileName=3%20CCR%20719-1" }, { "id": "co-sb26-066", "type": "other", "title": "Colorado General Assembly: SB26-066, Regulation of Compounded Weight-Loss Medication (postponed indefinitely May 5, 2026), accessed 2026-09-22", "url": "https://leg.colorado.gov/bills/sb26-066" }, { "id": "co-12-280-120", "type": "other", "title": "C.R.S. 12-280-120, Compounding, dispensing, and sale of drugs and devices", "url": "https://law.justia.com/codes/colorado/2021/title-12/article-280/part-1/section-12-280-120/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "fda-glp1-clarifies", "type": "fda", "title": "FDA: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize", "url": "https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "connecticut", "name": "Connecticut", "abbreviation": "CT", "kind": "state", "summary": "Yes. A Connecticut resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Connecticut-licensed provider, including by telehealth under Connecticut General Statutes section 19a-906, which covers synchronous, asynchronous store-and-forward, and remote monitoring care. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Connecticut pharmacy or a registered nonresident pharmacy; a nonresident pharmacy that compounds sterile products such as injectable peptides for Connecticut patients must file a sterile compounding addendum and receive written approval from the Department of Consumer Protection and the Commission of Pharmacy first (section 20-633b).", "telehealth": { "allowed": true, "notes": "Section 19a-906 defines telehealth to include synchronous interactions, asynchronous store and forward transfers, and remote patient monitoring, and requires a telehealth provider to meet the same standard of care as in-person care, have access to the patient's relevant medical history, and obtain consent. The statute bars telehealth prescribing of schedule I, II, and III controlled substances except narrow non-opioid psychiatric and substance use disorder cases; peptides in this database are not controlled, so that limit does not affect GLP-1 or compounded peptide prescriptions. The temporary authorization in section 19a-906 that let certain out-of-state providers treat Connecticut patients ran through June 30, 2025, so a prescriber now generally needs a Connecticut license. Because asynchronous care is expressly part of the definition, a non-controlled prescription may follow an asynchronous evaluation that meets the standard of care.", "async_prescribing_allowed": true, "source_ids": [ "ct-19a-906", "ct-chap-368ll" ] }, "compounding": { "board_name": "Connecticut Commission of Pharmacy (Department of Consumer Protection, Drug Control Division)", "board_url": "https://portal.ct.gov/dcp/drug-control-division/commission-of-pharmacy", "follows_fda_503a_bulks": true, "notes": "Connecticut regulates pharmacies through the Department of Consumer Protection and the Commission of Pharmacy under chapter 400j of the General Statutes. Connecticut has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Two Connecticut rules matter for injectable peptides. First, a pharmacy outside Connecticut must hold a nonresident pharmacy registration under section 20-627 and disclose whether it dispenses sterile pharmaceuticals into the state. Second, section 20-633b defines a sterile compounding pharmacy to include registered nonresident pharmacies and requires a nonresident applicant that intends to compound sterile products for Connecticut patients to file an addendum, provide proof of a passed home-state inspection, and wait for written approval from the Department and the Commission before shipping. Connecticut's sterile compounding regulations (Regulations of Connecticut State Agencies sections 20-576-64 to 20-576-68, adopted 2011) apply to pharmacies licensed under section 20-594 and require compliance with the current USP chapter 797, a policy and procedure manual that complies with chapter 797, a two-week limit on compounded products supplied to practitioners for office use, and at least 35 open hours a week unless waived. Those regulations do not set separate compounding standards for nonresident pharmacies; a nonresident sterile compounder is governed by the section 20-633b addendum, inspection, and approval process described above.", "source_ids": [ "ct-commission", "ct-20-627", "ct-20-633b", "ct-chap-400j", "ct-rcsa-20-576-66", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because compounded GLP-1 injections are sterile preparations, an out-of-state pharmacy shipping them to Connecticut must have an approved sterile compounding addendum under section 20-633b in addition to its nonresident registration.", "source_ids": [ "fda-glp1-compounding", "ct-20-633b", "ct-20-627" ] }, "research_peptide_sales": { "notes": "Only Connecticut-licensed pharmacies and registered nonresident pharmacies may dispense prescription drugs to Connecticut patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law, are not dispensed by a pharmacist, and fall outside Connecticut's sterile compounding approval system. Connecticut law also bars the sale directly: under the Connecticut Food, Drug and Cosmetic Act, section 21a-110 provides that no person shall sell, deliver, offer for sale, hold for sale, or give away any new drug unless an application for it has been approved under section 355 of the federal act or, for a drug not subject to the federal act, a state application has been filed with the Commissioner of Consumer Protection. The Connecticut Attorney General has used the Connecticut Unfair Trade Practices Act (Conn. Gen. Stat. 42-110a and following) against sellers of research-grade GLP-1s, including a 2025 settlement with an online distributor and a May 2026 settlement under which an international online trade platform agreed to stop GLP-1 sales to US consumers and remove such listings. The same May 2026 announcement included a settlement with a medical spa that stopped advertising and prescribing compounded semaglutide and tirzepatide.", "source_ids": [ "ct-20-627", "ct-21a-110", "usc-331", "ct-ag-2026-05-06" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including after an asynchronous telehealth evaluation under section 19a-906. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025, and out-of-state compounded vials require an approved sterile compounding addendum.", "source_ids": [ "ct-19a-906", "fda-glp1-compounding", "ct-20-633b" ] } ], "faqs": [ { "q": "Does Connecticut allow asynchronous telehealth prescribing for GLP-1 drugs?", "a": "Yes. Section 19a-906 defines telehealth to include asynchronous store and forward transfers, and semaglutide and tirzepatide are not controlled substances, so a Connecticut-licensed provider may prescribe them after an evaluation that meets the in-person standard of care and includes access to your medical history.", "source_ids": [ "ct-19a-906" ] }, { "q": "Can an out-of-state telehealth doctor still treat me in Connecticut?", "a": "Generally only with a Connecticut license. The temporary out-of-state authorization in section 19a-906 ran through June 30, 2025. Check the provider on the Department of Public Health license lookup before paying.", "source_ids": [ "ct-19a-906", "ct-chap-368ll" ] }, { "q": "What does an out-of-state pharmacy need to send me injectable compounded peptides in Connecticut?", "a": "A nonresident pharmacy registration under section 20-627 plus an approved sterile compounding addendum under section 20-633b, which requires proof of a passed home-state inspection and written approval from the Department of Consumer Protection and the Commission of Pharmacy before any sterile product is shipped.", "source_ids": [ "ct-20-627", "ct-20-633b" ] }, { "q": "Can a Connecticut pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ct-commission", "type": "other", "title": "Connecticut Commission of Pharmacy, Department of Consumer Protection", "url": "https://portal.ct.gov/dcp/drug-control-division/commission-of-pharmacy" }, { "id": "ct-19a-906", "type": "other", "title": "Connecticut General Statutes section 19a-906, Telehealth services", "url": "https://law.justia.com/codes/connecticut/title-19a/chapter-368-i-ll-i/section-19a-906/" }, { "id": "ct-chap-368ll", "type": "other", "title": "Connecticut General Statutes chapter 368ll (current text of section 19a-906)", "url": "https://www.cga.ct.gov/current/pub/chap_368ll.htm" }, { "id": "ct-chap-400j", "type": "other", "title": "Connecticut General Statutes chapter 400j, Pharmacy", "url": "https://www.cga.ct.gov/current/pub/chap_400j.htm" }, { "id": "ct-20-627", "type": "other", "title": "Connecticut General Statutes section 20-627, Nonresident pharmacy registration", "url": "https://law.justia.com/codes/connecticut/2014/title-20/chapter-400j/section-20-627/" }, { "id": "ct-20-633b", "type": "other", "title": "Connecticut General Statutes section 20-633b, Sterile compounding pharmacies", "url": "https://law.justia.com/codes/connecticut/title-20/chapter-400j/section-20-633b/" }, { "id": "ct-rcsa-20-576-66", "type": "other", "title": "Regulations of Connecticut State Agencies sections 20-576-64 to 20-576-68, Sterile compounding pharmacies (standards in section 20-576-66, adopted effective July 12, 2011), accessed 2026-09-22", "url": "https://eregulations.ct.gov/eRegsPortal/Browse/RCSA/Title_20Subtitle_20-576Section_20-576-66/" }, { "id": "ct-21a-110", "type": "other", "title": "Connecticut General Statutes chapter 418 (Connecticut Food, Drug and Cosmetic Act), section 21a-110, New drugs, accessed 2026-09-22", "url": "https://www.cga.ct.gov/current/pub/chap_418.htm" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "ct-ag-2026-05-06", "type": "other", "title": "Connecticut Attorney General: Online Platform to Cease Bootleg GLP-1 Weight Loss Drug Sales Nationwide (May 6, 2026)", "url": "https://portal.ct.gov/ag/press-releases/2026-press-releases/attorney-general-tong-announces-online-platform-to-cease-bootleg-weight-loss-drug-sales" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "delaware", "name": "Delaware", "abbreviation": "DE", "kind": "state", "summary": "Yes. A Delaware resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription through telehealth under Title 24, chapter 60 of the Delaware Code, from a Delaware-licensed provider or from an out-of-state physician who holds a Delaware interstate telehealth registration. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Delaware pharmacy or a pharmacy holding a Delaware nonresident pharmacy license (24 Del. C. 2535 through 2537), which must send the Delaware Board of Pharmacy its home-state inspection reports. Delaware bars prescribing solely from an internet questionnaire when no provider-patient relationship exists.", "telehealth": { "allowed": true, "notes": "Delaware repealed its older physician telemedicine section (24 Del. C. 1769D) effective July 1, 2021 and moved telehealth rules for all professions into Title 24, chapter 60. Section 6001 defines telemedicine to include secure video conferencing and store and forward transfer, which may be synchronous or asynchronous. Section 6003 requires a health-care provider-patient relationship before telehealth care; the relationship may be established in person or through telehealth but must include verification of the patient's identity and location and disclosure of the provider's identity and credentials, and without a proper relationship a provider may not issue a prescription solely in response to an internet questionnaire, internet consult, or telephone consult. The Division of Professional Regulation also issues interstate telehealth registrations that let physicians and physician assistants licensed in good standing in another state treat Delaware patients by telehealth without a full Delaware license. Section 6003(b) answers the asynchronous question directly: telehealth services may be synchronous or asynchronous using store-and-forward technology, and telehealth may be used to establish the provider-patient relationship if the provider determines the provider can meet the same standard of care as an in-person visit. Section 6004(a) adds that before diagnosis and treatment the provider must do at least one of the following: an in-person exam, having another Delaware-licensed provider present with the patient, making the diagnosis using audio or visual communication, or meeting professional society guidelines for establishing a relationship in evidence-based telemedicine practice. An asynchronous first prescription is therefore allowed when those conditions are met, but not one issued solely from an internet questionnaire without a proper relationship.", "async_prescribing_allowed": true, "source_ids": [ "de-ch-60", "de-6003", "de-interstate-registration" ] }, "compounding": { "board_name": "Delaware Board of Pharmacy (Division of Professional Regulation)", "board_url": "https://dpr.delaware.gov/boards/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The Delaware Board of Pharmacy licenses pharmacies under Title 24, chapter 25 of the Delaware Code and its Board regulations. Delaware has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Chapter 25 was reorganized by 85 Del. Laws chapter 49, effective June 30, 2026; in the current Delaware Code, checked 2026-09-22, a pharmacy in another state that delivers, dispenses, or distributes a prescription drug to a Delaware patient must hold a Delaware nonresident pharmacy license (section 2535), which requires good standing in every state where it is licensed and the most recent Board-approved inspection report covering the business it will conduct in Delaware, performed by or for its home-state licensing authority (or, if the home state has not inspected, by a national pharmacy verification program or another qualified entity). It must designate a Delaware registered agent (section 2536), keep a valid home-state license, and may be disciplined for failing to send the Board later inspection reports within 60 days of receiving them (section 2537). The Board's regulations (24 Del. Admin. Code 2500) require all compounding to comply with section 503A of the federal act (regulation 5.1.6) and require every Board licensee that compounds to comply with USP chapters 795 and 797 (regulation 10.0).", "source_ids": [ "de-board", "de-ch-25", "de-ch-25-sc4", "de-admin-2500", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Delaware patients using an out-of-state telehealth GLP-1 program should confirm the prescriber is Delaware-licensed or holds an interstate telehealth registration, and that the pharmacy holds a Delaware nonresident pharmacy license.", "source_ids": [ "fda-glp1-compounding", "de-interstate-registration", "de-ch-25-sc4" ] }, "research_peptide_sales": { "notes": "Only Delaware-licensed pharmacies and licensed nonresident pharmacies may dispense prescription drugs to Delaware patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law, are not dispensed by a pharmacist, and fall outside Delaware's pharmacy licensing system. Delaware's own food and drug law (16 Del. C. chapter 33, Pure Food and Drugs) prohibits manufacturing or selling an adulterated or misbranded drug (section 3302) but has no separate new-drug approval provision, so the prohibition on selling unapproved new drugs comes from federal law.", "source_ids": [ "de-ch-25-sc4", "de-16-ch-33", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription through telehealth under 24 Del. C. chapter 60, including from out-of-state physicians with a Delaware interstate telehealth registration. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "de-ch-60", "de-interstate-registration", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can an out-of-state telehealth doctor prescribe me a GLP-1 in Delaware?", "a": "Yes, if the physician holds a Delaware license or a Delaware interstate telehealth registration. The Division of Professional Regulation issues these registrations to physicians licensed in good standing in another state, and the provider must still establish a provider-patient relationship under 24 Del. C. 6003.", "source_ids": [ "de-interstate-registration", "de-6003" ] }, { "q": "Can I get a prescription in Delaware just by filling out an online form?", "a": "Not without a proper provider-patient relationship. Section 6003 bars issuing a prescription solely in response to an internet questionnaire, internet consult, or telephone consult when no relationship has been established, and the relationship requires identity and location verification and disclosure of the provider's credentials.", "source_ids": [ "de-6003" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Delaware?", "a": "A Delaware nonresident pharmacy license. The pharmacy must also designate a Delaware registered agent, keep its home-state license valid, and send the Board of Pharmacy its inspection reports. Check the Division of Professional Regulation license lookup before ordering.", "source_ids": [ "de-ch-25-sc4", "de-board" ] }, { "q": "Can a Delaware pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "de-board", "type": "other", "title": "Delaware Board of Pharmacy, Division of Professional Regulation", "url": "https://dpr.delaware.gov/boards/pharmacy/" }, { "id": "de-ch-60", "type": "other", "title": "Delaware Code Title 24, chapter 60, Provisions applicable to telehealth and telemedicine", "url": "https://delcode.delaware.gov/title24/c060/index.html" }, { "id": "de-6003", "type": "other", "title": "24 Del. C. 6003, Scope of practice; provider-patient relationship required", "url": "https://law.justia.com/codes/delaware/title-24/chapter-60/section-6003/" }, { "id": "de-interstate-registration", "type": "other", "title": "Delaware Division of Professional Regulation: medical interstate telehealth registrations", "url": "https://dpr.delaware.gov/boards/medicalpractice/medical-interstate-telehealth-registrations/" }, { "id": "de-ch-25", "type": "other", "title": "Delaware Code Title 24, chapter 25, Pharmacy", "url": "https://delcode.delaware.gov/title24/c025/index.html" }, { "id": "de-ch-25-sc4", "type": "other", "title": "Delaware Code Title 24, chapter 25, subchapter IV, Pharmacies (nonresident pharmacy sections 2535 to 2537)", "url": "https://delcode.delaware.gov/title24/c025/sc04/index.html" }, { "id": "de-admin-2500", "type": "other", "title": "Delaware Administrative Code Title 24, 2500 Board of Pharmacy regulations (5.1.6 Compounding; 10.0 Pharmaceutical Compounding), accessed 2026-09-22", "url": "https://regulations.delaware.gov/AdminCode/title24/2500.shtml" }, { "id": "de-16-ch-33", "type": "other", "title": "Delaware Code Title 16, chapter 33, Pure Food and Drugs (section 3302), accessed 2026-09-22", "url": "https://delcode.delaware.gov/title16/c033/index.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "florida", "name": "Florida", "abbreviation": "FL", "kind": "state", "summary": "Yes. A Florida resident can legally obtain FDA approved peptides such as semaglutide and tirzepatide from any Florida-licensed prescriber, including by telehealth, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy that holds a Florida permit or a Florida nonresident pharmacy registration. Florida's telehealth statute (section 456.47) lets in-state and registered out-of-state practitioners prescribe non-controlled drugs without an in-person visit, and the Florida Board of Pharmacy regulates compounding under chapter 465 and rule chapter 64B16-27. Out-of-state pharmacies shipping compounded sterile injectables into Florida need an additional nonresident sterile compounding permit.", "telehealth": { "allowed": true, "notes": "Section 456.47, Florida Statutes, defines telehealth as synchronous or asynchronous telecommunications technology used to assess, diagnose, treat, and monitor a patient (email and fax do not count). A telehealth provider may evaluate a patient and prescribe without an in-person examination as long as the care meets the prevailing professional standard of practice. The statute bars telehealth prescribing of Schedule II controlled substances except for narrow cases (psychiatric disorders, hospital inpatients, hospice, nursing home residents); peptides in this database are not scheduled, so GLP-1 and compounded peptide prescriptions are not affected by that limit. Practitioners licensed in another state must hold a Florida out-of-state telehealth provider registration with the applicable Florida board (or the Department of Health where there is no board) before treating Florida patients, and they cannot open a Florida office or provide in-person care under that registration.", "async_prescribing_allowed": true, "source_ids": [ "fl-456-47", "fl-doh-telehealth" ] }, "compounding": { "board_name": "Florida Board of Pharmacy (Florida Department of Health)", "board_url": "https://floridaspharmacy.gov/", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy regulates compounding through chapter 465 (Pharmacy) and rule chapter 64B16-27, including rule 64B16-27.700 (definition of compounding) and rule 64B16-27.797 (standards of practice for sterile compounding). Florida has no separate state bulks list; eligibility of a peptide for compounding follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Two Florida-specific requirements matter for peptide patients: any out-of-state pharmacy that ships a dispensed drug to a Florida patient must register as a nonresident pharmacy under section 465.0156, and any pharmacy or outsourcing facility shipping a compounded sterile product (which covers injectable peptides) into Florida must also hold a nonresident sterile compounding permit under section 465.0158. A telehealth prescription filled by an unregistered mail-order pharmacy is being dispensed unlawfully in Florida even if the prescriber is compliant.", "source_ids": [ "fl-board", "fl-465", "fl-465-0156", "fl-465-0158", "fl-64b16-27-700", "fl-64b16-27-797", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to the federal exception for documented patient specific needs because the FDA shortage allowances ended in 2025. Florida patients using telehealth GLP-1 programs should confirm the dispensing pharmacy appears in the Department of Health license lookup as a Florida pharmacy or a registered nonresident pharmacy with a sterile compounding permit.", "source_ids": [ "fda-glp1-compounding", "fl-465-0158", "fl-board" ] }, "research_peptide_sales": { "notes": "The Florida Drug and Cosmetic Act (chapter 499) prohibits manufacturing, distributing, or selling adulterated, misbranded, or unapproved new drugs in the state (section 499.005), and requires a Florida drug wholesale or manufacturer permit for anyone distributing prescription drugs. Sellers of \"research use only\" peptides shipped to Florida consumers for injection are not permitted under chapter 499 and are also subject to federal enforcement.", "source_ids": [ "fl-499", "fl-499-005", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Florida through telehealth without seeing a doctor in person?", "a": "Yes. Florida's telehealth law (section 456.47) allows a licensed or Florida-registered telehealth provider to evaluate you, diagnose, and prescribe using synchronous or asynchronous technology, as long as the care meets the standard of practice. Semaglutide and tirzepatide are not controlled substances, so the Schedule II telehealth restriction does not apply.", "source_ids": [ "fl-456-47", "fl-doh-telehealth" ] }, { "q": "Can an out-of-state telehealth clinic treat me in Florida?", "a": "Only if the practitioner holds a Florida license or an out-of-state telehealth provider registration issued by the applicable Florida board (or the Department of Health where there is no board). Registered providers may not open a Florida office or provide in-person services, and the Department of Health can discipline them. Look the provider up in the Department of Health license portal before paying.", "source_ids": [ "fl-456-47", "fl-doh-telehealth" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Florida?", "a": "Only in limited, patient specific cases. The federal shortage allowances ended in 2025, so a Florida pharmacy can compound a GLP-1 only when the approved product cannot meet a documented need. Any compounded injectable shipped into Florida must also come from a pharmacy holding a Florida nonresident sterile compounding permit.", "source_ids": [ "fda-glp1-compounding", "fl-465-0158" ] }, { "q": "How do I check whether a pharmacy is allowed to ship compounded peptides to Florida?", "a": "Search the Florida Department of Health license verification for the pharmacy name. An out-of-state pharmacy needs a nonresident pharmacy registration (section 465.0156), and if it ships sterile compounded products such as injectable peptides it also needs a nonresident sterile compounding permit (section 465.0158). If neither appears, the shipment is not lawful in Florida.", "source_ids": [ "fl-465-0156", "fl-465-0158", "fl-board" ] }, { "q": "Can a Florida pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fl-64b16-27-700", "fda-category-2", "fda-pcac" ] }, { "q": "Is it legal to buy research peptides online and have them shipped to Florida?", "a": "No. Chapter 499 bars the sale and distribution of unapproved or misbranded drugs in Florida and requires permits for anyone distributing prescription drugs. \"Research use only\" peptides sold for injection are unapproved drugs under both Florida and federal law, and they are not dispensed by a pharmacist.", "source_ids": [ "fl-499", "fl-499-005", "usc-331" ] } ], "sources": [ { "id": "fl-board", "type": "other", "title": "Florida Board of Pharmacy (Florida Department of Health)", "url": "https://floridaspharmacy.gov/" }, { "id": "fl-456-47", "type": "other", "title": "Florida Statutes section 456.47, Use of telehealth to provide services", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0456/Sections/0456.47.html" }, { "id": "fl-doh-telehealth", "type": "other", "title": "Florida Department of Health: telehealth and out-of-state telehealth provider registration", "url": "https://flhealthsource.gov/telehealth/" }, { "id": "fl-465", "type": "other", "title": "Florida Statutes chapter 465, Pharmacy", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0465/0465.html" }, { "id": "fl-465-0156", "type": "other", "title": "Florida Statutes section 465.0156, Registration of nonresident pharmacies", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0465/Sections/0465.0156.html" }, { "id": "fl-465-0158", "type": "other", "title": "Florida Statutes section 465.0158, Nonresident sterile compounding permit", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0465/Sections/0465.0158.html" }, { "id": "fl-64b16-27-700", "type": "other", "title": "Florida Administrative Code rule 64B16-27.700, Definition of compounding", "url": "https://www.flrules.org/gateway/ruleNo.asp?id=64B16-27.700" }, { "id": "fl-64b16-27-797", "type": "other", "title": "Florida Administrative Code rule 64B16-27.797, Standards of practice for compounding sterile preparations", "url": "https://www.flrules.org/gateway/ruleNo.asp?id=64B16-27.797" }, { "id": "fl-499", "type": "other", "title": "Florida Statutes chapter 499, Florida Drug and Cosmetic Act", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0499/0499.html" }, { "id": "fl-499-005", "type": "other", "title": "Florida Statutes section 499.005, Prohibited acts", "url": "https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0499/Sections/0499.005.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "georgia", "name": "Georgia", "abbreviation": "GA", "kind": "state", "summary": "Yes, but Georgia is one of the stricter telehealth states. A Georgia resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Georgia-licensed provider, but Georgia Composite Medical Board rule 360-3-.07 generally requires the patient to have been examined, in person or with technology equal to an in-person exam, before an initial prescription for a dangerous drug by telemedicine, and the Board ended its pandemic-era flexibility in 2024. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Georgia pharmacy or a pharmacy holding a Georgia nonresident pharmacy permit (O.C.G.A. 26-4-114.1); nonresident pharmacies that compound must also submit an inspection report.", "telehealth": { "allowed": true, "notes": "Georgia Composite Medical Board rule 360-3-.07 (Practice through electronic or other such means) authorizes telemedicine by a Georgia-licensed physician, physician assistant, or advanced practice registered nurse when the provider has personally seen and examined the patient and provides ongoing care electronically, is covering for or acting at the request of a Georgia-licensed clinician who examined the patient, or can examine the patient using technology or peripherals equal or superior to an in-person exam. Board rule 360-3-.02(6) separately makes it unprofessional conduct to provide treatment by electronic means unless a history and physical examination of the patient has been performed by a Georgia licensee, with exceptions for on-call coverage and consultations. In its January 10, 2024 statement the Board said an in-person visit is not required for every prescription, but that its rules in general require a patient to be examined once in person before an initial prescription for controlled substances and/or dangerous drugs, and that telemedicine providers must make diligent efforts to have patients examined in person annually. Under O.C.G.A. 16-13-71 a dangerous drug is any non-scheduled drug that federal law allows to be dispensed only by prescription, which includes GLP-1 drugs. In December 2023 the Board announced it would end its COVID-era tele-prescribing flexibility, and after an extension through May 1, 2024 licensees must follow the Medical Practice Act and Board rules strictly. A questionnaire-only first prescription does not meet this standard. Out-of-state providers need a Georgia license. On scope: neither rule 360-3-.07 (unchanged since September 28, 2020 in the Administrative Code current through September 2, 2026) nor rule 360-3-.02 draws a line between controlled and non-controlled dangerous drugs, so the same exam requirement applies to a first GLP-1 prescription; the only alternative to a prior in-person exam or a referral from an examining Georgia clinician is an exam using technology or peripherals equal or superior to an in-person exam under rule 360-3-.07(a)(3)(d).", "async_prescribing_allowed": false, "source_ids": [ "ga-360-3-07", "ga-360-3-02", "ga-board-telehealth-2023", "ga-board-telehealth-2024", "ga-16-13-71", "ga-medical-board" ] }, "compounding": { "board_name": "Georgia State Board of Pharmacy", "board_url": "https://gbp.georgia.gov/", "follows_fda_503a_bulks": true, "notes": "The Georgia State Board of Pharmacy regulates pharmacies under O.C.G.A. Title 26, Chapter 4 and Board rules in chapter 480 of the Rules and Regulations of the State of Georgia. Georgia has no separate state bulks list; Board rule 480-11-.02(6) lets pharmacists compound from bulk substances that meet an applicable USP-NF monograph, are components of FDA-approved drugs, or are otherwise approved by FDA, and federal 503A limits apply on top of that. Since July 1, 2013, O.C.G.A. 26-4-114.1 requires any person, pharmacy, or facility outside Georgia that ships, mails, or delivers dispensed drugs into Georgia to hold a Georgia nonresident pharmacy permit; under Board rule 480-6-.02 the pharmacist in charge must be licensed in the pharmacy's home state, and a nonresident pharmacy that performs sterile or non-sterile compounding must submit an inspection report with its application. Compounding standards are in Board rule chapter 480-11 (Pharmaceutical Compounding): rule 480-11-.02(8) makes all sterile compounded preparations subject to USP chapter 797 and non-sterile preparations subject to USP chapter 795, rule 480-11-.02(12)(b) bars compounding essentially copies of commercially available products except for a prescriber-ordered change for an individual patient, unavailability, or a drug-shortage listing, rule 480-11-.04(3) sets the facility and equipment requirements for sterile parenteral compounding, and rule 480-11-.09 requires a quality assurance program for sterile preparations.", "source_ids": [ "ga-board", "ga-26-4-114-1", "ga-480-6-02", "ga-480-11", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "The practical Georgia barrier is the prescription itself: many national asynchronous GLP-1 programs must add a video exam or require a prior in-person exam for Georgia patients to satisfy rule 360-3-.07.", "source_ids": [ "fda-glp1-compounding", "ga-360-3-07", "ga-board-telehealth-2023" ] }, "research_peptide_sales": { "notes": "Only Georgia-licensed pharmacies and permitted nonresident pharmacies may dispense prescription drugs to Georgia patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling and are not dispensed by a pharmacist. Georgia law also bars the sale directly: O.C.G.A. 26-3-10 provides that no person shall sell, deliver, offer for sale, hold for sale, or give away any new drug unless an application for it has become effective under section 505 of the federal act (or, for a drug not subject to the federal act, a state application has been filed with the State Board of Pharmacy), with an exemption only for drugs intended solely for investigational use by qualified experts and plainly labeled \"For investigational use only.\"", "source_ids": [ "ga-26-4-114-1", "ga-26-3-10", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, but a first telemedicine prescription in Georgia generally requires a prior in-person exam or an exam with technology equal to one under rule 360-3-.07. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "ga-360-3-07", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription under the same Georgia telemedicine exam rule. Compounded tirzepatide is limited to documented patient-specific needs since the 503A grace period ended February 18, 2025, and must come from a Georgia or permitted nonresident pharmacy.", "source_ids": [ "ga-360-3-07", "fda-glp1-compounding", "ga-26-4-114-1" ] } ], "faqs": [ { "q": "Do I need an in-person visit to get a GLP-1 prescription by telehealth in Georgia?", "a": "Usually, or a video exam that is equivalent to one. Georgia Composite Medical Board rule 360-3-.07 allows telemedicine prescribing when the provider has examined you in person, is covering for a Georgia clinician who has, or can examine you with technology equal to an in-person exam, and the Board has said an in-person exam is expected before an initial dangerous drug prescription. A questionnaire alone is not enough.", "source_ids": [ "ga-360-3-07", "ga-board-telehealth-2023" ] }, { "q": "Did Georgia's pandemic telehealth flexibility end?", "a": "Yes. The Georgia Composite Medical Board announced in December 2023 that it was rescinding its COVID-era tele-prescribing position, extended the change to May 1, 2024, and now requires licensees to follow the Medical Practice Act and Board rules for prescribing.", "source_ids": [ "ga-board-telehealth-2023" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Georgia?", "a": "A Georgia nonresident pharmacy permit under O.C.G.A. 26-4-114.1. Under Board rule 480-6-.02, a nonresident pharmacy that compounds must also submit an inspection report when it applies. Verify the permit on the Georgia Board of Pharmacy license lookup.", "source_ids": [ "ga-26-4-114-1", "ga-480-6-02" ] }, { "q": "Can a Georgia pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ga-board", "type": "other", "title": "Georgia State Board of Pharmacy", "url": "https://gbp.georgia.gov/" }, { "id": "ga-medical-board", "type": "other", "title": "Georgia Composite Medical Board", "url": "https://medicalboard.georgia.gov/" }, { "id": "ga-360-3-07", "type": "other", "title": "Georgia Composite Medical Board rule 360-3-.07, Practice through electronic or other such means (chapter 360-3)", "url": "https://rules.sos.ga.gov/gac/360-3" }, { "id": "ga-board-telehealth-2023", "type": "other", "title": "Georgia Composite Medical Board: Board updates position on telehealth prescribing (December 7, 2023)", "url": "https://medicalboard.georgia.gov/press-releases/2023-12-07/board-updates-position-telehealth-prescribing" }, { "id": "ga-26-4-114-1", "type": "other", "title": "O.C.G.A. 26-4-114.1, Nonresident pharmacy permits", "url": "https://law.justia.com/codes/georgia/title-26/chapter-4/article-6/section-26-4-114-1/" }, { "id": "ga-480-6-02", "type": "other", "title": "Georgia Board of Pharmacy rule 480-6-.02, Nonresident pharmacy permit", "url": "https://www.law.cornell.edu/regulations/georgia/Ga-Comp-R-Regs-R-480-6-.02" }, { "id": "ga-360-3-02", "type": "other", "title": "Georgia Composite Medical Board rule 360-3-.02, Unprofessional conduct defined (paragraph (6), treatment by electronic means; amended effective August 27, 2024), accessed 2026-09-22", "url": "https://rules.sos.ga.gov/gac/360-3-.02" }, { "id": "ga-board-telehealth-2024", "type": "other", "title": "Georgia Composite Medical Board: Board extends tele-prescribing flexibility until May 1 (January 10, 2024), accessed 2026-09-22", "url": "https://medicalboard.georgia.gov/press-releases/2024-01-10/board-extends-tele-prescribing-flexibility-until-may-1" }, { "id": "ga-16-13-71", "type": "other", "title": "O.C.G.A. 16-13-71, Dangerous drug (definition), accessed 2026-09-22", "url": "https://law.justia.com/codes/georgia/title-16/chapter-13/article-3/section-16-13-71/" }, { "id": "ga-480-11", "type": "other", "title": "Georgia State Board of Pharmacy rules chapter 480-11, Pharmaceutical Compounding (rules 480-11-.01 to 480-11-.10), accessed 2026-09-22", "url": "https://rules.sos.ga.gov/gac/480-11" }, { "id": "ga-26-3-10", "type": "other", "title": "O.C.G.A. 26-3-10, Selling, delivering, or giving away of new drugs; exemptions, accessed 2026-09-22", "url": "https://law.justia.com/codes/georgia/title-26/chapter-3/section-26-3-10/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "hawaii", "name": "Hawaii", "abbreviation": "HI", "kind": "state", "summary": "Yes. A Hawaii resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Hawaii-licensed physician, including by telehealth under Hawaii Revised Statutes section 453-1.3, but the statute says a prescription based solely on an online questionnaire is not acceptable care and a physician needs a Hawaii license to form a new patient relationship by telehealth. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Hawaii pharmacy or an out-of-state pharmacy holding a Hawaii Board of Pharmacy permit under HRS 461-15.", "telehealth": { "allowed": true, "notes": "HRS 453-1.3 lets a physician use telehealth to establish a physician-patient relationship with a patient in Hawaii only if the physician holds a Hawaii medical license; once a relationship exists, the patient or physician may use telehealth for any purpose. Telehealth services must include a documented evaluation, with history and a discussion of physical symptoms, adequate to establish a diagnosis and identify contraindications, and prescribing by telehealth is held to the same standard as traditional settings. The statute states that issuing a prescription based solely on an online questionnaire is not treatment and is not an acceptable standard of care. For opiates (and medical cannabis certification) the relationship must start with an in-person consultation; peptides in this database are not affected by that limit. The statute defines telehealth to include store and forward technologies and secure asynchronous information exchange, and it says a physician-patient relationship may be established via a telehealth interaction, so an asynchronous evaluation is not excluded as a modality. It does not say whether an asynchronous-only intake can satisfy the documented evaluation standard for a first prescription, beyond ruling out a questionnaire alone, so async_prescribing_allowed is left unknown.", "async_prescribing_allowed": null, "source_ids": [ "hi-453-1-3", "hi-hrs-453" ] }, "compounding": { "board_name": "Hawaii State Board of Pharmacy (Department of Commerce and Consumer Affairs)", "board_url": "https://cca.hawaii.gov/pvl/boards/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The Hawaii State Board of Pharmacy, part of the Professional and Vocational Licensing Division of the Department of Commerce and Consumer Affairs, regulates pharmacies under HRS chapter 461. Hawaii has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). HRS 461-14 makes it unlawful to operate a pharmacy in Hawaii without a Board permit, and HRS 461-15 requires any out-of-state pharmacy that ships, mails, or delivers prescription drugs into Hawaii to first obtain a Board permit, disclosing its principal officers, attesting to no drug law violations, keeping its home-state license in good standing, and employing a registered pharmacist in good standing. The Board's rules are Hawaii Administrative Rules chapter 16-95 (Pharmacists and Pharmacies). HAR 16-95-110(a)(17) makes failure to comply with the compounding requirements in USP chapters 795 (nonsterile preparations) and 797 (sterile preparations) a ground for discipline; the chapter has no separate compounding subchapter.", "source_ids": [ "hi-board", "hi-hrs-461", "hi-har-16-95", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because Hawaii rejects questionnaire-only prescribing, patients using national telehealth GLP-1 programs should expect a documented evaluation by a Hawaii-licensed physician, and any out-of-state pharmacy must hold a Hawaii out-of-state pharmacy permit.", "source_ids": [ "fda-glp1-compounding", "hi-453-1-3", "hi-hrs-461" ] }, "research_peptide_sales": { "notes": "Only pharmacies permitted by the Hawaii Board of Pharmacy, including out-of-state pharmacies permitted under HRS 461-15, may dispense prescription drugs to Hawaii patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law and are not dispensed by a pharmacist. The Hawaii Food, Drug, and Cosmetic Act, HRS 328-17(a), separately bars any person from selling, delivering, holding for sale, or giving away a new drug unless an application for it has been approved under section 505 of the federal act (or, for a drug outside the federal act, filed with and not refused by the Hawaii director of health).", "source_ids": [ "hi-hrs-461", "hi-hrs-328-17", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription from a Hawaii-licensed physician, including by telehealth after a documented evaluation; HRS 453-1.3 rejects prescriptions based solely on an online questionnaire. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "hi-453-1-3", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Hawaii from an online questionnaire?", "a": "No. HRS 453-1.3 states that a prescription based solely on an online questionnaire is not acceptable care. A Hawaii-licensed physician can prescribe by telehealth after a documented evaluation with history and a discussion of symptoms adequate to reach a diagnosis and rule out contraindications.", "source_ids": [ "hi-453-1-3" ] }, { "q": "Can a doctor licensed in another state start treating me in Hawaii by telehealth?", "a": "No. HRS 453-1.3 says a physician may not use telehealth to establish a physician-patient relationship with a patient in Hawaii without a Hawaii medical license.", "source_ids": [ "hi-453-1-3" ] }, { "q": "What does a mainland pharmacy need to ship compounded peptides to Hawaii?", "a": "A Hawaii Board of Pharmacy permit for out-of-state pharmacies under HRS 461-15. The pharmacy must keep its home-state license in good standing, employ a registered pharmacist, and disclose its principal officers. Check the Professional and Vocational Licensing search before ordering.", "source_ids": [ "hi-hrs-461", "hi-board" ] }, { "q": "Can a Hawaii pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "hi-board", "type": "other", "title": "Hawaii State Board of Pharmacy, Professional and Vocational Licensing Division", "url": "https://cca.hawaii.gov/pvl/boards/pharmacy/" }, { "id": "hi-453-1-3", "type": "other", "title": "Hawaii Revised Statutes section 453-1.3, Practice of telehealth", "url": "https://law.justia.com/codes/hawaii/title-25/chapter-453/section-453-1-3/" }, { "id": "hi-hrs-453", "type": "other", "title": "Hawaii Revised Statutes chapter 453, sections 453-1 to 453-3 (Hawaii Legislature)", "url": "https://data.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0453/HRS_0453-0001_0003.htm" }, { "id": "hi-hrs-461", "type": "other", "title": "Hawaii Revised Statutes chapter 461, Pharmacists and pharmacy (including sections 461-14 and 461-15)", "url": "https://files.hawaii.gov/dcca/pvl/pvl/hrs/hrs_pvl_461.pdf" }, { "id": "hi-har-16-95", "type": "other", "title": "Hawaii Administrative Rules chapter 16-95, Pharmacists and Pharmacies (compilation, Board of Pharmacy)", "url": "https://cca.hawaii.gov/wp-content/uploads/2026/02/HAR-16-95-C_0816.pdf" }, { "id": "hi-hrs-328-17", "type": "other", "title": "Hawaii Revised Statutes section 328-17, New drugs, regulation of sale (Hawaii Legislature)", "url": "https://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0328/HRS_0328-0017.htm" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "idaho", "name": "Idaho", "abbreviation": "ID", "kind": "state", "summary": "Yes. An Idaho resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Idaho-licensed provider, including through virtual care under the Idaho Virtual Care Access Act (Idaho Code 54-5701 and following), which lets a provider-patient relationship be established through virtual care technologies if the Idaho community standard of care is met. Compounded peptides are available when eligible under federal 503A rules and dispensed by an Idaho pharmacy or a nonresident drug outlet registered with the Idaho State Board of Pharmacy under Idaho Code 54-1729. Treatment based solely on a static online questionnaire is not acceptable in Idaho.", "telehealth": { "allowed": true, "notes": "Idaho Code 54-5705, amended in 2025, lets a provider deliver virtual care when the provider or the provider's group already has a relationship with the patient, is covering calls for a provider who does, or first establishes a relationship, and states that a provider-patient relationship may be established by use of virtual care technologies provided the applicable Idaho community standard of care is satisfied (earlier versions required two-way audio and visual interaction to form the relationship). The act requires the provider to obtain and document relevant clinical history and current symptoms before issuing a prescription drug order, and states that treatment based solely on a static online questionnaire does not meet the standard of care. Prescribing by virtual care is allowed within the provider's scope of practice; controlled substances must comply with federal law. Because the relationship may now be formed through any virtual care technology that meets the standard of care, an asynchronous evaluation that is more than a static questionnaire can support a non-controlled prescription. Idaho Code 54-5713 (added 2023) requires a provider to hold a license from the applicable Idaho board before delivering virtual care, with narrow exceptions for a provider licensed in another state who already has a relationship with a patient temporarily in Idaho, is giving short-term follow-up for continuity of care, is employed by or contracted with an Idaho facility, is responding to a disaster, is preparing for a scheduled in-person visit, or is consulting with or referring to an Idaho-licensed provider. A direct-to-consumer telehealth program run from another state generally fits none of these exceptions, so its prescriber needs an Idaho license, and an exempt provider consents to Idaho law, the Idaho community standard of care, and Idaho board jurisdiction.", "async_prescribing_allowed": true, "source_ids": [ "id-54-5705", "id-54-5713", "id-ch-57" ] }, "compounding": { "board_name": "Idaho State Board of Pharmacy (Division of Occupational and Professional Licenses)", "board_url": "https://dopl.idaho.gov/bop/", "follows_fda_503a_bulks": true, "notes": "The Idaho State Board of Pharmacy, administered by the Division of Occupational and Professional Licenses, regulates compounding under the Idaho Pharmacy Act (Idaho Code Title 54, Chapter 17). In 2025, House Bill 200 moved the Board's rules into statute and IDAPA 24.36.01, including its former compounding section 24.36.01.700, ceased to have effect on July 1, 2025. Compounding standards now sit in Idaho Code 54-1765 through 54-1767: section 54-1765 treats any compounding it does not permit as manufacturing, requires active ingredients from an FDA registered manufacturer with a certificate of analysis unless the ingredient meets a USP-NF monograph, prohibits compounding drugs FDA has identified as demonstrably difficult to compound or withdrawn from the market, limits copies of commercially available products, and requires policies that take into account USP chapters 795 and 797; section 54-1766 covers sterile preparation. Idaho's pharmacy law is shorter than most, but eligibility of a peptide for compounding still follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Under Idaho Code 54-1729, every drug outlet doing business in or into Idaho must be licensed or registered, a nonresident pharmacy must be licensed in good standing in its home state with a registered person in charge, and the Board may inspect a nonresident outlet at the outlet's expense if its home state will not.", "source_ids": [ "id-board", "id-54-1729", "id-54-1765", "id-ch-17", "id-rules-revoked-2025", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Branded Wegovy, Zepbound, Ozempic, and Mounjaro are available from Idaho pharmacies by prescription, and Idaho's virtual care law makes remote prescribing straightforward when the standard of care is met. Patients should confirm an out-of-state pharmacy is registered as a nonresident drug outlet with the Idaho Board.", "source_ids": [ "fda-glp1-compounding", "id-54-5705", "id-54-1729" ] }, "research_peptide_sales": { "notes": "Idaho Code 54-1729 requires every drug outlet doing business in or into Idaho to be licensed or registered with the Board of Pharmacy. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling, are not dispensed by a pharmacist, and do not become lawful because Idaho's pharmacy rules are comparatively light.", "source_ids": [ "id-54-1729", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including through virtual care where the relationship is formed with virtual care technologies under Idaho Code 54-5705. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "id-54-5705", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Idaho without a video visit?", "a": "Possibly. Since the 2025 amendment, Idaho Code 54-5705 allows a provider-patient relationship to be established with any virtual care technology that meets the Idaho community standard of care, rather than requiring two-way audio and video. A static online questionnaire alone is still not acceptable, and the provider must document your clinical history and current symptoms.", "source_ids": [ "id-54-5705", "id-ch-57" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Idaho?", "a": "Registration as a nonresident drug outlet with the Idaho State Board of Pharmacy under Idaho Code 54-1729, a home-state license in good standing, and a registered person in charge. Check the Division of Occupational and Professional Licenses lookup before ordering.", "source_ids": [ "id-54-1729", "id-board" ] }, { "q": "Does Idaho's lighter pharmacy rulebook mean more peptides can be compounded there?", "a": "No. Idaho's compounding statute, Idaho Code 54-1765, sets quality standards but does not create a state list of allowed substances, so eligibility still follows the federal 503A test, and peptides in FDA Category 2 cannot be compounded.", "source_ids": [ "id-54-1765", "fda-503a", "fda-category-2" ] }, { "q": "Can an Idaho pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-pcac", "fda-503a", "fda-category-2" ] } ], "sources": [ { "id": "id-board", "type": "other", "title": "Idaho State Board of Pharmacy, Division of Occupational and Professional Licenses", "url": "https://dopl.idaho.gov/bop/" }, { "id": "id-54-5705", "type": "other", "title": "Idaho Code 54-5705, Provider-patient relationship (Idaho Virtual Care Access Act)", "url": "https://legislature.idaho.gov/statutesrules/idstat/title54/t54ch57/sect54-5705/" }, { "id": "id-ch-57", "type": "other", "title": "Idaho Code Title 54, Chapter 57, Idaho Virtual Care Access Act", "url": "https://legislature.idaho.gov/statutesrules/idstat/title54/t54ch57/" }, { "id": "id-54-1729", "type": "other", "title": "Idaho Code 54-1729, Registration and licensure of facilities (drug outlets, including nonresident)", "url": "https://legislature.idaho.gov/statutesrules/idstat/title54/t54ch17/sect54-1729/" }, { "id": "id-54-5713", "type": "other", "title": "Idaho Code 54-5713, Virtual care licensure exemptions and jurisdiction consent", "url": "https://legislature.idaho.gov/statutesrules/idstat/Title54/T54CH57/SECT54-5713/" }, { "id": "id-54-1765", "type": "other", "title": "Idaho Code 54-1765, Compounding drug preparations, general provisions (added 2025)", "url": "https://legislature.idaho.gov/statutesrules/idstat/Title54/T54CH17/SECT54-1765/" }, { "id": "id-ch-17", "type": "other", "title": "Idaho Code Title 54, Chapter 17, Pharmacists (including sections 54-1765 to 54-1767 on compounding)", "url": "https://legislature.idaho.gov/statutesrules/idstat/Title54/T54CH17/" }, { "id": "id-rules-revoked-2025", "type": "other", "title": "Idaho Administrative Bulletin, July 2025: notice of revocation of IDAPA 24.36.01 (Docket 24-3601-2500) after House Bill 200", "url": "https://idahodocs.contentdm.oclc.org/digital/api/collection/p16293coll4/id/252604/download" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "illinois", "name": "Illinois", "abbreviation": "IL", "kind": "state", "summary": "Yes. An Illinois resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Illinois-licensed provider, including by telehealth under the Illinois Telehealth Act (225 ILCS 150), which requires any professional treating a patient located in Illinois to be licensed or authorized in Illinois and to meet the in-person standard of care. Compounded peptides are available when eligible under federal 503A rules and dispensed by an Illinois pharmacy or a nonresident pharmacy licensed by the Illinois Department of Financial and Professional Regulation under the Pharmacy Practice Act (225 ILCS 85/16a).", "telehealth": { "allowed": true, "notes": "The Telehealth Act (225 ILCS 150) defines telehealth as the evaluation, diagnosis, or interpretation of electronically transmitted patient-specific data between a remote location and a licensed professional that generates interaction or treatment recommendations, lets a professional practice telehealth to the extent of the scope set by their licensing act, and requires the in-person standard of care. A professional treating a patient located in Illinois must be licensed or authorized to practice in Illinois, and section 49.5 of the Medical Practice Act (225 ILCS 60/49.5) separately requires a physician engaged in telemedicine with Illinois patients to hold an Illinois license. The statutes do not set a real-time video requirement for non-controlled prescriptions, but they also do not expressly approve questionnaire-only prescribing. Section 5 of the Telehealth Act defines telehealth services to include care delivered by an asynchronous store and forward system (transmission that does not require real-time interaction), e-visits, and virtual check-ins, so asynchronous care is a recognized telehealth modality, held to the in-person standard of care under section 15. Neither the Act nor the IDFPR pharmacy page addresses whether a first prescription may follow an asynchronous-only intake, and no IDFPR guidance on that point was found, so async_prescribing_allowed is left unknown.", "async_prescribing_allowed": null, "source_ids": [ "il-telehealth-act", "il-telehealth-act-ilga", "il-60-49-5", "il-board" ] }, "compounding": { "board_name": "Illinois State Board of Pharmacy (Illinois Department of Financial and Professional Regulation)", "board_url": "https://idfpr.illinois.gov/profs/pharm.html", "follows_fda_503a_bulks": true, "notes": "In Illinois, pharmacy licensing and discipline are handled by the Department of Financial and Professional Regulation (IDFPR) with the State Board of Pharmacy acting in an advisory role, under the Pharmacy Practice Act (225 ILCS 85) and the rules at 68 Illinois Administrative Code Part 1330. Illinois has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Under 225 ILCS 85/16a, a nonresident pharmacy (one outside Illinois that ships, delivers, dispenses, or distributes prescription drugs into Illinois by any means, including over the internet) must be licensed by IDFPR and follow the Department's nonresident rules. Section 1330.640 (Pharmaceutical Compounding Standards) governs both sterile and nonsterile compounding by the official USP-NF (USP 47-NF 42, 2024 edition), limits dispensing of compounded drugs to valid patient-specific prescriptions except for defined nonsterile office use, and prohibits sterile compounding for office use unless the pharmacy is registered as a 503B outsourcing facility and licensed as a wholesale distributor; the former separate sterile section, 1330.670, is repealed. Section 1330.30(j) lists as unprofessional conduct dispensing or offering to dispense any drug that is not FDA approved, not in the USP-NF, and not on the FDA list of bulk drug substances that may be used in compounding.", "source_ids": [ "il-board", "il-85-16a", "il-part-1330", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Illinois patients using telehealth GLP-1 programs should confirm the prescriber holds an Illinois license and that the dispensing pharmacy holds an IDFPR nonresident pharmacy license. IDFPR has not issued its own GLP-1 rule, but it relays federal positions to licensees: its Pharmacy page posts FDA's July 2024 letter on adverse events with compounded semaglutide and tirzepatide, and its Spring 2025 compliance newsletter restated FDA's timelines that ended 503A enforcement discretion for compounded tirzepatide and set April 22, 2025 for semaglutide.", "source_ids": [ "fda-glp1-compounding", "il-telehealth-act", "il-85-16a", "il-board", "il-idfpr-capsule-2025" ] }, "research_peptide_sales": { "notes": "Only IDFPR-licensed pharmacies, including licensed nonresident pharmacies, may dispense prescription drugs to Illinois patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling and are not dispensed by a pharmacist. The Illinois Food, Drug and Cosmetic Act, 410 ILCS 620/17, separately bars any person from selling, delivering, holding for sale, or giving away a new drug unless an application for it has been approved under section 505 of the federal act, and 68 Ill. Adm. Code 1330.30(j) makes dispensing a drug that is not FDA approved, not in the USP-NF, and not on the FDA bulks list unprofessional conduct for a licensee.", "source_ids": [ "il-85-16a", "il-410-620-17", "il-part-1330", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription from an Illinois-licensed provider, including by telehealth under 225 ILCS 150. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "il-telehealth-act", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription through telehealth in Illinois?", "a": "Yes, from a provider licensed or authorized to practice in Illinois. The Illinois Telehealth Act lets licensed professionals practice by telehealth within their scope of practice, held to the same standard of care as in-person visits.", "source_ids": [ "il-telehealth-act" ] }, { "q": "Can a doctor licensed only in another state prescribe to me in Illinois?", "a": "Generally no. The Telehealth Act requires a professional treating a patient located in Illinois to be licensed or authorized in Illinois, and section 49.5 of the Medical Practice Act requires physicians practicing telemedicine with Illinois patients to hold an Illinois license.", "source_ids": [ "il-telehealth-act", "il-60-49-5" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Illinois?", "a": "A nonresident pharmacy license from the Illinois Department of Financial and Professional Regulation under 225 ILCS 85/16a, which covers pharmacies that ship or deliver prescription drugs into Illinois by any means, including online. Check the IDFPR license lookup before ordering.", "source_ids": [ "il-85-16a", "il-board" ] }, { "q": "Can an Illinois pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "il-board", "type": "other", "title": "Illinois Department of Financial and Professional Regulation: Pharmacy (State Board of Pharmacy)", "url": "https://idfpr.illinois.gov/profs/pharm.html" }, { "id": "il-telehealth-act", "type": "other", "title": "Illinois Telehealth Act, 225 ILCS 150", "url": "https://law.justia.com/codes/illinois/chapter-225/act-225-ilcs-150/" }, { "id": "il-60-49-5", "type": "other", "title": "Illinois Medical Practice Act, 225 ILCS 60/49.5, Telemedicine", "url": "https://www.ilga.gov/documents/legislation/ilcs/documents/022500600K49.5.htm" }, { "id": "il-85-16a", "type": "other", "title": "Illinois Pharmacy Practice Act, 225 ILCS 85/16a, Nonresident pharmacies", "url": "https://www.ilga.gov/documents/legislation/ilcs/documents/022500850K16a.htm" }, { "id": "il-part-1330", "type": "other", "title": "68 Illinois Administrative Code Part 1330, Pharmacy Practice Act rules (including sections 1330.30 and 1330.640)", "url": "https://ilga.gov/agencies/JCAR/EntirePart?titlepart=06801330" }, { "id": "il-telehealth-act-ilga", "type": "other", "title": "Illinois Telehealth Act, 225 ILCS 150, sections 5, 10, and 15 (Illinois General Assembly)", "url": "https://www.ilga.gov/Legislation/ILCS/Articles?ActID=3807&ChapterID=24&Print=True" }, { "id": "il-410-620-17", "type": "other", "title": "Illinois Food, Drug and Cosmetic Act, 410 ILCS 620/17, New drugs (Illinois General Assembly)", "url": "https://ilga.gov/Legislation/ILCS/Articles?ActID=1577&ChapterID=35&Print=True" }, { "id": "il-idfpr-capsule-2025", "type": "other", "title": "IDFPR Compliance Capsule, Spring 2025 (semaglutide and tirzepatide compounding updates)", "url": "https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/forms/dpr/compliance-capsule-newsletter-archive-/compliance-capsule-spring25.pdf" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "indiana", "name": "Indiana", "abbreviation": "IN", "kind": "state", "summary": "Yes. An Indiana resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Indiana-licensed prescriber, including by telehealth under Indiana Code 25-1-9.5, which allows the provider-patient relationship to be established through telehealth. Compounded peptides are available when eligible under federal 503A rules and dispensed by an Indiana pharmacy or a nonresident pharmacy licensed by the Indiana Board of Pharmacy. Indiana tightened compounding in 2026: Senate Enrolled Act 282, signed March 5, 2026, requires bulk drug substances used in compounding to come from FDA-registered manufacturers with a certificate of analysis and requires medical spas to register with the Medical Licensing Board beginning January 1, 2027.", "telehealth": { "allowed": true, "notes": "Indiana Code 25-1-9.5 (Telehealth Services and Prescriptions) bars a prescriber from treating or prescribing for a patient located in Indiana by telehealth unless a provider-patient relationship exists, but allows that relationship to be established through telehealth. At a minimum the prescriber must obtain the patient's name, contact information, and location and, as far as reasonably possible, verify identity, must create and keep a medical record, and must notify the patient's primary care provider of prescriptions issued if the patient supplies that contact information. The chapter defines store and forward (transmission of medical information without the patient present) as part of telehealth. Telehealth providers must hold an Indiana license (Indiana is an Interstate Medical Licensure Compact state, which is one route). Section 25-1-9.5-7 also requires the practitioner to obtain informed consent and the medical history needed for a diagnosis, discuss the diagnosis, the evidence for it, and the risks and benefits of treatment options, give follow-up instructions, and provide a visit summary listing any prescription. Section 25-1-9.5-8 lets a prescriber issue a non-opioid prescription to a telehealth patient never examined in person if the standard of care is met, and requires a real-time, two-way audiovisual connection only for controlled substances. The chapter does not say whether an asynchronous-only intake can satisfy the section 7 elements for a first non-controlled prescription, so async_prescribing_allowed is left unknown.", "async_prescribing_allowed": null, "source_ids": [ "in-25-1-9-5", "in-25-1-9-5-7", "in-25-1-9-5-8", "in-pla-telehealth", "imlc-states" ] }, "compounding": { "board_name": "Indiana Board of Pharmacy (Indiana Professional Licensing Agency)", "board_url": "https://www.in.gov/pla/professions/pharmacy-home/", "follows_fda_503a_bulks": true, "notes": "The Indiana Board of Pharmacy, administered by the Professional Licensing Agency, regulates pharmacies under Indiana Code Title 25, Article 26 and Title 856 of the Indiana Administrative Code. Indiana follows the federal 503A framework for which substances may be compounded (approved drug component, USP or NF monograph, or FDA 503A bulks list), and Senate Enrolled Act 282 (2026) adds a state layer: bulk drug substances used for compounding must be manufactured by an FDA-registered establishment and be accompanied by a certificate of analysis, with most provisions effective July 1, 2026. The same act creates medical spa registration with the Medical Licensing Board of Indiana starting January 1, 2027, including a responsible practitioner and serious adverse event reporting, which reaches weight-loss and wellness clinics that administer compounded drugs. Pharmacies outside Indiana that ship prescription drugs to Indiana patients must hold an Indiana nonresident pharmacy license under Indiana Code 25-26-17. The enrolled act (Public Law 136, signed March 5, 2026) adds Indiana Code 16-42-22.5, effective July 1, 2026, which bars compounding unless the bulk drug substance is not research grade (outside an IRB-approved study) or veterinary grade, was made by an establishment registered with FDA as a human drug establishment, comes with a valid certificate of analysis stating its identity, content, and country of original manufacture, and has had quality control testing, and unless the compounding complies with the federal Food, Drug, and Cosmetic Act and applicable USP chapters. On Board request, a nonresident pharmacy shipping compounded drugs into Indiana must document compliance, and sellers must keep bulk substance records for two years after the last lot expires. Sterile preparation standards are in the Board's rules at 856 IAC 1, Rule 30 (sterile pharmaceuticals).", "source_ids": [ "in-board", "in-sb-282", "in-sea-282-enrolled", "in-25-26-17", "in-856-iac-1", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to documented patient-specific needs after the FDA shortage allowances ended in 2025, and Indiana's 2026 law adds sourcing rules (FDA-registered bulk manufacturers with certificates of analysis) that exclude the unregistered active ingredient suppliers behind many cheap compounded GLP-1 products. Medical spas offering GLP-1 injections will need to register with the Medical Licensing Board from January 1, 2027.", "source_ids": [ "fda-glp1-compounding", "in-sb-282" ] }, "research_peptide_sales": { "notes": "Only Indiana-licensed pharmacies, including licensed nonresident pharmacies, may dispense prescription drugs to Indiana patients, and Senate Enrolled Act 282 (2026) requires compounders to source bulk substances from FDA-registered establishments. Indiana Code 16-42-22.5, added by that act, expressly bars compounding with a research grade bulk substance outside an IRB-approved study. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law, are not dispensed by a pharmacist, and do not meet Indiana's new sourcing standard.", "source_ids": [ "in-25-26-17", "in-sb-282", "in-sea-282-enrolled", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telehealth under Indiana Code 25-1-9.5. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025, and Indiana compounders must now use FDA-registered bulk sources with a certificate of analysis.", "source_ids": [ "in-25-1-9-5", "fda-glp1-compounding", "in-sb-282" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. Even if it becomes eligible, Indiana's 2026 law requires the bulk substance to come from an FDA-registered establishment with a certificate of analysis.", "source_ids": [ "fda-pcac", "fda-category-2", "in-sb-282" ] } ], "faqs": [ { "q": "Can I start GLP-1 treatment in Indiana through telehealth?", "a": "Yes. Indiana Code 25-1-9.5 lets an Indiana-licensed prescriber establish a provider-patient relationship through telehealth, provided they verify who and where you are, keep a medical record, and meet the standard of care. They must also tell your primary care provider about the prescription if you share that contact.", "source_ids": [ "in-25-1-9-5", "in-pla-telehealth" ] }, { "q": "What did Indiana's 2026 compounding law change?", "a": "Senate Enrolled Act 282, signed March 5, 2026, requires bulk drug substances used in compounding to come from FDA-registered manufacturers with a certificate of analysis, mostly effective July 1, 2026, and requires medical spas to register with the Medical Licensing Board beginning January 1, 2027.", "source_ids": [ "in-sb-282" ] }, { "q": "Do medical spas in Indiana need a license to give GLP-1 injections?", "a": "Starting January 1, 2027, medical spas must register with the Medical Licensing Board of Indiana, designate a responsible practitioner, and report serious adverse events under Senate Enrolled Act 282. The prescription and any compounded product must still meet federal and state pharmacy rules.", "source_ids": [ "in-sb-282" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Indiana?", "a": "An Indiana nonresident pharmacy license from the Indiana Board of Pharmacy under Indiana Code 25-26-17. Check the Professional Licensing Agency lookup before ordering.", "source_ids": [ "in-25-26-17", "in-board" ] } ], "sources": [ { "id": "in-board", "type": "other", "title": "Indiana Board of Pharmacy, Indiana Professional Licensing Agency", "url": "https://www.in.gov/pla/professions/pharmacy-home/" }, { "id": "in-25-1-9-5", "type": "other", "title": "Indiana Code Title 25, Article 1, Chapter 9.5, Telehealth services and prescriptions", "url": "https://law.justia.com/codes/indiana/title-25/article-1/chapter-9-5/" }, { "id": "in-25-1-9-5-7", "type": "other", "title": "Indiana Code 25-1-9.5-7, Standards for providing telehealth", "url": "https://law.justia.com/codes/indiana/title-25/article-1/chapter-9-5/section-25-1-9-5-7/" }, { "id": "in-25-1-9-5-8", "type": "other", "title": "Indiana Code 25-1-9.5-8, Issuance of prescription; controlled substance conditions", "url": "https://law.justia.com/codes/indiana/title-25/article-1/chapter-9-5/section-25-1-9-5-8/" }, { "id": "in-sea-282-enrolled", "type": "other", "title": "Senate Enrolled Act 282 (2026), enrolled text, Public Law 136, adding Indiana Code 16-42-22.5", "url": "https://legiscan.com/IN/text/SB0282/id/3378111/Indiana-2026-SB0282-Enrolled.pdf" }, { "id": "in-856-iac-1", "type": "other", "title": "856 Indiana Administrative Code Article 1, Pharmacies and Pharmacists (including Rule 30, sterile pharmaceuticals)", "url": "https://iar.iga.in.gov/code/current/856/1" }, { "id": "in-pla-telehealth", "type": "other", "title": "Indiana Professional Licensing Agency: telehealth", "url": "https://in.gov/pla/resources/telehealth-home/" }, { "id": "in-sb-282", "type": "other", "title": "Indiana General Assembly, Senate Bill 282 (2026), Compounding drugs; registration of medical spas", "url": "https://iga.in.gov/legislative/2026/bills/senate/282/details" }, { "id": "in-25-26-17", "type": "other", "title": "Indiana Code Title 25, Article 26, Chapter 17, Nonresident pharmacies", "url": "https://law.justia.com/codes/indiana/title-25/article-26/chapter-17/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "iowa", "name": "Iowa", "abbreviation": "IA", "kind": "state", "summary": "Yes. An Iowa resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from an Iowa-licensed physician, including by telemedicine under Iowa Board of Medicine rule 481-655.9, which counts asynchronous store-and-forward care as telemedicine and allows an adaptive, interactive online interview but prohibits prescribing based solely on a static internet questionnaire. Compounded peptides are available when eligible under federal 503A rules and dispensed by an Iowa pharmacy or a pharmacy holding an Iowa nonresident pharmacy license under Iowa Code 155A.13A, which must submit an inspection report under two years old covering every part of its business used in Iowa, including any compounding.", "telehealth": { "allowed": true, "notes": "Iowa Board of Medicine rule 481-655.9 (renumbered from 653-13.11 when Iowa's licensing boards moved into the Department of Inspections, Appeals, and Licensing; current version effective May 21, 2025) defines telemedicine to include asynchronous store-and-forward, remote monitoring, and real-time interactive services, but not care delivered only by audio-only telephone, email, fax, or mail. A physician treating a patient located in Iowa must hold an active Iowa license (subrule 655.9(3)). A valid physician-patient relationship may be established through telemedicine when the standard of care does not require an in-person encounter (655.9(7)), and before prescribing the physician must collect the relevant history and perform an exam when medically necessary; an adaptive, interactive, and responsive online interview can qualify, but a static internet questionnaire does not, and subrule 655.9(21) expressly prohibits prescribing based solely on an internet request or static questionnaire. Asynchronous prescribing is therefore allowed when the asynchronous intake is interactive and meets the standard of care.", "async_prescribing_allowed": true, "source_ids": [ "ia-481-655-9", "ia-board-medicine" ] }, "compounding": { "board_name": "Iowa Board of Pharmacy (Department of Inspections, Appeals, and Licensing)", "board_url": "https://dial.iowa.gov/licenses/health-professions/pharmacy", "follows_fda_503a_bulks": true, "notes": "The Iowa Board of Pharmacy, now housed in the Department of Inspections, Appeals, and Licensing, regulates pharmacies under Iowa Code chapter 155A and Board rules. Effective July 16, 2025 (after a 70-day legislative delay that was lifted in August 2025), the Board rescinded its former rules at 657 IAC, including the old compounding chapter 20, and replaced them with 481 IAC chapters 550 to 557. Compounding is now rule 481-552.22: preparations compounded under section 503A must meet USP General Chapter 795 (2023) for nonsterile and 797 (2023) for sterile compounds, and compounding a preparation that is essentially a copy of an FDA-approved drug is prohibited unless the prescriber documents a clinically significant difference for the individual patient or the approved product is listed as in shortage on the FDA drug shortages database. Iowa has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Iowa Code 155A.13A requires any pharmacy outside Iowa that delivers, dispenses, or distributes prescription drugs to an Iowa patient by any method to obtain an Iowa nonresident pharmacy license, and the applicant must submit its most recent inspection report, less than two years old, conducted while the pharmacy was operating and covering every part of its business that will be used in Iowa, along with evidence of corrective action for any deficiencies.", "source_ids": [ "ia-board", "ia-pharmacy-rules-2025", "ia-481-552", "ia-155a-13a", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Iowa's telemedicine rule allows asynchronous GLP-1 programs only if the online intake is adaptive and interactive rather than a static form, and the rule also bars physicians from steering prescriptions to a specific pharmacy in exchange for any benefit (subrule 655.9(19)), which matters for bundled telehealth and pharmacy offers.", "source_ids": [ "fda-glp1-compounding", "ia-481-655-9" ] }, "research_peptide_sales": { "notes": "Only Iowa-licensed pharmacies, including nonresident pharmacies licensed under Iowa Code 155A.13A, may dispense prescription drugs to Iowa patients.", "source_ids": [ "ia-155a-13a", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including through asynchronous telemedicine that uses an adaptive, interactive interview under rule 481-655.9. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "ia-481-655-9", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to documented patient-specific needs since the 503A grace period ended February 18, 2025, and must be dispensed by an Iowa pharmacy or an Iowa-licensed nonresident pharmacy.", "source_ids": [ "fda-glp1-compounding", "ia-155a-13a" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Iowa from an online form?", "a": "Only if the online intake is an adaptive, interactive interview that meets the standard of care. Iowa Board of Medicine rule 481-655.9 counts asynchronous store-and-forward care as telemedicine but prohibits prescribing based solely on a static internet questionnaire.", "source_ids": [ "ia-481-655-9" ] }, { "q": "Does a telehealth doctor need an Iowa license to treat me?", "a": "Yes. Subrule 655.9(3) requires a physician who uses telemedicine to diagnose or treat a patient located in Iowa to hold an active Iowa medical license, subject to the narrow licensure exceptions in the Board's rules.", "source_ids": [ "ia-481-655-9" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Iowa?", "a": "An Iowa nonresident pharmacy license under Iowa Code 155A.13A. It must give the Board its most recent inspection report, less than two years old and covering every part of its business used in Iowa, including any compounding. Iowa rule 481-552.22 holds compounded preparations to USP chapters 795 and 797. Check the Department of Inspections, Appeals, and Licensing lookup before ordering.", "source_ids": [ "ia-155a-13a", "ia-481-552", "ia-board" ] }, { "q": "Can an Iowa pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ia-board", "type": "other", "title": "Iowa Board of Pharmacy, Department of Inspections, Appeals, and Licensing", "url": "https://dial.iowa.gov/licenses/health-professions/pharmacy" }, { "id": "ia-board-medicine", "type": "other", "title": "Iowa Board of Medicine, Department of Inspections, Appeals, and Licensing", "url": "https://dial.iowa.gov/about-dial/boards-and-commissions/board-medicine" }, { "id": "ia-481-655-9", "type": "other", "title": "Iowa Administrative Code 481-655.9, Standards of practice: telemedicine (effective May 21, 2025)", "url": "https://www.legis.iowa.gov/docs/iac/rule/06-11-2025.481.655.9.pdf" }, { "id": "ia-155a-13a", "type": "other", "title": "Iowa Code 155A.13A, Nonresident pharmacy license", "url": "https://www.legis.iowa.gov/docs/code/155A.13A.pdf" }, { "id": "ia-481-552", "type": "other", "title": "Iowa Administrative Code 481, chapter 552, Standards: practice of pharmacy (rule 481-552.22, Compounding)", "url": "https://www.legis.iowa.gov/docs/iac/chapter/481.552.pdf" }, { "id": "ia-pharmacy-rules-2025", "type": "other", "title": "Iowa Department of Inspections, Appeals, and Licensing: Pharmacy laws and rules (657 IAC replaced by 481 IAC chapters 550 to 557)", "url": "https://dial.iowa.gov/licenses/health-professions/pharmacy/pharmacy-laws-rules" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "kansas", "name": "Kansas", "abbreviation": "KS", "kind": "state", "summary": "Yes. A Kansas resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Kansas-licensed provider, including by telemedicine under the Kansas Telemedicine Act (K.S.A. 40-2,210 through 40-2,216), which says telemedicine may be used to establish a valid provider-patient relationship and applies in-person standards of practice and prescribing law. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Kansas pharmacy or a pharmacy registered as a nonresident pharmacy under K.S.A. 65-1657, which bars unregistered out-of-state pharmacies from shipping prescription drugs to Kansas patients or prescribers' offices.", "telehealth": { "allowed": true, "notes": "The Kansas Telemedicine Act (2018) defines telemedicine as care delivered by real-time two-way interactive audio, visual, or audio-visual communication, including secure video conferencing or store-and-forward technology used to provide or support care (K.S.A. 40-2,211). K.S.A. 40-2,212 states that telemedicine may be used to establish a valid provider-patient relationship, that in-person standards of practice and conduct apply, that the provider must give guidance on follow-up care, and that with patient consent the provider must send a report to the patient's primary care or treating physician within three business days. K.S.A. 40-2,214 directed the State Board of Healing Arts to adopt rules on prescribing by telemedicine, which the Board did in K.A.R. 100-77. Because the statutory definition centers on real-time interaction and treats store-and-forward as supporting care, it is unclear whether a purely asynchronous first encounter satisfies Kansas law. K.A.R. 100-77 has three short regulations: 100-77-1 adopts the statutory definitions, 100-77-2 deems telemedicine rendered where the patient is, and 100-77-3 says the same laws that apply to in-person prescribing, including for controlled substances, apply to prescribing by telemedicine. None of them addresses asynchronous-only prescribing, so async_prescribing_allowed is left unknown.", "async_prescribing_allowed": null, "source_ids": [ "ks-40-2-211", "ks-40-2-212", "ks-40-2-214", "ks-kar-100-77-3", "ks-healing-arts" ] }, "compounding": { "board_name": "Kansas State Board of Pharmacy", "board_url": "https://www.pharmacy.ks.gov/", "follows_fda_503a_bulks": true, "notes": "The Kansas State Board of Pharmacy regulates pharmacies under the Kansas Pharmacy Act (K.S.A. 65-1625 and following) and Board regulations in K.A.R. Article 68. Kansas has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). K.S.A. 65-1657 bars any nonresident pharmacy from shipping, mailing, or delivering prescription drugs or devices to a patient, a patient's agent, or a prescriber's office in Kansas unless it holds an annual Kansas nonresident pharmacy registration, and it prohibits unregistered pharmacies from advertising to Kansas residents. Covering shipments to prescribers' offices matters for clinics that order compounded peptides for in-office administration. Compounding standards are in K.A.R. Article 13 of the Board's regulations: 68-13-2 (definitions), 68-13-3 (nonsterile preparations), and 68-13-4 (sterile preparations), and 68-13-4 bars compounding a sterile preparation that is essentially a copy of a commercially available drug unless the prescriber documents a clinically significant difference for the individual patient or the drug is on the federal shortage list. House Bill 2068 (2026) adopts USP chapters 795, 797, and 825 under the Kansas Pharmacy Act effective July 1, 2027, and the Board is drafting matching amendments to Article 13.", "source_ids": [ "ks-board", "ks-65-1657", "ks-kar-68-13", "ks-compounding-compliance", "ks-glp1-statement", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Kansas patients using telehealth GLP-1 programs should confirm the prescriber holds a Kansas license and that the dispensing pharmacy has a Kansas nonresident pharmacy registration under K.S.A. 65-1657. The Kansas Board of Pharmacy's statement on compounding and dispensing GLP-1 and GIP receptor agonists (last updated August 26, 2026) says semaglutide and tirzepatide are no longer in shortage, that no salt form of either may be used in a compounded drug, and that even when compounding is otherwise allowed, a non-pharmaceutical grade bulk substance or one not made in an FDA-registered establishment is prohibited. It also says pre-printed or check-box prescriptions may not document the patient-specific need that copies of approved drugs require, and that retatrutide and cagrilintide cannot be used to compound under federal law.", "source_ids": [ "fda-glp1-compounding", "fda-glp1-clarifies", "ks-65-1657", "ks-glp1-statement" ] }, "research_peptide_sales": { "notes": "K.S.A. 65-1657 bars unregistered nonresident pharmacies from shipping prescription drugs into Kansas and from advertising to Kansas residents. The Kansas Board of Pharmacy's GLP-1 statement adds that compounding pharmacies must use pharmaceutical-grade active ingredients, not research use, investigational, food, or supplement grade, with a certificate of analysis naming the original manufacturer, and that a pharmacist may not dispense a product compounded in a non-compliant manner.", "source_ids": [ "ks-65-1657", "ks-glp1-statement", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telemedicine under the Kansas Telemedicine Act, which requires a report to your primary care physician within three business days when you consent. Compounded semaglutide is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "ks-40-2-212", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can a telehealth provider start me on a GLP-1 in Kansas without an office visit?", "a": "Yes, if the provider is licensed in Kansas and meets in-person standards of practice. K.S.A. 40-2,212 says telemedicine may be used to establish a valid provider-patient relationship, and prescribing by telemedicine follows the same laws as in-person prescribing.", "source_ids": [ "ks-40-2-212", "ks-40-2-214" ] }, { "q": "Will my regular doctor be told about a telehealth prescription in Kansas?", "a": "If you consent and have a primary care or treating physician, K.S.A. 40-2,212 requires the telemedicine provider to send that physician a report of the treatment within three business days.", "source_ids": [ "ks-40-2-212" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Kansas?", "a": "A Kansas nonresident pharmacy registration under K.S.A. 65-1657, renewed annually. The law covers shipments to patients, their agents, and prescribers' offices, and unregistered pharmacies may not advertise to Kansas residents.", "source_ids": [ "ks-65-1657" ] }, { "q": "Can a Kansas pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ks-board", "type": "other", "title": "Kansas State Board of Pharmacy", "url": "https://www.pharmacy.ks.gov/" }, { "id": "ks-healing-arts", "type": "other", "title": "Kansas State Board of Healing Arts", "url": "https://www.ksbha.ks.gov/" }, { "id": "ks-kar-100-77-3", "type": "other", "title": "K.A.R. 100-77-3, Prescribing drugs by means of telemedicine (Kansas Secretary of State)", "url": "https://rules.ks.gov/browse/collections/0ae1e448-f5a1-4e09-9d6d-a488ac7c284a/policies/a49491ad-0fb9-4577-accf-fa6398dbec59" }, { "id": "ks-kar-68-13", "type": "other", "title": "K.A.R. Article 68-13, State Board of Pharmacy regulations (68-13-2 definitions, 68-13-3 nonsterile, 68-13-4 sterile preparations)", "url": "https://rules.ks.gov/browse/collections/0ae1e448-f5a1-4e09-9d6d-a488ac7c284a/sections/c80f9415-2860-4f4d-80b7-ebbdff01dbfc" }, { "id": "ks-compounding-compliance", "type": "other", "title": "Kansas Board of Pharmacy: Compounding compliance (House Bill 2068 adoption of USP 795, 797, and 825)", "url": "https://www.pharmacy.ks.gov/legal/compounding-compliance" }, { "id": "ks-glp1-statement", "type": "other", "title": "Kansas Board of Pharmacy: Statement on compounding and dispensing of compounded GLP-1 and GIP receptor agonists (updated August 26, 2026)", "url": "https://www.pharmacy.ks.gov/home/showpublisheddocument/9120/639249783816700000" }, { "id": "ks-40-2-211", "type": "other", "title": "K.S.A. 40-2,211, Kansas Telemedicine Act definitions", "url": "https://ksrevisor.gov/statutes/chapters/ch40/040_002_0211.html" }, { "id": "ks-40-2-212", "type": "other", "title": "K.S.A. 40-2,212, Telemedicine confidentiality, provider-patient relationship, and standards of practice", "url": "https://ksrevisor.gov/statutes/chapters/ch40/040_002_0212.html" }, { "id": "ks-40-2-214", "type": "other", "title": "K.S.A. 40-2,214, Prescribing of drugs via telemedicine (rulemaking)", "url": "https://ksrevisor.gov/statutes/chapters/ch40/040_002_0214.html" }, { "id": "ks-65-1657", "type": "other", "title": "K.S.A. 65-1657, Nonresident pharmacy registration", "url": "https://ksrevisor.gov/statutes/chapters/ch65/065_016_0057.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "fda-glp1-clarifies", "type": "fda", "title": "FDA: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize", "url": "https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "kentucky", "name": "Kentucky", "abbreviation": "KY", "kind": "state", "summary": "Yes, but Kentucky's Board of Pharmacy has been unusually explicit about GLP-1 copies. A Kentucky resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a Kentucky-licensed provider, including by telehealth, since KRS 211.336 lets a practitioner-patient relationship begin via telehealth. Compounded peptides are available only when eligible under federal 503A rules and dispensed by a Kentucky-permitted pharmacy; Kentucky Board of Pharmacy regulation 201 KAR 2:076 separately prohibits compounding essential copies of commercially available drugs, and the Board's 2025 guidance states that pharmacies in general may not compound semaglutide or tirzepatide.", "telehealth": { "allowed": true, "notes": "Kentucky's general telehealth statute, KRS 211.336, provides that a practitioner-patient relationship may commence via telehealth and that an initial in-person meeting is not required unless the provider decides one is medically necessary. KRS 311.5975 requires physicians using telehealth to obtain informed consent and protect confidentiality, and directs the Kentucky Board of Medical Licensure to adopt regulations to prevent telehealth fraud and abuse. Physicians must hold a Kentucky license (Kentucky participates in the Interstate Medical Licensure Compact). The statutes do not bar asynchronous care for non-controlled drugs. The Board of Medical Licensure's current regulations (201 KAR chapter 9) include no telehealth-specific regulation; the prescribing standards there, 201 KAR 9:260 and 9:270, cover controlled substances and buprenorphine only. Kentucky's medical rules therefore do not address whether a first non-controlled prescription may follow an asynchronous-only intake, so async_prescribing_allowed is left unknown.", "async_prescribing_allowed": null, "source_ids": [ "ky-211-336", "ky-311-5975", "ky-kbml", "ky-201-kar-9", "imlc-states" ] }, "compounding": { "board_name": "Kentucky Board of Pharmacy", "board_url": "https://pharmacy.ky.gov/", "follows_fda_503a_bulks": true, "notes": "The Kentucky Board of Pharmacy regulates pharmacies under KRS chapter 315 and Title 201, chapter 2 of the Kentucky Administrative Regulations. Kentucky follows the federal 503A framework for which bulk substances may be compounded, and 201 KAR 2:076 (compounding) incorporates the federal essentially-a-copy limit into state law by prohibiting compounding of essential copies of a commercially available drug product unless authorized by 21 U.S.C. 353a, which the Board says it enforces against every Kentucky licensee and permit holder. Out-of-state pharmacies that ship dispensed drugs to Kentucky patients must hold a Kentucky out-of-state pharmacy permit. KRS 315.0351 requires every pharmacy outside Kentucky that does business in the state, physically or by internet, phone, mail, or other means, to hold an out-of-state pharmacy permit from the Board, disclose its principal officers and dispensing pharmacists annually, keep its home-state license valid, and file its most recent home-state inspection report before applying and each later report after.", "source_ids": [ "ky-board", "ky-201-kar-2-076", "ky-glp1-guidance", "ky-315-0351", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "The Kentucky Board of Pharmacy's 2025 guidance, \"Important Update: Compounding Semaglutide and Tirzepatide,\" states that in general compounding pharmacies may not compound semaglutide or tirzepatide because they are commercially available, that adding another ingredient such as B12 does not avoid the essentially-a-copy rule, that a lower price is not a valid reason, and that noncompliant compounding may lead to action by both FDA and the Board. The narrow exceptions are a documented patient-specific change that produces a significant difference for that patient, or a return of the drug to the FDA shortage list.", "source_ids": [ "ky-glp1-guidance", "ky-201-kar-2-076", "fda-glp1-clarifies" ] }, "research_peptide_sales": { "notes": "Only Kentucky-permitted pharmacies may dispense prescription drugs to Kentucky patients. \"Research use only\" peptides sold for human injection are unapproved new drugs under federal law regardless of labeling, are not dispensed by a pharmacist, and fall outside Kentucky's compounding regulation. The Kentucky Food, Drug and Cosmetic Act, KRS 217.075, separately bars any person from selling, delivering, holding for sale, or giving away a new drug unless an application for it has become effective under the federal act; its investigational exemption covers only drugs intended solely for investigational use by qualified experts and labeled for investigational use only.", "source_ids": [ "ky-board", "ky-217-075", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telehealth. The Kentucky Board of Pharmacy's 2025 guidance says compounding pharmacies in general may not compound semaglutide, and 201 KAR 2:076 makes the essentially-a-copy prohibition enforceable by the Board; adding B12 does not change that.", "source_ids": [ "ky-glp1-guidance", "ky-201-kar-2-076" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. The same Kentucky guidance covers tirzepatide: 503A compounding under the shortage allowance ended in 2025, and compounded copies are allowed only for a documented significant patient-specific difference.", "source_ids": [ "ky-glp1-guidance", "fda-glp1-clarifies" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. Because it is not commercially available, the essentially-a-copy rule does not apply to it; Kentucky pharmacies apply the federal bulks eligibility test.", "source_ids": [ "fda-category-2", "fda-pcac", "ky-201-kar-2-076" ] } ], "faqs": [ { "q": "Can Kentucky pharmacies compound semaglutide or tirzepatide?", "a": "In general, no. The Kentucky Board of Pharmacy's 2025 guidance says compounding pharmacies may not compound semaglutide or tirzepatide because both are commercially available, and 201 KAR 2:076 lets the Board enforce the federal essentially-a-copy ban. The exceptions are a documented patient-specific change that makes a significant difference for that patient, or a return to the FDA shortage list.", "source_ids": [ "ky-glp1-guidance", "ky-201-kar-2-076" ] }, { "q": "Does adding B12 to compounded semaglutide make it legal in Kentucky?", "a": "No. The Kentucky Board's guidance repeats FDA's position that a compounded product containing the same active ingredients as commercially available drugs, such as semaglutide plus B12, is still essentially a copy unless the prescriber documents a patient-specific need.", "source_ids": [ "ky-glp1-guidance" ] }, { "q": "Do I need an in-person visit to get a prescription by telehealth in Kentucky?", "a": "Not necessarily. KRS 211.336 allows a practitioner-patient relationship to begin via telehealth, and an in-person meeting is required only if the provider decides it is medically necessary. The prescriber must be licensed in Kentucky.", "source_ids": [ "ky-211-336", "ky-311-5975" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Kentucky?", "a": "A Kentucky out-of-state pharmacy permit from the Kentucky Board of Pharmacy, and any compounded product must still comply with 201 KAR 2:076. Check the Board's license verification before ordering.", "source_ids": [ "ky-315-0351", "ky-201-kar-2-076", "ky-board" ] }, { "q": "Can a Kentucky pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ky-board", "type": "other", "title": "Kentucky Board of Pharmacy", "url": "https://pharmacy.ky.gov/" }, { "id": "ky-kbml", "type": "other", "title": "Kentucky Board of Medical Licensure", "url": "https://kbml.ky.gov/" }, { "id": "ky-glp1-guidance", "type": "other", "title": "Kentucky Board of Pharmacy: Important update, compounding semaglutide and tirzepatide (2025)", "url": "https://pharmacy.ky.gov/professionals/Documents/GLP-1%20Compounding%20Guidance%202025.pdf", "year": 2025 }, { "id": "ky-201-kar-2-076", "type": "other", "title": "201 KAR 2:076, Compounding (Kentucky Board of Pharmacy)", "url": "https://apps.legislature.ky.gov/law/kar/titles/201/002/076/" }, { "id": "ky-211-336", "type": "other", "title": "KRS 211.336, Telehealth practitioner-patient relationship", "url": "https://law.justia.com/codes/kentucky/chapter-211/section-211-336/" }, { "id": "ky-311-5975", "type": "other", "title": "KRS 311.5975, Duty of treating physician utilizing telehealth", "url": "https://law.justia.com/codes/kentucky/chapter-311/section-311-5975/" }, { "id": "ky-315-0351", "type": "other", "title": "KRS 315.0351, Out-of-state pharmacy permit (Kentucky Legislative Research Commission)", "url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53707" }, { "id": "ky-217-075", "type": "other", "title": "KRS 217.075, Restrictions on handling of new drugs (Kentucky Food, Drug and Cosmetic Act)", "url": "https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=9278" }, { "id": "ky-201-kar-9", "type": "other", "title": "201 KAR chapter 9, Kentucky Board of Medical Licensure regulations (Legislative Research Commission index)", "url": "https://apps.legislature.ky.gov/law/kar/titles/201/009/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-clarifies", "type": "fda", "title": "FDA: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize", "url": "https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "louisiana", "name": "Louisiana", "abbreviation": "LA", "kind": "state", "summary": "Yes. A Louisiana resident can obtain FDA approved peptides such as semaglutide and tirzepatide by prescription from a physician licensed to practice medicine or telemedicine in Louisiana under La. R.S. 37:1271, and a physician with an unrestricted Louisiana license does not need an in-person exam before a telemedicine visit for non-controlled drugs. For obesity treatment and weight management, Act 345 of 2026 requires a synchronous (live) interaction with the patient. Compounded peptides are available when eligible under federal 503A rules and dispensed by a Louisiana pharmacy or a nonresident pharmacy holding a Louisiana Board of Pharmacy permit (La. R.S. 37:1232). The Louisiana Board of Pharmacy was one of the first boards, in 2023, to tell pharmacies to stop compounding with semaglutide salt forms and to stop shipping such products into the state.", "telehealth": { "allowed": true, "notes": "La. R.S. 37:1271 requires a license to practice medicine or telemedicine in Louisiana to treat Louisiana patients; Louisiana is one of the few states that issues a limited telemedicine license to physicians licensed elsewhere, in addition to full licensure. A physician practicing telemedicine must use the same standard of care as in person and, if the physician holds an unrestricted Louisiana license, is not required to conduct an in-person history or exam before a telemedicine encounter; controlled dangerous substances require an appropriate in-person history or exam first except as the statute or Board rules allow. The Louisiana State Board of Medical Examiners' telemedicine rules (Louisiana Administrative Code Title 46, Part XLV, chapter 75, beginning at section 7501) require a physician-patient relationship consisting of patient verification, evaluation, diagnosis, treatment plan, and follow-up, with documentation to the same standard as in-person care. Section 7503 defines telemedicine as interaction by simultaneous two-way video and audio (audio-only is allowed if the physician can meet the in-person standard of care after reviewing the records), says an email between physician and patient is not telemedicine, and section 7505 says an online, electronic, or written mail message does not satisfy the standard of care, so an asynchronous-only intake is not a basis for a Louisiana prescription. The limited license for physicians licensed elsewhere is the telemedicine permit in section 408 of the Board's rules; a permit holder may not open an office, meet patients, or take patient calls in Louisiana (section 7513.D). Section 7513.C.2 still bars telemedicine for obesity treatment, but Act 345 of 2026 (La. R.S. 40:1223.4(D), effective May 22, 2026) bars the Board of Medical Examiners and the Board of Nursing from adopting or enforcing any rule that prohibits using telehealth to evaluate, diagnose, or treat obesity or provide weight management, provided the provider conducts a synchronous interaction with the patient and follows the standard of care.", "async_prescribing_allowed": false, "source_ids": [ "la-37-1271", "la-lac-46-xlv-7503", "la-lac-46-xlv", "la-act-345", "la-lsbme" ] }, "compounding": { "board_name": "Louisiana Board of Pharmacy", "board_url": "https://www.pharmacy.la.gov/", "follows_fda_503a_bulks": true, "notes": "The Louisiana Board of Pharmacy regulates pharmacies under the Louisiana Pharmacy Practice Act (La. R.S. Title 37, chapter 14) and its rules in Louisiana Administrative Code Title 46, Part LIII. Louisiana has no separate state bulks list, so peptide eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list), and the Board's executive director has stated publicly that compounders may only use bulk substances that meet the federal requirements. Under La. R.S. 37:1232, a pharmacy outside Louisiana that does business in Louisiana must hold a Louisiana pharmacy permit, disclose its officers and pharmacist in charge, submit its latest home-state, FDA, and DEA inspection reports before permitting and every later report after, and keep Louisiana prescription records readily retrievable. The Board's compounding rules are LAC 46:LIII, Chapter 25, Subchapter C (sections 2531 to 2535). Section 2535 requires compounding to comply with the federal Food, Drug and Cosmetic Act, 21 CFR, and all relevant USP-NF chapters; sterile preparations compounded on a patient-specific prescription must meet section 503A and USP chapter 797, and nonsterile ones section 503A and USP chapter 795. A pharmacy must notify the Board and receive approval before starting sterile compounding, products removed from the market for safety may not be used to compound for humans, and copies of commercial products (same active ingredient, strength within 10 percent, same route) require a documented prescriber determination of a clinically significant difference unless the product is discontinued, on the FDA shortage list, or temporarily unavailable. Act 374 of 2026 (Senate Bill 253), signed May 22, 2026 and effective August 1, 2026, enacts La. R.S. 37:23.5. It bars any professional or occupational licensing board from prohibiting a prescriber from providing patients with peptides shipped from an FDA-registered 503B outsourcing facility that complies with 21 U.S.C. 353b or from a 503A compounding pharmacy that complies with 21 U.S.C. 353a and applicable USP-NF chapters. It also bars boards from prohibiting a Louisiana-licensed pharmacist in a state-permitted pharmacy from compounding and dispensing peptides in compliance with 21 U.S.C. 353a and applicable USP-NF chapters. The act protects only compounding that already complies with federal law. It does not make any peptide eligible for 503A or 503B compounding.", "source_ids": [ "la-board", "la-37-1232", "la-practice-act", "la-lac-46-liii", "la-lac-46-liii-2026", "la-board-compounding", "la-nbc-semaglutide", "fda-503a", "la-act-374" ] }, "glp1_access": { "compounded_available": "limited", "notes": "In spring 2023, while semaglutide was still in shortage, the Louisiana Board of Pharmacy told in-state compounders to stop compounding semaglutide made from unapproved salt forms (such as semaglutide sodium or acetate) and told out-of-state compounders not to ship such products into Louisiana; the Board's director clarified that compounding with the approved base form was not banned at the time. Since the FDA shortage allowances ended in 2025, compounded semaglutide and tirzepatide are limited to documented patient-specific needs in Louisiana as elsewhere. Telehealth weight management programs serving Louisiana patients must use a live, synchronous interaction under Act 345 of 2026.", "source_ids": [ "la-nbc-semaglutide", "fda-glp1-compounding", "la-board", "la-act-345" ] }, "research_peptide_sales": { "notes": "Only Louisiana-permitted pharmacies, including nonresident pharmacies permitted under La. R.S. 37:1232, may dispense prescription drugs to Louisiana patients. The Louisiana Board of Pharmacy has described semaglutide salt forms sold as \"research use only\" as not intended for human use, and \"research use only\" peptides sold for injection are unapproved new drugs under federal law.", "source_ids": [ "la-37-1232", "la-nbc-semaglutide", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription. The Louisiana Board of Pharmacy warned in 2023 against compounding with semaglutide salt forms and against shipping such products into Louisiana, and compounded semaglutide base is limited to documented patient-specific needs since the 503A grace period ended April 22, 2025.", "source_ids": [ "la-nbc-semaglutide", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription, including by telemedicine from a physician with a Louisiana license or telemedicine license. Compounded tirzepatide is limited to documented patient-specific needs since the 503A grace period ended February 18, 2025.", "source_ids": [ "la-37-1271", "fda-glp1-compounding" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. The Louisiana Board of Pharmacy has not issued a BPC-157 specific rule, and its stated position is that compounders may use only bulk substances that meet federal requirements. Act 374 of 2026 (La. R.S. 37:23.5) bars Louisiana licensing boards from prohibiting peptide compounding that complies with section 503A, but BPC-157 is still not eligible under 503A until FDA adds it to the bulks list.", "source_ids": [ "fda-category-2", "fda-pcac", "la-nbc-semaglutide", "la-act-374" ] } ], "faqs": [ { "q": "Does Louisiana let out-of-state doctors prescribe by telemedicine?", "a": "Only with Louisiana authorization. La. R.S. 37:1271 requires a license to practice medicine or telemedicine in Louisiana, and Louisiana issues telemedicine licenses to qualifying physicians licensed in other states. Check the Louisiana State Board of Medical Examiners lookup.", "source_ids": [ "la-37-1271", "la-lsbme" ] }, { "q": "Do I need an in-person visit before a telemedicine GLP-1 prescription in Louisiana?", "a": "Not if the physician holds an unrestricted Louisiana license. La. R.S. 37:1271 says such a physician is not required to do an in-person history or exam before a telemedicine encounter, though the same standard of care applies. The in-person requirement applies to controlled dangerous substances, and GLP-1 drugs are not controlled. When the prescription is for obesity or weight management, Act 345 of 2026 requires the provider to conduct a live, synchronous interaction with you; a questionnaire or message exchange alone is not enough.", "source_ids": [ "la-37-1271", "la-lac-46-xlv-7503", "la-act-345" ] }, { "q": "Did Louisiana ban compounded semaglutide?", "a": "Not outright. In 2023 the Louisiana Board of Pharmacy told pharmacies to stop compounding with unapproved semaglutide salt forms and not to ship them into Louisiana, and its director said compounding with the approved form was still allowed then. Since the FDA shortage ended in 2025, compounded semaglutide is limited to documented patient-specific needs.", "source_ids": [ "la-nbc-semaglutide", "fda-glp1-compounding" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Louisiana?", "a": "A Louisiana Board of Pharmacy permit under La. R.S. 37:1232. The pharmacy must give the Board its latest inspection reports from its home state, FDA, and DEA, and keep Louisiana prescription records readily retrievable. Verify the permit on the Board's lookup before ordering.", "source_ids": [ "la-37-1232", "la-board" ] }, { "q": "Can a Louisiana pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac" ] }, { "q": "Does Louisiana's 2026 peptide law allow any compounded peptide?", "a": "No. Act 374 of 2026 (La. R.S. 37:23.5, effective August 1, 2026) stops Louisiana licensing boards from banning peptides that come from a 503A pharmacy or 503B outsourcing facility complying with federal compounding law. A peptide that is not eligible under federal law, such as one not on the 503A bulks list, is still not lawfully compounded.", "source_ids": [ "la-act-374", "fda-503a" ] } ], "sources": [ { "id": "la-board", "type": "other", "title": "Louisiana Board of Pharmacy", "url": "https://www.pharmacy.la.gov/" }, { "id": "la-lsbme", "type": "other", "title": "Louisiana State Board of Medical Examiners", "url": "https://www.lsbme.la.gov/" }, { "id": "la-37-1271", "type": "other", "title": "La. R.S. 37:1271, License to practice medicine or telemedicine required", "url": "https://law.justia.com/codes/louisiana/revised-statutes/title-37/rs-37-1271/" }, { "id": "la-lac-46-xlv-7503", "type": "other", "title": "Louisiana Administrative Code Title 46, Part XLV, section 7503, Telemedicine definitions (LSBME rules)", "url": "https://www.law.cornell.edu/regulations/louisiana/La-Admin-Code-tit-46-SS-XLV-7503" }, { "id": "la-37-1232", "type": "other", "title": "La. R.S. 37:1232, Nonresident pharmacy", "url": "https://law.justia.com/codes/louisiana/revised-statutes/title-37/rs-37-1232/" }, { "id": "la-practice-act", "type": "other", "title": "Louisiana Board of Pharmacy: Title 37, chapter 14, Pharmacy Practice Act", "url": "https://www.pharmacy.la.gov/page/title-37-chapter-14-pharmacy-practice-act" }, { "id": "la-lac-46-liii", "type": "other", "title": "Louisiana Administrative Code Title 46, Part LIII, Pharmacists (Board of Pharmacy rules)", "url": "https://www.law.cornell.edu/regulations/louisiana/title-46/part-LIII" }, { "id": "la-lac-46-liii-2026", "type": "other", "title": "Louisiana Administrative Code Title 46, Part LIII, Pharmacists, official compilation from the Office of the State Register (Board of Pharmacy rules, updated May 2026), Chapter 25, Subchapter C, sections 2531 to 2535", "url": "https://www.doa.la.gov/media/bfajf0q2/46v53.docx" }, { "id": "la-board-compounding", "type": "other", "title": "Louisiana Board of Pharmacy: Compounding pharmacies", "url": "https://www.pharmacy.la.gov/page/compounding-pharmacies" }, { "id": "la-lac-46-xlv", "type": "other", "title": "Louisiana Administrative Code Title 46, Part XLV, Medical Professions, official compilation from the Office of the State Register (sections 408 and 7501 to 7521, telemedicine)", "url": "https://www.doa.la.gov/media/t5scfw11/46v45.docx" }, { "id": "la-act-345", "type": "other", "title": "Louisiana Act 345 of 2026 (Senate Bill 30), enacting La. R.S. 40:1223.4(D) on telehealth obesity treatment", "url": "https://www.legis.la.gov/legis/ViewDocument.aspx?d=1478286" }, { "id": "la-nbc-semaglutide", "type": "other", "title": "NBC News: Safety worries over copycat versions of Ozempic and Wegovy prompt state crackdowns (Louisiana Board of Pharmacy, 2023)", "url": "https://www.nbcnews.com/health/health-news/ozempic-wegovy-weight-loss-compounded-crackdowns-rcna82405", "year": 2023 }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "la-act-374", "type": "other", "title": "Louisiana Act No. 374 of 2026 (SB 253), enacting R.S. 37:23.5", "url": "https://legis.la.gov/legis/ViewDocument.aspx?d=1478374" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "maine", "name": "Maine", "abbreviation": "ME", "kind": "state", "summary": "Yes. A Maine resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Maine-licensed prescriber, including by telehealth, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Maine Board of Pharmacy. Out-of-state pharmacies that mail prescriptions to Maine patients must hold a Board license as mail order prescription pharmacies under the Maine Pharmacy Act (32 M.R.S. section 13751) and Board rules chapter 11. Out-of-state physicians who are not licensed in Maine may only provide consultative telehealth to another Maine clinician under 32 M.R.S. section 3300-D, so a direct-to-patient GLP-1 or peptide prescriber must hold a Maine license.", "telehealth": { "allowed": true, "notes": "Maine permits licensed physicians to treat patients through telehealth under rules adopted by the Board of Licensure in Medicine, which must hold telehealth care to the same standard as in-person care. Title 32, section 3300-D uses the definition of telehealth in Title 24-A, section 4316, which covers real-time interactive visits and asynchronous store-and-forward transfers. The same section limits physicians who are not licensed in Maine to registered, consultative interstate telehealth requested by a Maine-licensed physician, advanced practice registered nurse, or physician associate, who keeps authority over diagnosis and treatment. In practice, a telehealth clinic that prescribes directly to a Maine patient needs a prescriber with a full Maine license. Whether a prescription may be issued from an asynchronous (questionnaire or message-based) encounter alone is governed by the Board's telehealth rules and the standard of care rather than an express statute, so this record leaves it unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "me-32-3300-d", "me-bolim-rules" ] }, "compounding": { "board_name": "Maine Board of Pharmacy (Office of Professional and Occupational Regulation)", "board_url": "https://www.maine.gov/pfr/professionallicensing/professions/board-pharmacy", "follows_fda_503a_bulks": true, "notes": "The Maine Board of Pharmacy licenses pharmacists and pharmacies under the Maine Pharmacy Act, 32 M.R.S. chapter 117, and adopts practice rules in chapter 02-392 of the Code of Maine Rules. Section 13751, subsection 1, requires every pharmacy to obtain an annual Board license, and subsection 2 lists the classifications, including mail order prescription pharmacy. Board rules chapter 11, section 1 applies that classification to a pharmacy that dispenses prescription drugs by mail or carrier from a facility outside Maine to a patient who lives in Maine; the applicant must file a copy of its most recent inspection report from its home state and keep a toll-free line to a pharmacist open at least 40 hours a week. Inside Maine, a sterile compounding pharmacy needs a separate license under Board rules chapter 37, and non-sterile compounding must follow USP chapter 795 under Board rules chapter 13, section 7. A 2013 bill that would have required out-of-state pharmacies that compound drugs for Maine patients to hold their own annual Maine license (LD 1315, 126th Legislature) was vetoed, and the veto was sustained on June 26, 2013; section 13751 as checked on 2026-09-22 contains no compounding-specific license for out-of-state pharmacies, and the scope section of Board rules chapter 37 does not address pharmacies located outside Maine. Maine has no state bulks list; eligibility of a peptide for compounding follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "me-board", "me-pharmacy-act", "me-13751", "me-rules-ch11-1", "me-rules-ch37", "me-rules-ch13-7", "me-ld-1315", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because Maine requires a pharmacy that mails prescriptions to Maine patients from outside the state to hold a mail order prescription pharmacy license, a telehealth GLP-1 program that ships a compounded vial into Maine from a pharmacy without that license is not lawful in the state. Maine patients should also confirm that the prescriber holds a full Maine license, since unregistered out-of-state physicians may only consult.", "source_ids": [ "fda-glp1-compounding", "me-13751", "me-rules-ch11-1", "me-32-3300-d" ] }, "research_peptide_sales": { "notes": "The Maine Pharmacy Act limits dispensing of prescription drugs to licensed pharmacies and practitioners, so an online seller of \"research use only\" injectable peptides to Maine consumers is not a lawful dispenser in Maine.", "source_ids": [ "me-pharmacy-act", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Maine through telehealth?", "a": "Yes, from a prescriber who holds a Maine license. Maine allows telehealth care that meets the in-person standard, and semaglutide and tirzepatide are not controlled substances. Whether a questionnaire-only encounter is enough is set by licensing board rules and the standard of care, so expect at least a structured clinical review.", "source_ids": [ "me-32-3300-d", "me-bolim-rules" ] }, { "q": "Can an out-of-state doctor prescribe to me in Maine over telehealth?", "a": "Not directly unless the doctor holds a Maine license. Under 32 M.R.S. section 3300-D, a physician not licensed in Maine may register only to provide consultative telehealth requested by a Maine-licensed clinician, who keeps authority over diagnosis and treatment.", "source_ids": [ "me-32-3300-d" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Maine?", "a": "Only if it holds a Maine mail order prescription pharmacy license. The Maine Pharmacy Act and Board rules chapter 11 require a pharmacy that mails prescriptions to Maine patients from outside the state to be licensed and to file its latest home-state inspection report. A 2013 bill that would have added a separate license for out-of-state compounders was vetoed, so the mail order license is the Maine requirement. Check the pharmacy in the state license lookup before ordering.", "source_ids": [ "me-13751", "me-rules-ch11-1", "me-ld-1315", "me-board" ] }, { "q": "Can a Maine pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "me-board", "type": "other", "title": "Maine Board of Pharmacy (Office of Professional and Occupational Regulation)", "url": "https://www.maine.gov/pfr/professionallicensing/professions/board-pharmacy" }, { "id": "me-32-3300-d", "type": "other", "title": "Maine Revised Statutes Title 32, section 3300-D, Interstate practice of telehealth", "url": "https://legislature.maine.gov/legis/statutes/32/title32sec3300-D.html" }, { "id": "me-bolim-rules", "type": "other", "title": "Maine Board of Licensure in Medicine: rules and statutes (including telehealth standards of practice)", "url": "https://www1.maine.gov/md/laws-rules-updates/rules" }, { "id": "me-pharmacy-act", "type": "other", "title": "Maine Revised Statutes Title 32, chapter 117, Maine Pharmacy Act", "url": "https://www.mainelegislature.org/legis/statutes/32/title32ch117sec0.html" }, { "id": "me-13751", "type": "other", "title": "Maine Revised Statutes Title 32, section 13751, Registration and licensure of drug outlets", "url": "https://legislature.maine.gov/statutes/32/title32sec13751.html" }, { "id": "me-ld-1315", "type": "other", "title": "Maine LD 1315 (126th Legislature), An Act To Ensure the Safety of Compounded Drugs: status page (vetoed June 21, 2013; veto sustained June 26, 2013)", "url": "https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1315&snum=126" }, { "id": "me-rules-ch11-1", "type": "other", "title": "Code of Maine Rules 02-392, chapter 11, section 1, Mail order prescription pharmacy", "url": "https://www.law.cornell.edu/regulations/maine/02-392-C-M-R-ch-2-SS-11-1" }, { "id": "me-rules-ch37", "type": "other", "title": "Code of Maine Rules 02-392, chapter 37, Licensure of sterile compounding pharmacies", "url": "https://www.law.cornell.edu/regulations/maine/department-02/division-392/part-5/chapter-37" }, { "id": "me-rules-ch13-7", "type": "other", "title": "Code of Maine Rules 02-392, chapter 13, section 7, Compounding (non-sterile, USP chapter 795)", "url": "https://www.law.cornell.edu/regulations/maine/02-392-C-M-R-ch-3-SS-13-7" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "maryland", "name": "Maryland", "abbreviation": "MD", "kind": "state", "summary": "Yes. A Maryland resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Maryland-licensed prescriber, including through telehealth, and Maryland's telehealth statute (Health Occupations Article, section 1-1001 and following) expressly lets a practitioner perform the clinical evaluation required before treatment through either a synchronous or an asynchronous interaction. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy holding a Maryland pharmacy permit; out-of-state pharmacies need a Maryland nonresident pharmacy permit, which requires a recent home-state inspection report and a Maryland agent for service of process.", "telehealth": { "allowed": true, "notes": "The Preserve Telehealth Access Act of 2021 added Health Occupations Article sections 1-1001 through 1-1006. Telehealth is defined to include both synchronous and asynchronous interactions, and an asynchronous interaction includes the secure transmission of medical information, clinical data, images, lab results, and self-reported medical history. Section 1-1003 requires a clinical evaluation before a practitioner provides telehealth services and states that the practitioner may use a synchronous or an asynchronous telehealth interaction to perform it; telehealth care is held to the same standard as in-person care. The stricter in-person assessment requirement in section 1-1003 applies only to certain controlled substances, such as Schedule II opioids. The Maryland Board of Physicians implements these rules for physicians in COMAR 10.32.05. The practitioner must be licensed in Maryland. Semaglutide, tirzepatide, and the other peptides in this database are not controlled substances, so federal telemedicine controlled substance rules do not apply.", "async_prescribing_allowed": true, "source_ids": [ "md-ho-1-1001", "md-ho-1-1003", "md-comar-10-32-05" ] }, "compounding": { "board_name": "Maryland Board of Pharmacy (Maryland Department of Health)", "board_url": "https://health.maryland.gov/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The Maryland Board of Pharmacy regulates pharmacists and pharmacies under Health Occupations Article, Title 12, and COMAR Title 10, Subtitle 34, including COMAR 10.34.19 on sterile pharmaceutical compounding. Maryland has no state bulks list; eligibility of a peptide for compounding follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list). Under Health Occupations section 12-403, a nonresident pharmacy that dispenses to Maryland patients must hold a Maryland pharmacy permit, submit the most recent inspection report from its home-state regulator, and designate a Maryland agent for service of process. Maryland no longer issues a separate sterile compounding permit: Chapter 5 of the Acts of 2015 (Senate Bill 69) repealed the sterile compounding permit requirement. Instead, section 12-403 requires a nonresident pharmacy that will dispense compounded sterile preparations to Maryland patients to submit a report of an inspection, conducted within 90 days before its application by a Board designee or another Board-approved entity, that shows compliance with USP chapter 797, and to keep complying with USP chapter 797 and the Board's sterile compounding regulations. COMAR 10.34.37.04 likewise requires a nonresident pharmacy that compounds sterile preparations to follow USP standards and COMAR 10.34.19.", "source_ids": [ "md-board", "md-ho-12-403", "md-comar-10-34", "md-comar-10-34-37-04", "md-sb-69-2015", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Maryland's asynchronous telehealth rule makes app-based GLP-1 programs lawful on the prescribing side, but the dispensing pharmacy must still hold a Maryland pharmacy or nonresident pharmacy permit.", "source_ids": [ "fda-glp1-compounding", "md-ho-1-1003", "md-ho-12-403" ] }, "research_peptide_sales": { "notes": "Maryland's Food, Drug, and Cosmetic Act (Health-General Article, Title 21) prohibits selling adulterated or misbranded drugs, and Health Occupations Title 12 limits dispensing of prescription drugs to permitted pharmacies and authorized practitioners.", "source_ids": [ "md-hg-21", "md-board", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Maryland from an online questionnaire or app?", "a": "Maryland law allows it in principle. Health Occupations section 1-1003 lets a Maryland-licensed practitioner perform the required clinical evaluation through an asynchronous telehealth interaction, and the care must meet the in-person standard. The prescriber still decides whether the information is enough to prescribe safely.", "source_ids": [ "md-ho-1-1001", "md-ho-1-1003" ] }, { "q": "Does a telehealth prescriber need a Maryland license?", "a": "Yes. Maryland's telehealth statute applies to practitioners licensed in Maryland, and the Board of Physicians' telehealth regulations in COMAR 10.32.05 require Maryland licensure to treat a patient located in Maryland.", "source_ids": [ "md-ho-1-1001", "md-comar-10-32-05" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Maryland?", "a": "Only if it holds a Maryland nonresident pharmacy permit. Under Health Occupations section 12-403, the pharmacy must submit its latest home-state inspection report and name a Maryland agent for service of process, and a pharmacy that ships compounded sterile preparations such as injectable peptides must also file a USP chapter 797 inspection report from an inspection done within 90 days before its application. Search the Board of Pharmacy license verification before ordering.", "source_ids": [ "md-ho-12-403", "md-board" ] }, { "q": "Can a Maryland pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "md-board", "type": "other", "title": "Maryland Board of Pharmacy", "url": "https://health.maryland.gov/pharmacy/" }, { "id": "md-ho-1-1001", "type": "other", "title": "Maryland Code, Health Occupations section 1-1001, Telehealth definitions", "url": "https://mgaleg.maryland.gov/mgawebsite/laws/StatuteText?article=gho§ion=1-1001&enactments=false" }, { "id": "md-ho-1-1003", "type": "other", "title": "Maryland Code, Health Occupations section 1-1003, Telehealth clinical evaluation and prescribing", "url": "https://mgaleg.maryland.gov/mgawebsite/laws/StatuteText?article=gho§ion=1-1003&enactments=false" }, { "id": "md-comar-10-32-05", "type": "other", "title": "COMAR 10.32.05, Telehealth (Maryland Board of Physicians)", "url": "https://health.maryland.gov/regs/Pages/10-32-05-Telehealth-(BOARD-OF-PHYSICIANS).aspx" }, { "id": "md-ho-12-403", "type": "other", "title": "Maryland Code, Health Occupations section 12-403, Required standards (including nonresident pharmacies)", "url": "https://mgaleg.maryland.gov/mgawebsite/laws/StatuteText?article=gho§ion=12-403&enactments=false" }, { "id": "md-comar-10-34", "type": "other", "title": "COMAR Title 10, Subtitle 34, Board of Pharmacy regulations", "url": "https://regs.maryland.gov/us/md/exec/comar/10.34" }, { "id": "md-comar-10-34-37-04", "type": "other", "title": "COMAR 10.34.37.04, Requirements for nonresident pharmacy operations", "url": "https://regs.maryland.gov/us/md/exec/comar/10.34.37.04" }, { "id": "md-sb-69-2015", "type": "other", "title": "Maryland Senate Bill 69 (2015), Chapter 5: repeal of the sterile compounding permit requirement", "url": "https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0069?ys=2015RS" }, { "id": "md-hg-21", "type": "other", "title": "Maryland Code, Health-General Title 21, Food, Drugs, and Cosmetics", "url": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=21-201&enactments=false" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "massachusetts", "name": "Massachusetts", "abbreviation": "MA", "kind": "state", "summary": "Yes. A Massachusetts resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Massachusetts-licensed prescriber, including through telemedicine, which the Board of Registration in Medicine treats as the practice of medicine held to the in-person standard. Compounded peptides are available only when eligible under federal 503A rules and dispensed under one of the strictest compounding regimes in the country: after the 2012 New England Compounding Center outbreak, Massachusetts created separate sterile compounding licenses, and an out-of-state pharmacy may not ship sterile compounded preparations such as injectable peptides into the state without a Massachusetts nonresident sterile compounding license (M.G.L. chapter 112, section 39J).", "telehealth": { "allowed": true, "notes": "Board of Registration in Medicine regulations at 243 CMR 2.01 define the practice of medicine to include telemedicine, and Board Policy 2020-01 (amended in 2022) confirms that a Massachusetts-licensed physician may practice through telemedicine under the same standard of care as an in-person visit, including prescribing when that standard is met. The physician must hold a Massachusetts license to treat a patient located in Massachusetts. Chapter 260 of the Acts of 2020 extended insurance coverage to telehealth, which it defines to include synchronous and asynchronous technology, but no Massachusetts statute expressly authorizes prescribing from a questionnaire alone, so this record leaves asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "ma-243-cmr-2", "ma-borim-policy-2020-01" ] }, "compounding": { "board_name": "Massachusetts Board of Registration in Pharmacy (Department of Public Health)", "board_url": "https://www.mass.gov/orgs/board-of-registration-in-pharmacy", "follows_fda_503a_bulks": true, "notes": "The Board of Registration in Pharmacy licenses pharmacies under M.G.L. chapter 112, sections 24 through 42D, and Board regulations in 247 CMR, including 247 CMR 6.00 (licensure of pharmacies) and 247 CMR 9.00 (professional practice standards, including non-resident pharmacies). Chapter 159 of the Acts of 2014, An Act relative to pharmacy practice in the Commonwealth, passed after the New England Compounding Center meningitis outbreak, inserted sections 39D through 39J into chapter 112: section 39G created a license for retail sterile compounding pharmacies, section 39H a license for retail complex non-sterile compounding pharmacies, section 39I a license for institutional sterile compounding pharmacies, and section 39J non-resident pharmacy licensure. Under section 39J(d), no pharmacy, pharmacist, or outsourcing facility outside Massachusetts may ship, sell, or dispense sterile or complex non-sterile drug preparations into the state unless they were compounded in a facility holding a Massachusetts nonresident sterile compounding license, nonresident complex non-sterile compounding license, or nonresident outsourcing facility registration. 247 CMR 17.00 (sterile compounding) and 247 CMR 18.00 (non-sterile compounding) are posted on the Board's draft regulations page and are not in the Trial Court Law Libraries compilation of current 247 CMR checked on 2026-09-22, so this record treats them as drafts, not adopted rules. Massachusetts has no state bulks list, so peptide eligibility follows the federal 503A framework.", "source_ids": [ "ma-board", "ma-112-39j", "ma-112-39g", "ma-acts-2014-159", "ma-247-cmr", "ma-247-cmr-drafts", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because compounded GLP-1s are injectable sterile preparations, an out-of-state telehealth program can ship them into Massachusetts only from a pharmacy that holds a Massachusetts nonresident sterile compounding license, which narrows the pool further.", "source_ids": [ "fda-glp1-compounding", "ma-112-39j" ] }, "research_peptide_sales": { "notes": "M.G.L. chapter 94 (food and drugs) prohibits selling adulterated or misbranded drugs in Massachusetts, and chapter 112 limits dispensing of prescription drugs to licensed pharmacies and practitioners.", "source_ids": [ "ma-94", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded from any Massachusetts pharmacy by prescription, including by telemedicine from a Massachusetts-licensed physician. Compounded semaglutide injections are limited to the federal patient specific exception since April 22, 2025, and must come from a Massachusetts sterile compounding licensee.", "source_ids": [ "fda-glp1-compounding", "ma-112-39j" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. Massachusetts pharmacies apply the federal test, and an injectable BPC-157 preparation would also have to come from a pharmacy holding a Massachusetts sterile compounding license (M.G.L. chapter 112, section 39G) or, if shipped from out of state, a nonresident sterile compounding license (section 39J).", "source_ids": [ "fda-category-2", "fda-pcac", "ma-112-39g", "ma-112-39j" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Massachusetts through telemedicine?", "a": "Yes, from a Massachusetts-licensed physician. The Board of Registration in Medicine treats telemedicine as the practice of medicine under the same standard of care as an in-person visit, and semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "ma-243-cmr-2", "ma-borim-policy-2020-01" ] }, { "q": "Why are Massachusetts compounding rules stricter than most states?", "a": "The 2012 fungal meningitis outbreak traced to the New England Compounding Center in Framingham led to Chapter 159 of the Acts of 2014, which created separate sterile compounding licenses and barred out-of-state compounders from shipping sterile preparations in without a Massachusetts nonresident sterile compounding license.", "source_ids": [ "ma-acts-2014-159", "ma-112-39g", "ma-112-39j" ] }, { "q": "Can an out-of-state pharmacy ship compounded injectable peptides to me in Massachusetts?", "a": "Only if the preparation was made in a pharmacy holding a Massachusetts nonresident sterile compounding license, or in an outsourcing facility with a Massachusetts nonresident registration, under M.G.L. chapter 112, section 39J. Check the Board's license lookup before ordering.", "source_ids": [ "ma-112-39j", "ma-board" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Massachusetts?", "a": "Only in limited, patient specific cases. The federal shortage allowances ended in 2025, and any compounded injectable must also come from a pharmacy with the right Massachusetts sterile compounding license.", "source_ids": [ "fda-glp1-compounding", "ma-112-39j" ] }, { "q": "Can a Massachusetts pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ma-board", "type": "other", "title": "Massachusetts Board of Registration in Pharmacy", "url": "https://www.mass.gov/orgs/board-of-registration-in-pharmacy" }, { "id": "ma-243-cmr-2", "type": "other", "title": "Massachusetts Board of Registration in Medicine: physician regulations (243 CMR 2.00), policies, and guidelines", "url": "https://www.mass.gov/lists/physician-regulations-policies-and-guidelines" }, { "id": "ma-borim-policy-2020-01", "type": "other", "title": "Massachusetts Board of Registration in Medicine Policy 2020-01, Policy on telemedicine (amended)", "url": "https://www.mass.gov/doc/policy-20-01-policy-on-telemedicine-amended-february-3-2022/download" }, { "id": "ma-112-39j", "type": "other", "title": "M.G.L. chapter 112, section 39J, Non-resident pharmacies; licensure; compounded preparations", "url": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter112/Section39j" }, { "id": "ma-112-39g", "type": "other", "title": "M.G.L. chapter 112, section 39G, Retail sterile compounding pharmacies; licensure", "url": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter112/Section39G" }, { "id": "ma-acts-2014-159", "type": "other", "title": "Chapter 159 of the Acts of 2014, An Act relative to pharmacy practice in the Commonwealth", "url": "https://malegislature.gov/Laws/SessionLaws/Acts/2014/Chapter159" }, { "id": "ma-247-cmr", "type": "other", "title": "247 CMR, Board of Registration in Pharmacy regulations (Trial Court Law Libraries compilation)", "url": "https://www.mass.gov/law-library/247-cmr" }, { "id": "ma-247-cmr-drafts", "type": "other", "title": "Board of Registration in Pharmacy: draft regulations, including draft 247 CMR 17.00 (sterile compounding) and 18.00 (non-sterile compounding)", "url": "https://www.mass.gov/lists/draft-regulations-for-the-board-of-registration-in-pharmacy" }, { "id": "ma-94", "type": "other", "title": "M.G.L. chapter 94, Inspection and sale of food, drugs and various articles", "url": "https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXV/Chapter94" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "michigan", "name": "Michigan", "abbreviation": "MI", "kind": "state", "summary": "Yes. A Michigan resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Michigan-licensed prescriber, including through telehealth, because the Public Health Code (MCL 333.16285) lets a prescriber providing a telehealth service prescribe any non-controlled drug within scope of practice. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Michigan Board of Pharmacy; under MCL 333.17748, any pharmacy doing business in Michigan, wherever located, must hold a Michigan pharmacy license.", "telehealth": { "allowed": true, "notes": "Michigan's telehealth provisions are in the Public Health Code, MCL 333.16283 through 333.16288 (2016 Public Act 359, effective March 29, 2017). A health professional must obtain the patient's consent before providing a telehealth service (MCL 333.16284). Under MCL 333.16285, a professional providing a telehealth service may prescribe a drug if the professional is a prescriber acting within scope of practice, and, for controlled substances, meets the controlled substance requirements that apply to that professional; the prescriber must also refer the patient to geographically accessible care when medically necessary. The telehealth professional must hold a Michigan license. The statute does not separately address whether a store-and-forward or questionnaire encounter is sufficient; that turns on the standard of care, so this record leaves asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "mi-333-16285", "mi-lara-pharmacy" ] }, "compounding": { "board_name": "Michigan Board of Pharmacy (Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing)", "board_url": "https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/pharmacy", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy, housed in LARA, regulates pharmacy under Part 177 of the Public Health Code (MCL 333.17701 to 333.17780) and the Board of Pharmacy General Rules in the Michigan Administrative Code (Part 3, pharmacy licenses, R 338.531 to R 338.539, and Part 6, practice of pharmacy, R 338.582 to R 338.591). MCL 333.17748 requires a pharmacy, whether or not located in Michigan, to be licensed to do business in the state; MCL 333.17748e sets narrow conditions under which a licensed out-of-state pharmacy may deliver through a Michigan-licensed wholesale distributor-broker. After the 2012 compounding outbreak, Michigan enacted MCL 333.17748a (2014 Public Act 280, effective September 30, 2014), which requires a pharmacy that provides compounding services for sterile pharmaceuticals to hold current accreditation from a Board-approved national accrediting organization, or to show USP compliance in a manner the Board determines, to verify that status with each license renewal, and to notify the department within 30 days of a complaint from another state or a federal investigation about its compounding. Under R 338.533 the Board adopts USP chapters 795 and 797 (both revised 2023) as the compounding standards, and under R 338.534 an out-of-state pharmacy that will provide sterile compounded preparations in Michigan must have an inspection completed no more than 18 months before its initial or renewal application, by the department, a Board-recognized national inspection program, an approved accrediting organization, or its home-state licensing agency. Michigan has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "mi-lara-pharmacy", "mi-333-17748", "mi-333-17748a", "mi-r-338-533", "mi-r-338-534", "mi-rules-part-3", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "A telehealth GLP-1 program shipping compounded injections into Michigan must use a pharmacy that holds a Michigan pharmacy license under MCL 333.17748, which patients can check in the LARA license verification system.", "source_ids": [ "fda-glp1-compounding", "mi-333-17748", "mi-lara-pharmacy" ] }, "research_peptide_sales": { "notes": "Part 177 of the Public Health Code restricts the dispensing and sale of prescription drugs to licensed pharmacies and prescribers, and a seller of \"research use only\" injectable peptides to Michigan consumers holds no such license.", "source_ids": [ "mi-333-17748", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Michigan through telehealth?", "a": "Yes. MCL 333.16285 lets a Michigan-licensed prescriber providing a telehealth service prescribe a non-controlled drug within scope of practice, after obtaining your consent. Semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "mi-333-16285" ] }, { "q": "Does Michigan require consent for telehealth?", "a": "Yes. Under the Public Health Code, a health professional must obtain the patient's consent, directly or through a representative, before providing a telehealth service. The prescriber must also refer you to local care when that is medically necessary.", "source_ids": [ "mi-333-16285" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Michigan?", "a": "Generally only if it holds a Michigan pharmacy license. MCL 333.17748 requires any pharmacy doing business in Michigan to be licensed, whether or not it is located in the state. Check the pharmacy in the LARA license lookup before ordering.", "source_ids": [ "mi-333-17748", "mi-lara-pharmacy" ] }, { "q": "Can a Michigan pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "mi-lara-pharmacy", "type": "other", "title": "Michigan Board of Pharmacy (LARA Bureau of Professional Licensing)", "url": "https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/pharmacy" }, { "id": "mi-333-16285", "type": "other", "title": "MCL 333.16285, Telehealth service; prescribing a drug", "url": "https://legislature.mi.gov/Laws/MCL?objectName=MCL-333-16285" }, { "id": "mi-333-17748", "type": "other", "title": "MCL 333.17748, Pharmacy, manufacturer, or wholesale distributor license required", "url": "https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-17748" }, { "id": "mi-333-17748a", "type": "other", "title": "MCL 333.17748a, Compounding services for sterile pharmaceuticals; accreditation", "url": "https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-17748a" }, { "id": "mi-r-338-533", "type": "other", "title": "Mich. Admin. Code R 338.533, Compounding standards and requirements; outsourcing facilities", "url": "https://www.law.cornell.edu/regulations/michigan/Mich-Admin-Code-R-338-533" }, { "id": "mi-r-338-534", "type": "other", "title": "Mich. Admin. Code R 338.534, Out-of-state pharmacy licensure inspection; in-state renewal inspection", "url": "https://www.law.cornell.edu/regulations/michigan/Mich-Admin-Code-R-338-534" }, { "id": "mi-rules-part-3", "type": "other", "title": "Michigan Board of Pharmacy General Rules, Part 3, Pharmacy licenses (R 338.531 to R 338.539)", "url": "https://www.law.cornell.edu/regulations/michigan/department-licensing-and-regulatory-affairs/bureau-of-professional-licensing/board-of-pharmacy/board-of-pharmacy-general-rules/pharmacy-services-in-medical-institutions/part-3" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "minnesota", "name": "Minnesota", "abbreviation": "MN", "kind": "state", "summary": "Yes. A Minnesota resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Minnesota-licensed prescriber, including through telehealth. Minnesota Statutes section 151.37 requires a documented patient evaluation including an examination only for a listed set of drugs (controlled substances, muscle relaxants, opioid-type analgesics, butalbital products, and PDE5 inhibitors for erectile dysfunction), so GLP-1s and other peptides fall under the general standard of care instead. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Minnesota Board of Pharmacy, and out-of-state pharmacies that regularly ship into Minnesota need a nonresident pharmacy license under section 151.19.", "telehealth": { "allowed": true, "notes": "The Minnesota Telehealth Act (Minn. Stat. section 62A.673, 2021) defines telehealth for coverage purposes to include real-time interactive communication and store-and-forward technology. Minn. Stat. section 151.37, subdivision 2, makes a prescription invalid unless based on a documented patient evaluation including an examination, but only for the drugs listed in paragraph (d): controlled substances, Board-designated controlled substances, muscle relaxants, centrally acting analgesics with opioid activity, drugs containing butalbital, and PDE5 inhibitors for erectile dysfunction. For PDE5 inhibitors and certain opioid use disorder medications, the examination may be completed by telehealth. Semaglutide, tirzepatide, and the other peptides in this database are not on that list, so prescribing them by telehealth is governed by the general standard of care rather than an express examination rule, and no Minnesota statute located for this draft expressly permits or bars questionnaire-only prescribing for them. Physicians must hold a Minnesota license or an interstate telemedicine registration under Minn. Stat. section 147.032.", "async_prescribing_allowed": null, "source_ids": [ "mn-151-37", "mn-62a-673", "mn-147-032" ] }, "compounding": { "board_name": "Minnesota Board of Pharmacy", "board_url": "https://mn.gov/boards/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The Minnesota Board of Pharmacy licenses pharmacies under Minn. Stat. chapter 151 (the Pharmacy Practice and Wholesale Distribution Act) and regulates practice through Minnesota Rules chapter 6800. Under section 151.19, a pharmacy located outside Minnesota that dispenses to Minnesota residents and ships prescription drugs into the state must hold a Minnesota nonresident pharmacy license, disclose its home-state licensure, and name the pharmacists dispensing to Minnesota patients; the Board also requires a nonresident pharmacist-in-charge designation. Minnesota has no state bulks list; peptide eligibility follows the federal 503A framework. The Board's published guidance documents and its compounding FAQ page, checked on 2026-09-22, do not address semaglutide salt forms or research-grade ingredients, so this record makes no Minnesota-specific claim about them; the federal 503A limits apply.", "source_ids": [ "mn-board", "mn-151", "mn-151-19", "mn-rules-6800", "mn-board-guidance", "mn-board-compounding-faq", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Minnesota's statutory examination requirement in section 151.37 does not list GLP-1s, so the main state-specific check for a telehealth GLP-1 program is licensure: a Minnesota-licensed prescriber and a pharmacy holding a Minnesota or nonresident Minnesota license.", "source_ids": [ "fda-glp1-compounding", "mn-151-37", "mn-151-19" ] }, "research_peptide_sales": { "notes": "Minn. Stat. section 151.34 prohibits manufacturing, selling, or delivering adulterated or misbranded drugs and selling legend drugs without a prescription in Minnesota.", "source_ids": [ "mn-151-34", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telehealth; it is not one of the drugs for which Minn. Stat. section 151.37 requires a documented examination. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "mn-151-37" ] } ], "faqs": [ { "q": "Does Minnesota require an exam before a telehealth GLP-1 prescription?", "a": "Not by a specific statute. Minn. Stat. section 151.37 requires a documented examination only for listed drugs such as controlled substances, muscle relaxants, butalbital products, and PDE5 inhibitors for erectile dysfunction. GLP-1s are not on that list, so the prescriber decides what evaluation the standard of care requires.", "source_ids": [ "mn-151-37" ] }, { "q": "Can an out-of-state doctor treat me in Minnesota by telehealth?", "a": "Only if the doctor holds a Minnesota license or an interstate telehealth registration with the Minnesota Board of Medical Practice under Minn. Stat. section 147.032.", "source_ids": [ "mn-147-032" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Minnesota?", "a": "Only if it holds a Minnesota nonresident pharmacy license under Minn. Stat. section 151.19. Search the Board of Pharmacy license lookup before ordering.", "source_ids": [ "mn-151-19", "mn-board" ] }, { "q": "Can a Minnesota pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "mn-board", "type": "other", "title": "Minnesota Board of Pharmacy", "url": "https://mn.gov/boards/pharmacy/" }, { "id": "mn-151-37", "type": "other", "title": "Minnesota Statutes section 151.37, Legend drugs; who may prescribe, possess", "url": "https://www.revisor.mn.gov/statutes/cite/151.37" }, { "id": "mn-62a-673", "type": "other", "title": "Minnesota Statutes section 62A.673, Coverage of services provided through telehealth (Minnesota Telehealth Act)", "url": "https://www.revisor.mn.gov/statutes/cite/62A.673" }, { "id": "mn-147-032", "type": "other", "title": "Minnesota Statutes section 147.032, Interstate practice of telemedicine", "url": "https://www.revisor.mn.gov/statutes/cite/147.032" }, { "id": "mn-151", "type": "other", "title": "Minnesota Statutes chapter 151, Pharmacy Practice and Wholesale Distribution Act", "url": "https://www.revisor.mn.gov/statutes/cite/151" }, { "id": "mn-151-19", "type": "other", "title": "Minnesota Statutes section 151.19, Pharmacy licensure requirements (including nonresident pharmacies)", "url": "https://www.revisor.mn.gov/statutes/cite/151.19" }, { "id": "mn-151-34", "type": "other", "title": "Minnesota Statutes section 151.34, Prohibited acts", "url": "https://www.revisor.mn.gov/statutes/cite/151.34" }, { "id": "mn-rules-6800", "type": "other", "title": "Minnesota Rules chapter 6800, Pharmacy and pharmacists", "url": "https://www.revisor.mn.gov/rules/6800/" }, { "id": "mn-board-guidance", "type": "other", "title": "Minnesota Board of Pharmacy: guidance documents", "url": "https://mn.gov/boards/pharmacy/statutes/guidance.jsp" }, { "id": "mn-board-compounding-faq", "type": "other", "title": "Minnesota Board of Pharmacy: compounding FAQs", "url": "https://mn.gov/boards/pharmacy/resourcesfaqs/faqs/compounding.jsp" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "mississippi", "name": "Mississippi", "abbreviation": "MS", "kind": "state", "summary": "Yes. A Mississippi resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Mississippi-licensed physician, including by telemedicine under the Board of Medical Licensure's telemedicine rule (Miss. Admin. Code Title 30, Part 2635, Chapter 5), which requires a Mississippi license and a valid physician-patient relationship. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy permitted by the Mississippi Board of Pharmacy; out-of-state pharmacies need a nonresident permit under Miss. Code section 73-21-106 and must use a pharmacist-in-charge who also holds a Mississippi pharmacist license. The Board has issued guidance rejecting compounded semaglutide made from salt forms.", "telehealth": { "allowed": true, "notes": "The Mississippi State Board of Medical Licensure regulates telemedicine in Title 30, Part 2635, Chapter 5 of the Mississippi Administrative Code. Only physicians holding a valid Mississippi license may practice telemedicine with patients in Mississippi, and a valid physician-patient relationship must be established. Telemedicine is defined to include HIPAA-compliant electronic communication, remote monitoring, and store-and-forward technology, and care is held to the in-person standard. Miss. Code sections 83-9-351 and 83-9-353 require insurers to cover telemedicine and store-and-forward services. The rule does not clearly state whether a relationship can be established by an asynchronous questionnaire alone, so this record leaves asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "ms-part-2635-ch5", "ms-msbml" ] }, "compounding": { "board_name": "Mississippi Board of Pharmacy", "board_url": "https://www.mbp.ms.gov/", "follows_fda_503a_bulks": true, "notes": "The Mississippi Board of Pharmacy regulates pharmacies under the Mississippi Pharmacy Practice Act (Miss. Code sections 73-21-69 to 73-21-129) and the Mississippi Pharmacy Practice Regulations (Title 30, Part 3001), including Article VI on pharmacy permits. Under section 73-21-106, any pharmacy outside Mississippi that ships, mails, or delivers prescription drugs to Mississippi residents must hold a nonresident permit, submit its latest home-state inspection report, and designate a pharmacist-in-charge who holds a Mississippi pharmacist license as well as a home-state license. The Board has published guidance on semaglutide compounding stating that semaglutide salt forms (such as semaglutide sodium or acetate) do not meet federal requirements because they are not the active ingredient in the approved product. Mississippi has no state bulks list; peptide eligibility follows the federal 503A framework. Section 73-21-106 was reenacted and amended by House Bill 856 of the 2025 Regular Session (section 18), effective on passage, and the same act moved the Pharmacy Practice Act repealer to July 1, 2029 (\"Sections 73-21-71 through 73-21-129 ... shall stand repealed on July 1, 2029\"), so the nonresident permit requirement is in force as of this record's check on 2026-09-22 and stays in force unless the Legislature lets the Act lapse on that date.", "source_ids": [ "ms-board", "ms-73-21-106", "ms-hb-856-2025", "ms-regs-3001", "ms-semaglutide-guidance", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "A telehealth GLP-1 program must use a Mississippi-licensed physician and a pharmacy holding a Mississippi permit or nonresident permit.", "source_ids": [ "fda-glp1-compounding", "ms-semaglutide-guidance", "ms-73-21-106" ] }, "research_peptide_sales": { "notes": "The Mississippi Pharmacy Practice Act limits dispensing of prescription drugs to permitted pharmacies and licensed practitioners, so sellers of \"research use only\" injectable peptides to Mississippi consumers are not lawful dispensers in the state. On August 19, 2026 the Mississippi State Board of Medical Licensure, Board of Nursing, and Board of Pharmacy issued a joint statement that no healthcare provider may compound, administer, dispense, prescribe, advise on, recommend, or supply a non-FDA-approved or research-grade peptide, or delegate those acts to another provider. The boards said a patient consent form calling a product research grade does not remove the provider's professional or legal liability, and providers must buy all prescription products, drugs, and ingredients from entities permitted by the Mississippi Board of Pharmacy.", "source_ids": [ "ms-board", "usc-331", "ms-joint-peptide-statement" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription from a Mississippi-licensed physician, including by telemedicine. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025, and the Mississippi Board of Pharmacy has said salt forms such as semaglutide sodium or acetate may not be used.", "source_ids": [ "fda-glp1-compounding", "ms-semaglutide-guidance" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Mississippi through telemedicine?", "a": "Yes, from a physician with a Mississippi license who establishes a valid physician-patient relationship under the Board of Medical Licensure's telemedicine rule. Semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "ms-part-2635-ch5" ] }, { "q": "Can an out-of-state telehealth doctor treat me in Mississippi?", "a": "Only if the physician holds a valid Mississippi license. The Board's telemedicine rule limits telemedicine with Mississippi patients to Mississippi licensees.", "source_ids": [ "ms-part-2635-ch5", "ms-msbml" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Mississippi?", "a": "Only with a Mississippi nonresident permit under Miss. Code section 73-21-106. The pharmacy must also name a pharmacist-in-charge licensed in both Mississippi and its home state. Check the Board of Pharmacy license lookup before ordering.", "source_ids": [ "ms-73-21-106", "ms-board" ] }, { "q": "Is compounded semaglutide still available in Mississippi?", "a": "Only in limited, patient specific cases after the federal shortage allowances ended in 2025, and never from semaglutide salt forms, which the Mississippi Board of Pharmacy has said do not meet federal requirements.", "source_ids": [ "fda-glp1-compounding", "ms-semaglutide-guidance" ] }, { "q": "Can a Mississippi pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ms-board", "type": "other", "title": "Mississippi Board of Pharmacy", "url": "https://www.mbp.ms.gov/" }, { "id": "ms-msbml", "type": "other", "title": "Mississippi State Board of Medical Licensure: administrative code (June 2025 compilation)", "url": "https://www.msbml.ms.gov/sites/default/files/Rules_Laws_Policies/6-2025Administrative%20Code.pdf" }, { "id": "ms-part-2635-ch5", "type": "other", "title": "Miss. Admin. Code Title 30, Part 2635, Chapter 5, Practice of telemedicine (rule 5.1 definitions)", "url": "https://www.law.cornell.edu/regulations/mississippi/30-Miss-Code-R-SS-2635-5-1" }, { "id": "ms-73-21-106", "type": "other", "title": "Miss. Code section 73-21-106, Registration requirement for nonresident pharmacies", "url": "https://law.justia.com/codes/mississippi/title-73/chapter-21/mississippi-pharmacy-practice-act/section-73-21-106/" }, { "id": "ms-hb-856-2025", "type": "other", "title": "Mississippi House Bill 856, 2025 Regular Session (as sent to Governor): reenacts section 73-21-106 and extends the Pharmacy Practice Act repealer to July 1, 2029", "url": "https://billstatus.ls.state.ms.us/documents/2025/html/HB/0800-0899/HB0856SG.htm" }, { "id": "ms-regs-3001", "type": "other", "title": "Mississippi Pharmacy Practice Regulations (Title 30, Part 3001)", "url": "https://www.mbp.ms.gov/sites/default/files/2022-01/Regulations%20and%20Administrative%20Rules%201.7.22.pdf" }, { "id": "ms-semaglutide-guidance", "type": "other", "title": "Mississippi Board of Pharmacy: semaglutide compounding guidance", "url": "https://www.mbp.ms.gov/sites/default/files/inline-images/Semaglutide.compoundguidance%20(002).pdf" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "ms-joint-peptide-statement", "type": "other", "title": "Joint Statement Concerning the Prescribing of Non-FDA Approved (Research-Grade) Peptides (Mississippi Board of Nursing, Board of Pharmacy, State Board of Medical Licensure, August 19, 2026)", "url": "https://www.mbp.ms.gov/sites/default/files/inline-images/1_Joint_Statement_SIGNED_Accessible.pdf" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "missouri", "name": "Missouri", "abbreviation": "MO", "kind": "state", "summary": "Yes. A Missouri resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Missouri-licensed physician, including by telehealth, but Missouri's telehealth statute (RSMo 191.1146, as amended effective August 28, 2026) requires a properly established physician-patient relationship, an evaluation, a medical history review, and an examination sufficient for diagnosis before prescribing, and it accepts a patient questionnaire only when the treating health care professional reviews it and it holds enough information to stand in for an in-person evaluation. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Missouri Board of Pharmacy; out-of-state pharmacies need a Missouri nonresident pharmacy license (20 CSR 2220-2.025).", "telehealth": { "allowed": true, "notes": "RSMo 191.1145 defines telehealth and permits licensed providers to deliver services by telehealth under the in-person standard of care. RSMo 191.1146 requires a physician using telemedicine to ensure a properly established physician-patient relationship, which can be formed in person, through consultation with a physician who has an existing relationship, or through a telemedicine encounter if the standard of care does not require an in-person visit. Before prescribing, the physician must evaluate the patient, collect or review relevant history, and perform an examination sufficient for diagnosis and treatment. 2026 House Bill 2372 amended RSMo 191.1146 and 334.108 effective August 28, 2026. Under the amended 191.1146, a questionnaire completed by the patient online or by telephone counts only if the treating health care professional reviews it and it contains enough information to stand in for an in-person evaluation; a provider who uses a questionnaire to establish the relationship must be employed by or contracted with a business entity licensed to provide health care in Missouri, and must send a written report to the patient's primary care provider, if the patient names one, within 14 days. The amended 334.108 requires a valid physician-patient relationship under 191.1146 before any telemedicine or internet prescription, and its subsection 3 bars prescribing based solely on a telemedicine evaluation unless a previously established and ongoing physician-patient relationship exists. The House summary of the truly agreed bill describes it as permitting such questionnaires, but the statute text does not say how subsection 3 applies to a relationship first established by questionnaire under 191.1146, so this record leaves asynchronous prescribing unconfirmed rather than recording it as allowed or barred.", "async_prescribing_allowed": null, "source_ids": [ "mo-191-1146", "mo-334-108", "mo-hb-2372" ] }, "compounding": { "board_name": "Missouri Board of Pharmacy (Division of Professional Registration)", "board_url": "https://pr.mo.gov/pharmacists.asp", "follows_fda_503a_bulks": true, "notes": "The Missouri Board of Pharmacy licenses pharmacies under RSMo chapter 338 and regulates practice through 20 CSR 2220, including 20 CSR 2220-2.200 (sterile compounding), which sets standards for handling, labeling, distributing, and dispensing compounded sterile preparations, and 20 CSR 2220-2.400 (compounding standards of practice), which defines compounding and sets compounding guidelines. Under 20 CSR 2220-2.025, pharmacies outside Missouri that dispense and ship drugs to Missouri patients must hold a Missouri nonresident pharmacy license. Missouri has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "mo-board", "mo-338", "mo-2220-2-025", "mo-2220-2-200", "mo-2220-2-400", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Missouri requires a real clinical evaluation before a telehealth GLP-1 prescription: since August 28, 2026 a questionnaire counts only when a treating health care professional reviews it and it holds enough information to stand in for an in-person evaluation, and RSMo 334.108 limits prescribing based solely on a telemedicine evaluation. The dispensing pharmacy needs a Missouri or Missouri nonresident license.", "source_ids": [ "fda-glp1-compounding", "mo-191-1146", "mo-334-108", "mo-2220-2-025" ] }, "research_peptide_sales": { "notes": "Missouri food and drug law (RSMo chapter 196) prohibits selling adulterated or misbranded drugs, and chapter 338 limits dispensing of prescription drugs to licensed pharmacies.", "source_ids": [ "mo-196", "mo-338", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription after a telehealth evaluation and examination that meets RSMo 191.1146 as amended in 2026. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "mo-191-1146" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Missouri from an online questionnaire?", "a": "Only in limited cases, and not from an unreviewed form. Since August 28, 2026, RSMo 191.1146 accepts a questionnaire only if the treating health care professional reviews it and it contains enough information to stand in for an in-person evaluation, and the provider must work for or contract with an entity licensed to provide health care in Missouri. RSMo 334.108 separately limits prescribing based solely on a telemedicine evaluation, so expect a clinician review and possibly a live visit.", "source_ids": [ "mo-191-1146", "mo-334-108", "mo-hb-2372" ] }, { "q": "Can a telehealth visit start a new physician-patient relationship in Missouri?", "a": "Yes, if the standard of care does not require an in-person encounter and the visit follows evidence-based telemedicine practice guidelines. The physician must be licensed in Missouri.", "source_ids": [ "mo-191-1146" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Missouri?", "a": "Only with a Missouri nonresident pharmacy license under 20 CSR 2220-2.025. Check the Division of Professional Registration license search before ordering.", "source_ids": [ "mo-2220-2-025", "mo-board" ] }, { "q": "Can a Missouri pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "mo-board", "type": "other", "title": "Missouri Board of Pharmacy", "url": "https://pr.mo.gov/pharmacists.asp" }, { "id": "mo-191-1146", "type": "other", "title": "RSMo 191.1146, Physician-patient relationship required for telemedicine, how established", "url": "https://revisor.mo.gov/main/OneSection.aspx?section=191.1146" }, { "id": "mo-334-108", "type": "other", "title": "RSMo 334.108, Telemedicine or internet prescriptions, physician-patient relationship required", "url": "https://revisor.mo.gov/main/OneSection.aspx?section=334.108" }, { "id": "mo-hb-2372", "type": "other", "title": "Missouri HB 2372 (2026) bill summary, health care and telehealth questionnaires (enacted; amended RSMo 191.1146 and 334.108 effective August 28, 2026)", "url": "https://documents.house.mo.gov/billtracking/bills261/sumpdf/HB2372T.pdf" }, { "id": "mo-338", "type": "other", "title": "RSMo chapter 338, Pharmacists and pharmacies", "url": "https://revisor.mo.gov/main/OneChapter.aspx?chapter=338" }, { "id": "mo-2220-2-025", "type": "other", "title": "20 CSR 2220-2.025, Nonresident pharmacies", "url": "https://www.law.cornell.edu/regulations/missouri/20-CSR-2220-2-025" }, { "id": "mo-2220-2-200", "type": "other", "title": "20 CSR 2220-2.200, Sterile compounding", "url": "https://www.law.cornell.edu/regulations/missouri/20-CSR-2220-2-200" }, { "id": "mo-2220-2-400", "type": "other", "title": "20 CSR 2220-2.400, Compounding standards of practice", "url": "https://www.law.cornell.edu/regulations/missouri/20-CSR-2220-2-400" }, { "id": "mo-196", "type": "other", "title": "RSMo chapter 196, Food, drugs and tobacco", "url": "https://revisor.mo.gov/main/OneChapter.aspx?chapter=196" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "montana", "name": "Montana", "abbreviation": "MT", "kind": "state", "summary": "Yes. A Montana resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Montana-licensed prescriber, including by telehealth, which Montana defines broadly (MCA 37-2-305) to include audio-only care, and a provider-patient relationship may be established through telemedicine when the standard of care does not require an in-person visit. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Montana Board of Pharmacy; out-of-state mail order pharmacies must register under MCA 37-7-703 and name the pharmacist in charge of Montana dispensing.", "telehealth": { "allowed": true, "notes": "MCA 37-2-305 authorizes health care providers licensed in Montana to provide services through telehealth, defines telehealth as audio, video, or other telecommunications technology (including audio-only communication) delivered over a secure connection, and lets each licensing board adopt telehealth rules for its licensees. Under the Board of Medical Examiners' telemedicine rules, a provider-patient relationship may be established by an in-person examination when the standard of care requires one, by consultation with a provider who has a documented relationship with the patient, or through telemedicine when the standard of care does not require an in-person encounter. The prescriber must hold a Montana license. Montana's definition does not separately address questionnaire-only asynchronous prescribing, so this record leaves it unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "mt-37-2-305" ] }, "compounding": { "board_name": "Montana Board of Pharmacy (Department of Labor and Industry, Business Standards Division)", "board_url": "https://boards.bsd.dli.mt.gov/pharmacy", "follows_fda_503a_bulks": true, "notes": "The Montana Board of Pharmacy licenses pharmacies under MCA Title 37, chapter 7, and adopts rules in ARM Title 24, chapter 174. Part 7 of chapter 7 (MCA 37-7-701 and following) requires every out-of-state mail order pharmacy that ships prescriptions to Montana residents to register with the Board, submit a good-standing certificate from its home-state licensing authority, disclose ownership and officers, and identify the home-state pharmacist in charge of dispensing to Montana (MCA 37-7-703; ARM 24.174.1001 and 24.174.1003). Montana has no state bulks list; peptide eligibility follows the federal 503A framework. Montana's sterile compounding standards are in ARM 24.174.841 (sterile products), in subchapter 8 of the Board's rules (pharmacies), which requires compounding pharmacies to keep policies and procedures that comply with the spirit of USP chapters 795 and 797. The Board has proposed amending that rule and adopting new rules on nonsterile compounding, hazardous drug handling, and outsourcing facilities in MAR Notice No. 2026-131 (public hearing August 14, 2026); this record treats those changes as proposals until the Board adopts them.", "source_ids": [ "mt-board", "mt-37-7-703", "mt-arm-24-174-1001", "mt-arm-24-174-841", "mt-mar-2026-131", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Rural Montana patients often rely on mail order; any pharmacy mailing compounded GLP-1s into Montana must be registered as an out-of-state mail order pharmacy under MCA 37-7-703.", "source_ids": [ "fda-glp1-compounding", "mt-37-7-703" ] }, "research_peptide_sales": { "notes": "The Montana Food, Drug, and Cosmetic Act (MCA Title 50, chapter 31) prohibits selling adulterated or misbranded drugs, and MCA Title 37, chapter 7 restricts dispensing of prescription drugs to licensed pharmacies.", "source_ids": [ "mt-50-31", "mt-board", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Montana through telehealth?", "a": "Yes, from a Montana-licensed prescriber. MCA 37-2-305 authorizes telehealth, including audio-only care, and a relationship may be established through telemedicine when the standard of care does not require an in-person visit. Semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "mt-37-2-305" ] }, { "q": "Does Montana count a phone call as telehealth?", "a": "Yes. Montana's statutory definition of telehealth expressly includes audio-only communication over a secure connection, though the prescriber must still meet the standard of care for the condition being treated.", "source_ids": [ "mt-37-2-305" ] }, { "q": "Can an out-of-state pharmacy mail compounded peptides to me in Montana?", "a": "Only if it is registered with the Montana Board of Pharmacy as an out-of-state mail order pharmacy under MCA 37-7-703, which requires a home-state good-standing certificate and a named pharmacist in charge of Montana dispensing.", "source_ids": [ "mt-37-7-703", "mt-arm-24-174-1001" ] }, { "q": "Can a Montana pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "mt-board", "type": "other", "title": "Montana Board of Pharmacy", "url": "https://boards.bsd.dli.mt.gov/pharmacy" }, { "id": "mt-37-2-305", "type": "other", "title": "MCA 37-2-305, Telehealth services, rulemaking authority", "url": "https://archive.legmt.gov/bills/mca/title_0370/chapter_0020/part_0030/section_0050/0370-0020-0030-0050.html" }, { "id": "mt-37-7-703", "type": "other", "title": "MCA 37-7-703, Out-of-state mail order pharmacy registration requirements", "url": "https://mca.legmt.gov/bills/mca/title_0370/chapter_0070/part_0070/section_0030/0370-0070-0070-0030.html" }, { "id": "mt-arm-24-174-1001", "type": "other", "title": "ARM 24.174.1001, Registration of out-of-state mail service pharmacies", "url": "http://www.mtrules.org/gateway/ruleno.asp?RN=24.174.1001" }, { "id": "mt-arm-24-174-841", "type": "other", "title": "ARM 24.174.841, Sterile products", "url": "https://www.law.cornell.edu/regulations/montana/Mont-Admin-r-24.174.841" }, { "id": "mt-mar-2026-131", "type": "other", "title": "Montana Board of Pharmacy, MAR Notice No. 2026-131, proposed amendment of ARM 24.174.841 and adoption of compounding rules", "url": "https://dli.mt.gov/_docs/rules/2026-131pro-arm.pdf" }, { "id": "mt-50-31", "type": "other", "title": "MCA Title 50, chapter 31, Food, drugs, and cosmetics", "url": "https://mca.legmt.gov/bills/mca/title_0500/chapter_0310/parts_index.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "nebraska", "name": "Nebraska", "abbreviation": "NE", "kind": "state", "summary": "Yes. A Nebraska resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Nebraska-credentialed prescriber, including by telehealth, because Neb. Rev. Stat. section 38-1,143 lets any credential holder providing a telehealth service prescribe a drug they are otherwise authorized to prescribe. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed in Nebraska; the Nebraska Board of Pharmacy works with the Department of Health and Human Services Licensure Unit, which issues pharmacy licenses, including mail service pharmacy licenses for out-of-state pharmacies shipping into Nebraska.", "telehealth": { "allowed": true, "notes": "Neb. Rev. Stat. section 38-1,143, in the Uniform Credentialing Act, provides that a credential holder who is providing a telehealth service to a patient may prescribe the patient a drug if the credential holder is authorized to prescribe under state and federal law, and lets the Department adopt consistent rules. The Nebraska Telehealth Act (Neb. Rev. Stat. sections 71-8501 to 71-8508) sets telehealth consent and coverage rules, mainly for Medicaid. The prescriber must hold a Nebraska credential. Neither statute expressly addresses questionnaire-only asynchronous prescribing, so this record leaves it unconfirmed; the standard of care still applies. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "ne-38-1-143", "ne-telehealth-act" ] }, "compounding": { "board_name": "Nebraska Board of Pharmacy (licensing through the Department of Health and Human Services, Division of Public Health, Licensure Unit)", "board_url": "https://dhhs.ne.gov/licensure/pages/pharmacist.aspx", "follows_fda_503a_bulks": true, "notes": "The Nebraska Board of Pharmacy advises the Department of Health and Human Services, which credentials pharmacists under the Pharmacy Practice Act (Neb. Rev. Stat. sections 38-2801 and following) and licenses pharmacies. Under Neb. Rev. Stat. section 71-2407, part of the Mail Service Pharmacy Licensure Act, any person operating a mail service pharmacy outside Nebraska must obtain a Nebraska mail service pharmacy license before shipping, mailing, or delivering dispensed prescription drugs into the state, must hold a valid pharmacy license in its home state, and must employ full time at least one pharmacist holding a Nebraska license who is responsible for compliance. Compounding standards are set by statute: Neb. Rev. Stat. section 38-2867.01 requires anyone authorized to compound to follow USP chapters 795 and 797 as they existed on January 1, 2023, and bars compounding a drug that is essentially a copy of an approved drug unless the Board determines there is a drug shortage or the patient is allergic to the approved drug, and bars compounding any drug FDA or the Board has identified as one that may not be compounded. Nebraska has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "ne-board", "ne-pharmacy-act", "ne-71-2407", "ne-38-2867-01", "ne-mail-service", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Nebraska patients using telehealth GLP-1 programs should confirm that the shipping pharmacy holds a Nebraska mail service pharmacy license in the DHHS license lookup.", "source_ids": [ "fda-glp1-compounding", "ne-mail-service" ] }, "research_peptide_sales": { "notes": "The Nebraska Pharmacy Practice Act limits dispensing of prescription drugs to licensed pharmacies and practitioners, so sellers of \"research use only\" injectable peptides to Nebraska consumers are not lawful dispensers in the state.", "source_ids": [ "ne-pharmacy-act", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Nebraska through telehealth?", "a": "Yes. Neb. Rev. Stat. section 38-1,143 lets a Nebraska credential holder who is providing telehealth prescribe any drug they are authorized to prescribe, and semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "ne-38-1-143" ] }, { "q": "Who licenses pharmacies in Nebraska?", "a": "The Department of Health and Human Services Licensure Unit issues pharmacist credentials and pharmacy licenses, with the Board of Pharmacy advising on standards and discipline. Use the DHHS license lookup to verify a pharmacy.", "source_ids": [ "ne-board", "ne-pharmacy-act" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Nebraska?", "a": "Only if it holds a Nebraska mail service pharmacy license from DHHS. If the pharmacy does not appear in the Nebraska license lookup, the shipment is not lawful in Nebraska.", "source_ids": [ "ne-71-2407", "ne-mail-service" ] }, { "q": "Can a Nebraska pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ne-board", "type": "other", "title": "Nebraska DHHS Licensure Unit: pharmacist and Board of Pharmacy information", "url": "https://dhhs.ne.gov/licensure/pages/pharmacist.aspx" }, { "id": "ne-38-1-143", "type": "other", "title": "Neb. Rev. Stat. section 38-1,143, Telehealth; prescribing", "url": "https://nebraskalegislature.gov/laws/statutes.php?statute=38-1%2C143" }, { "id": "ne-telehealth-act", "type": "other", "title": "Nebraska Telehealth Act, Neb. Rev. Stat. sections 71-8501 to 71-8508 (DHHS compilation)", "url": "https://dhhs.ne.gov/licensure/Documents/NebraskaTelehealthAct.pdf" }, { "id": "ne-pharmacy-act", "type": "other", "title": "Nebraska statutes relating to the Pharmacy Practice Act (DHHS compilation)", "url": "https://dhhs.ne.gov/licensure/Documents/Pharmacy.pdf" }, { "id": "ne-71-2407", "type": "other", "title": "Neb. Rev. Stat. section 71-2407, Mail service pharmacy license; requirements; fee", "url": "https://nebraskalegislature.gov/laws/statutes.php?statute=71-2407" }, { "id": "ne-38-2867-01", "type": "other", "title": "Neb. Rev. Stat. section 38-2867.01, Authority to compound; standards; labeling; prohibited acts", "url": "https://nebraskalegislature.gov/laws/statutes.php?statute=38-2867.01" }, { "id": "ne-mail-service", "type": "other", "title": "Nebraska DHHS: mail service pharmacy initial license application", "url": "https://dhhs.ne.gov/licensure/Documents/MailServicePharmInitialApp.pdf" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "nevada", "name": "Nevada", "abbreviation": "NV", "kind": "state", "summary": "Yes. A Nevada resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Nevada-licensed prescriber, including by telehealth, which Nevada defines (NRS 629.515) to include synchronous interaction, asynchronous store-and-forward systems, and audio-only interaction. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Nevada State Board of Pharmacy, which licenses both in-state and out-of-state pharmacies that ship prescriptions to Nevada patients under NRS chapter 639.", "telehealth": { "allowed": true, "notes": "NRS 629.515 requires a provider at a distant site who uses telehealth to diagnose, manage care, or write a prescription for a patient in Nevada to hold a valid Nevada license or certificate (including a telemedicine license under NRS 630.261), subjects the provider to Nevada law, jurisdiction, and licensing board regulations wherever the provider is located, and states that the section does not expand scope of practice or authorize care that violates the standard of care. Under NRS 629.515(4), a provider may establish a relationship with a patient using telehealth when it is clinically appropriate to do so, and the State Board of Health may adopt regulations governing that process; the statute itself lists no further conditions such as a required in-person visit. Nevada defines telehealth as delivering services through information and audio-visual communication technology (excluding fax and email), including synchronous interaction, an asynchronous system of storing and forwarding information, and audio-only interaction, whether synchronous or asynchronous. Because the statute expressly includes asynchronous delivery and allows the relationship to be formed by telehealth, this record treats asynchronous prescribing as allowed when the standard of care is met. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": true, "source_ids": [ "nv-629-515" ] }, "compounding": { "board_name": "Nevada State Board of Pharmacy", "board_url": "https://bop.nv.gov/", "follows_fda_503a_bulks": true, "notes": "The Nevada State Board of Pharmacy licenses pharmacists, pharmacies, and out-of-state pharmacies under NRS chapter 639 and adopts rules in NAC chapter 639. NRS 639.2328 provides that every pharmacy located outside Nevada that dispenses prescriptions to patients located in Nevada must be licensed by the Board, and to be licensed it must hold a pharmacy license in its home state, comply with applicable federal law, and name a responsible pharmacist. The Board's compounding rules are in NAC 639.661 to 639.690 (compounding and dispensing drug products): NAC 639.670 adopts the 2023 United States Pharmacopeia and National Formulary by reference, and NAC 639.67053 requires every pharmacist and technician who compounds sterile products to comply with USP chapter 797. Nevada has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nv-board", "nv-639-2328", "nv-nac-639-67053", "nv-nac-639", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Nevada's broad telehealth definition makes app-based GLP-1 programs lawful on the prescribing side if the prescriber holds a Nevada license, and the dispensing pharmacy must be licensed by the Nevada State Board of Pharmacy.", "source_ids": [ "fda-glp1-compounding", "nv-629-515", "nv-board" ] }, "research_peptide_sales": { "notes": "Nevada's food and drug law (NRS chapter 585) prohibits selling adulterated or misbranded drugs, and NRS chapter 639 restricts dispensing of prescription drugs to licensed pharmacies and practitioners.", "source_ids": [ "nv-nrs-585", "nv-nrs-639", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including from a Nevada-licensed telehealth prescriber using synchronous or asynchronous telehealth under NRS 629.515. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "nv-629-515" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Nevada through an asynchronous telehealth app?", "a": "Nevada's definition of telehealth includes asynchronous store-and-forward and audio-only interaction, and a provider-patient relationship can be established through telehealth, so app-based care is allowed if the prescriber holds a Nevada license and meets the standard of care.", "source_ids": [ "nv-629-515" ] }, { "q": "Does a telehealth prescriber need a Nevada license?", "a": "Yes. NRS 629.515 requires a valid Nevada license or certificate to provide telehealth services to a patient located in Nevada, subject to narrow exceptions.", "source_ids": [ "nv-629-515" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Nevada?", "a": "Only if it is licensed by the Nevada State Board of Pharmacy. Search the Board's license verification before ordering.", "source_ids": [ "nv-board", "nv-639-2328" ] }, { "q": "Can a Nevada pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nv-board", "type": "other", "title": "Nevada State Board of Pharmacy", "url": "https://bop.nv.gov/" }, { "id": "nv-629-515", "type": "other", "title": "NRS 629.515, Telehealth: license required; establishment of relationship with patient", "url": "https://www.leg.state.nv.us/NRS/NRS-629.html#NRS629Sec515" }, { "id": "nv-nrs-639", "type": "other", "title": "NRS chapter 639, Pharmacy", "url": "https://www.leg.state.nv.us/NRS/NRS-639.html" }, { "id": "nv-639-2328", "type": "other", "title": "NRS 639.2328, Pharmacy located outside Nevada that dispenses prescriptions to patients located in Nevada: licensing", "url": "https://www.leg.state.nv.us/NRS/NRS-639.html#NRS639Sec2328" }, { "id": "nv-nac-639-67053", "type": "other", "title": "NAC 639.67053, Compounding standards (sterile compounded drug products, USP chapter 797)", "url": "https://www.leg.state.nv.us/NAC/NAC-639.html#NAC639Sec67053" }, { "id": "nv-nac-639", "type": "other", "title": "NAC chapter 639, Pharmacy", "url": "https://www.leg.state.nv.us/NAC/NAC-639.html" }, { "id": "nv-nrs-585", "type": "other", "title": "NRS chapter 585, Food, drugs and cosmetics", "url": "https://www.leg.state.nv.us/NRS/NRS-585.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "new-hampshire", "name": "New Hampshire", "abbreviation": "NH", "kind": "state", "summary": "Yes. A New Hampshire resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a New Hampshire-licensed prescriber, including by telemedicine; RSA 329:1-d treats an out-of-state physician treating a New Hampshire patient by telemedicine as practicing medicine in New Hampshire, so a New Hampshire license is required. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy permitted by the New Hampshire Board of Pharmacy, part of the Office of Professional Licensure and Certification; out-of-state pharmacies need a New Hampshire mail-order (nonresident) pharmacy registration under RSA 318:37.", "telehealth": { "allowed": true, "notes": "RSA 329:1-d provides that an out-of-state physician providing services to a New Hampshire patient by telemedicine is practicing medicine and must be licensed under chapter 329, limits telemedicine prescribing authority to New Hampshire-licensed physicians and physician assistants, and requires all prescribing to comply with state and federal law. For Schedule II through IV controlled drugs, the statute requires a physician-patient relationship and periodic in-person exams, but those rules do not apply to the non-controlled peptides in this database. The statute does not expressly address questionnaire-only asynchronous prescribing, so this record leaves it unconfirmed; the Board of Medicine's standard of care applies.", "async_prescribing_allowed": null, "source_ids": [ "nh-329-1-d" ] }, "compounding": { "board_name": "New Hampshire Board of Pharmacy (Office of Professional Licensure and Certification)", "board_url": "https://www.oplc.nh.gov/board-pharmacy", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy regulates pharmacists and pharmacies under RSA chapter 318 and adopts the Ph 100 through Ph 2600 rules. Part Ph 404 (Standards for compounding and dispensing sterile and non-sterile pharmaceuticals) applies to all non-sterile and sterile compounding, and Ph 404.01(b) requires every compounder to comply with the current edition of the United States Pharmacopeia, including USP chapters 795 and 797. RSA 318:37 and the surrounding mail-order pharmacy provisions require an out-of-state pharmacy that ships prescriptions to New Hampshire residents to register with the Board, and let the Board seek disciplinary records from the pharmacy's home state. New Hampshire has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nh-board", "nh-318", "nh-318-37", "nh-rules", "nh-ph-404", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "A telehealth GLP-1 program serving New Hampshire needs a New Hampshire-licensed prescriber under RSA 329:1-d and a pharmacy with a New Hampshire mail-order registration.", "source_ids": [ "fda-glp1-compounding", "nh-329-1-d", "nh-318-37" ] }, "research_peptide_sales": { "notes": "RSA chapter 318 limits dispensing of prescription drugs to permitted pharmacies and licensed practitioners, so sellers of \"research use only\" injectable peptides to New Hampshire consumers are not lawful dispensers in the state.", "source_ids": [ "nh-318", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription from a New Hampshire-licensed prescriber, including by telemedicine under RSA 329:1-d. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "nh-329-1-d" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in New Hampshire through telemedicine?", "a": "Yes, from a New Hampshire-licensed physician or physician assistant. RSA 329:1-d limits telemedicine prescribing authority to New Hampshire licensees. Semaglutide and tirzepatide are not controlled substances, so the in-person exam rules for controlled drugs do not apply.", "source_ids": [ "nh-329-1-d" ] }, { "q": "Can an out-of-state doctor treat me in New Hampshire by telemedicine?", "a": "Only with a New Hampshire license. RSA 329:1-d treats an out-of-state physician providing telemedicine to a New Hampshire patient as practicing medicine in the state, apart from narrow physician-to-physician consultation.", "source_ids": [ "nh-329-1-d" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in New Hampshire?", "a": "Only if it is registered with the New Hampshire Board of Pharmacy as a mail-order pharmacy under RSA 318:37 and the related provisions. Check the OPLC license lookup before ordering.", "source_ids": [ "nh-318-37", "nh-board" ] }, { "q": "Can a New Hampshire pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nh-board", "type": "other", "title": "New Hampshire Board of Pharmacy (OPLC)", "url": "https://www.oplc.nh.gov/board-pharmacy" }, { "id": "nh-329-1-d", "type": "other", "title": "New Hampshire RSA 329:1-d, Telemedicine", "url": "https://gc.nh.gov/rsa/html/XXX/329/329-1-d.htm" }, { "id": "nh-318", "type": "other", "title": "New Hampshire RSA chapter 318, Pharmacists and pharmacies", "url": "https://gc.nh.gov/rsa/html/xxx/318/318-mrg.htm" }, { "id": "nh-318-37", "type": "other", "title": "New Hampshire RSA 318:37, Mail-order pharmacies: registration required; compliance", "url": "https://law.justia.com/codes/new-hampshire/2023/title-xxx/chapter-318/section-318-37/" }, { "id": "nh-rules", "type": "other", "title": "New Hampshire Board of Pharmacy laws and rules (Ph 100 to Ph 2600)", "url": "https://www.oplc.nh.gov/board-pharmacy-laws-and-rules" }, { "id": "nh-ph-404", "type": "other", "title": "N.H. Code Admin. R. Ph 404, Standards for compounding and dispensing sterile and non-sterile pharmaceuticals (in Ph 100 to Ph 2600)", "url": "https://www.gc.nh.gov/rules/state_agencies/ph100-2600.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "new-jersey", "name": "New Jersey", "abbreviation": "NJ", "kind": "state", "summary": "Yes. A New Jersey resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a New Jersey-licensed prescriber, including through telemedicine under the Telemedicine and Telehealth Act (P.L.2017, c.117, N.J.S.A. 45:1-61 and following). A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy the New Jersey State Board of Pharmacy permits or registers. The Board has also taken an explicit position on GLP-1s: its 2023 statement on semaglutide compounding says no salt form of semaglutide may be used and requires pharmaceutical-grade semaglutide base from an FDA-registered source with a valid certificate of analysis.", "telehealth": { "allowed": true, "notes": "N.J.S.A. 45:1-61 through 45:1-66 (P.L.2017, c.117) let a New Jersey-licensed health care provider establish a provider-patient relationship and treat through telemedicine, held to the in-person standard of care. Section 2(c) of P.L.2017, c.117 (N.J.S.A. 45:1-62) says telemedicine services shall be provided using interactive, real-time, two-way communication technologies. Asynchronous store-and-forward technology may be used to transmit images, diagnostics, data, and medical information, and real-time two-way audio without video may be combined with store-and-forward only if, after reviewing the patient's medical records, the provider determines the in-person standard of care can be met. For an initial encounter the provider must review the patient's medical history and records before contact. The Board of Medical Examiners' rule N.J.A.C. 13:35-6B.5 adds that physician telemedicine must include a video component unless that audio exception applies. Because both the statute and the rule require a real-time interaction, this record treats questionnaire-only asynchronous prescribing as not allowed. Schedule II prescribing by telemedicine requires an initial in-person exam and in-person visits every three months, but that rule does not apply to the non-controlled peptides in this database.", "async_prescribing_allowed": false, "source_ids": [ "nj-45-1-61", "nj-45-1-62", "nj-pl-2017-c117", "nj-13-35-6b-5" ] }, "compounding": { "board_name": "New Jersey State Board of Pharmacy (Division of Consumer Affairs)", "board_url": "https://www.njconsumeraffairs.gov/phar/", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy regulates pharmacy under the Pharmacy Practice Act of 2003 (N.J.S.A. 45:14-40 and following) and N.J.A.C. 13:39, including subchapter 11 on compounding sterile preparations. N.J.S.A. 45:14-73 requires any pharmacy located in another state that ships, mails, distributes, or delivers prescription legend drugs into New Jersey to register with the Board, submit its most recent home-state inspection report, and provide a toll-free line to a pharmacist with access to patient records; N.J.A.C. 13:39-4.20 implements the registration. Board rule N.J.A.C. 13:39-11.25 bars compounding a commercially available drug product unless the prescriber determines the change produces a significant difference for the patient. In its statement on semaglutide compounding (the version posted on the Board's site is dated November 6, 2023), the Board said that no salt form of semaglutide may be used in a compounded drug, and that a pharmacy using semaglutide base must ensure it is pharmaceutical grade, accompanied by a valid certificate of analysis, and sourced from an FDA-registered establishment. New Jersey has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nj-board", "nj-pharmacy-act", "nj-45-14-73", "nj-13-39-4-20", "nj-semaglutide-statement", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to the federal exception for documented patient specific needs because the FDA shortage allowances ended in 2025, and the Board's 2023 statement independently bars semaglutide salt forms and requires documented, FDA-registered sourcing of semaglutide base.", "source_ids": [ "fda-glp1-compounding", "nj-semaglutide-statement" ] }, "research_peptide_sales": { "notes": "New Jersey's food and drug law (N.J.S.A. Title 24) prohibits selling adulterated or misbranded drugs, and the Pharmacy Practice Act limits dispensing to licensed pharmacies. The Board's semaglutide statement also warns pharmacies against non-pharmaceutical-grade ingredients.", "source_ids": [ "nj-title-24", "nj-semaglutide-statement", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telemedicine under N.J.S.A. 45:1-61 and following. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025, and the New Jersey Board of Pharmacy bars any salt form of semaglutide in compounding.", "source_ids": [ "fda-glp1-compounding", "nj-semaglutide-statement" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. New Jersey pharmacies apply the federal eligibility test and the Board's sourcing expectations for pharmaceutical-grade ingredients.", "source_ids": [ "fda-category-2", "fda-pcac", "nj-semaglutide-statement" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in New Jersey through telemedicine?", "a": "Yes, from a New Jersey-licensed provider. The Telemedicine and Telehealth Act lets providers establish a relationship and prescribe through telemedicine under the in-person standard of care, and semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "nj-45-1-61", "nj-45-1-62" ] }, { "q": "Does New Jersey allow asynchronous or store-and-forward telemedicine?", "a": "Only as part of a real-time visit. N.J.S.A. 45:1-62 requires telemedicine to use interactive, real-time, two-way communication; store-and-forward may be used to send images, data, and records, and may be paired with real-time audio when the provider finds the in-person standard of care can be met. The Board of Medical Examiners' rule requires video for physician telemedicine unless that audio exception applies, so a questionnaire-only visit does not meet New Jersey's requirements.", "source_ids": [ "nj-45-1-62", "nj-pl-2017-c117", "nj-13-35-6b-5" ] }, { "q": "What did the New Jersey Board of Pharmacy say about compounded semaglutide?", "a": "In a 2023 statement (the version on the Board's site is dated November 6, 2023) the Board said that no salt form of semaglutide may be used in compounding, and that semaglutide base must be pharmaceutical grade, carry a valid certificate of analysis, and come from an FDA-registered establishment.", "source_ids": [ "nj-semaglutide-statement" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in New Jersey?", "a": "Only in limited, patient specific cases. The federal shortage allowances ended in 2025, and New Jersey also bars semaglutide salt forms, so routine compounded GLP-1 programs are not lawful.", "source_ids": [ "fda-glp1-compounding", "nj-semaglutide-statement" ] }, { "q": "Can a New Jersey pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nj-board", "type": "other", "title": "New Jersey State Board of Pharmacy (Division of Consumer Affairs)", "url": "https://www.njconsumeraffairs.gov/phar/" }, { "id": "nj-45-1-61", "type": "other", "title": "N.J.S.A. 45:1-61, Definitions relative to telemedicine and telehealth", "url": "https://law.justia.com/codes/new-jersey/2017/title-45/section-45-1-61/" }, { "id": "nj-45-1-62", "type": "other", "title": "N.J.S.A. 45:1-62, Provision of health care through telemedicine or telehealth; requirements", "url": "https://law.justia.com/codes/new-jersey/2017/title-45/section-45-1-62/" }, { "id": "nj-pl-2017-c117", "type": "other", "title": "New Jersey P.L.2017, c.117 (S291), Telemedicine and Telehealth Act", "url": "https://pub.njleg.gov/bills/2016/PL17/117_.HTM" }, { "id": "nj-pharmacy-act", "type": "other", "title": "New Jersey Pharmacy Practice Act, N.J.S.A. 45:14-40 and following, and N.J.A.C. 13:39 (Board laws and regulations)", "url": "https://www.njconsumeraffairs.gov/phar/Pages/regulations.aspx" }, { "id": "nj-45-14-73", "type": "other", "title": "N.J.S.A. 45:14-73, Registration of out-of-State pharmacies; requirements", "url": "https://law.justia.com/codes/new-jersey/title-45/section-45-14-73/" }, { "id": "nj-13-39-4-20", "type": "other", "title": "N.J.A.C. 13:39-4.20, Out-of-State pharmacy registration", "url": "https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-13-39-4-20" }, { "id": "nj-13-35-6b-5", "type": "other", "title": "N.J.A.C. 13:35-6B.5, Provision of health care services through telemedicine or telehealth (Board of Medical Examiners)", "url": "https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-13-35-6B-5" }, { "id": "nj-semaglutide-statement", "type": "other", "title": "New Jersey State Board of Pharmacy: Statement concerning semaglutide compounding (posted version dated November 6, 2023)", "url": "https://www.njconsumeraffairs.gov/phar/Documents/Semaglutide-Compounding-Statement-04282023.pdf" }, { "id": "nj-title-24", "type": "other", "title": "N.J.S.A. Title 24, Food and drugs", "url": "https://law.justia.com/codes/new-jersey/title-24/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "new-mexico", "name": "New Mexico", "abbreviation": "NM", "kind": "state", "summary": "Yes. A New Mexico resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a New Mexico-licensed prescriber, including by telehealth, which the New Mexico Telehealth Act (NMSA 1978, sections 24-25-1 to 24-25-7) defines to include interactive audio and video and store-and-forward technology. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the New Mexico Board of Pharmacy; out-of-state pharmacies need a New Mexico nonresident pharmacy license, and nonresident pharmacies that ship sterile compounded preparations such as injectable peptides apply under a separate nonresident sterile application tied to the Board's sterile compounding rule, 16.19.36 NMAC.", "telehealth": { "allowed": true, "notes": "The New Mexico Telehealth Act defines telehealth as the use of electronic information, imaging, and communication technologies, including interactive audio, video, and data communications as well as store-and-forward technologies, to deliver and support health care. The Act does not expand any provider's scope of practice or authorize care in a manner not otherwise allowed by law, so prescribing standards come from each licensing board; the prescriber must hold a New Mexico license. Because the Act recognizes store-and-forward delivery but defers to board rules for prescribing, this record leaves questionnaire-only asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "nm-telehealth-act", "nm-24-25-3" ] }, "compounding": { "board_name": "New Mexico Board of Pharmacy (Regulation and Licensing Department)", "board_url": "https://www.rld.nm.gov/boards-and-commissions/individual-boards-and-commissions/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The New Mexico Board of Pharmacy regulates pharmacy under the Pharmacy Act (NMSA 1978, sections 61-11-1 and following) and Title 16, Chapter 19 of the New Mexico Administrative Code. 16.19.36 NMAC governs compounded sterile preparations: it requires facilities, environmental monitoring, and written procedures consistent with USP chapter 797, sets minimum dedicated compounding space, and requires training of everyone who performs or oversees sterile compounding. The Board inspects sterile compounders by risk category and uses a separate nonresident sterile pharmacy application for out-of-state pharmacies that ship sterile preparations into New Mexico. Under the Pharmacy Act, NMSA 1978 section 61-11-2 defines a nonresident pharmacy as any pharmacy located outside New Mexico that ships, mails, or delivers drugs into New Mexico, and section 61-11-14 requires anyone who engages in an activity in the state requiring Board licensure to obtain the proper license, listing nonresident pharmacy as a license class. New Mexico has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nm-board", "nm-61-11-2", "nm-61-11-14", "nm-16-19-36", "nm-nonresident-sterile", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because compounded GLP-1 injections are sterile preparations, an out-of-state pharmacy shipping them into New Mexico must hold the Board's nonresident sterile licensure and meet 16.19.36 NMAC standards.", "source_ids": [ "fda-glp1-compounding", "nm-16-19-36", "nm-nonresident-sterile" ] }, "research_peptide_sales": { "notes": "The New Mexico Drug, Device and Cosmetic Act (NMSA 1978, sections 26-1-1 and following) prohibits selling adulterated or misbranded drugs and limits dispensing of dangerous drugs to licensed practitioners and pharmacies.", "source_ids": [ "nm-26-1", "usc-331" ] }, "peptide_notes": [ { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to the federal patient specific exception since February 18, 2025, and any compounded injection must be prepared under 16.19.36 NMAC or an equivalent nonresident sterile license.", "source_ids": [ "fda-glp1-compounding", "nm-16-19-36" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in New Mexico through telehealth?", "a": "Yes, from a New Mexico-licensed prescriber. The New Mexico Telehealth Act recognizes audio, video, and store-and-forward telehealth, and semaglutide and tirzepatide are not controlled substances. The prescriber's licensing board sets the prescribing standard.", "source_ids": [ "nm-telehealth-act", "nm-24-25-3" ] }, { "q": "Does the New Mexico Telehealth Act let out-of-state providers treat me without a New Mexico license?", "a": "No. The Act states that it does not alter any provider's scope of practice or authorize care in a way not otherwise allowed by law, so the provider still needs New Mexico licensure.", "source_ids": [ "nm-telehealth-act" ] }, { "q": "Can an out-of-state pharmacy ship compounded injectable peptides to me in New Mexico?", "a": "Only if it holds New Mexico nonresident licensure, and for sterile preparations such as injectable peptides the Board uses a separate nonresident sterile application. Check the Board's license lookup before ordering.", "source_ids": [ "nm-61-11-14", "nm-nonresident-sterile", "nm-board" ] }, { "q": "Can a New Mexico pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nm-board", "type": "other", "title": "New Mexico Board of Pharmacy (Regulation and Licensing Department)", "url": "https://www.rld.nm.gov/boards-and-commissions/individual-boards-and-commissions/pharmacy/" }, { "id": "nm-61-11-2", "type": "other", "title": "NMSA 1978, section 61-11-2, Pharmacy Act definitions (nonresident pharmacy)", "url": "https://law.justia.com/codes/new-mexico/chapter-61/article-11/section-61-11-2/" }, { "id": "nm-61-11-14", "type": "other", "title": "NMSA 1978, section 61-11-14, Pharmacy licensure; classes of licenses; requirements; fees; revocation", "url": "https://law.justia.com/codes/new-mexico/chapter-61/article-11/section-61-11-14/" }, { "id": "nm-telehealth-act", "type": "other", "title": "New Mexico Telehealth Act, NMSA 1978, Chapter 24, Article 25", "url": "https://law.justia.com/codes/new-mexico/chapter-24/article-25/" }, { "id": "nm-24-25-3", "type": "other", "title": "NMSA 1978, section 24-25-3, Telehealth Act definitions", "url": "https://law.justia.com/codes/new-mexico/chapter-24/article-25/section-24-25-3/" }, { "id": "nm-16-19-36", "type": "other", "title": "16.19.36 NMAC, Compounded sterile preparations", "url": "https://www.srca.nm.gov/parts/title16/16.019.0036.html" }, { "id": "nm-nonresident-sterile", "type": "other", "title": "New Mexico Board of Pharmacy: nonresident sterile pharmacy application (2022)", "url": "https://www.rld.nm.gov/wp-content/uploads/2022/11/Non-resident-STERILE-pharmacy-application-2022.pdf" }, { "id": "nm-26-1", "type": "other", "title": "New Mexico Drug, Device and Cosmetic Act, NMSA 1978, Chapter 26, Article 1", "url": "https://law.justia.com/codes/new-mexico/chapter-26/article-1/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "new-york", "name": "New York", "abbreviation": "NY", "kind": "state", "summary": "Yes. A New York resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a New York-licensed prescriber, including by telehealth under Public Health Law Article 29-G, which covers telemedicine, store-and-forward technology, remote patient monitoring, and audio-only calls. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy registered by the New York State Education Department on the advice of the State Board of Pharmacy; any pharmacy or outsourcing facility outside New York that ships prescription drugs to New York patients must register as a nonresident establishment under Education Law section 6808-b.", "telehealth": { "allowed": true, "notes": "Public Health Law Article 29-G (sections 2999-cc and following) limits telehealth to telemedicine, store-and-forward technology, remote patient monitoring, and audio-only telephone communication, and defines store-and-forward as the asynchronous transmission of patient-specific digital images or pre-recorded videos from an originating site to a telehealth provider at a distant site. Providers must hold a New York license and are held to the professional standards of Education Law Title VIII. Because New York's store-and-forward definition is limited to images and videos and does not describe questionnaire-based prescribing, this record leaves asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "ny-phl-29-g", "ny-2999-cc" ] }, "compounding": { "board_name": "New York State Board of Pharmacy (State Education Department, Office of the Professions)", "board_url": "https://www.op.nysed.gov/professions/pharmacy", "follows_fda_503a_bulks": true, "notes": "In New York, the State Education Department registers pharmacies and licenses pharmacists under Education Law Article 137 (sections 6800 and following), with the State Board of Pharmacy advising on standards and discipline, and Commissioner's regulations in 8 NYCRR Part 63 set practice rules. Education Law section 6808-b requires every nonresident establishment (a pharmacy, manufacturer, wholesaler, or outsourcing facility outside New York, including internet pharmacies) that ships, mails, or delivers prescription drugs to New York patients to register with the Department, be licensed and in good standing in its home state, and keep retrievable records of drugs shipped into New York; 8 NYCRR 63.8 implements that requirement. On sterile compounding standards, 8 NYCRR Part 63 does not adopt USP chapters 795 or 797 by number. Instead, the Regents rule 8 NYCRR 29.2 makes it unprofessional conduct for a health professional to fail to adhere to applicable practice guidelines, as determined by the Commissioner, for compounding sterile drugs and products, and 8 NYCRR 63.7 requires pharmacists to complete at least three hours of compounding continuing education, consistent with current compounding standards, in each registration period beginning on or after January 1, 2023. New York has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "ny-board", "ny-6808-b", "ny-63-8", "ny-part-63", "ny-29-2", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "A telehealth GLP-1 program shipping into New York must use a pharmacy registered as a nonresident establishment under Education Law section 6808-b, which patients can verify on the Office of the Professions license lookup.", "source_ids": [ "fda-glp1-compounding", "ny-6808-b" ] }, "research_peptide_sales": { "notes": "Education Law Article 137 limits dispensing of prescription drugs to registered pharmacies and licensed practitioners, and section 6808-b requires registration of any out-of-state establishment shipping prescription drugs into New York, including internet sellers.", "source_ids": [ "ny-6808-b", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including from a New York-licensed telehealth provider under Public Health Law Article 29-G. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "ny-phl-29-g" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to the federal patient specific exception since February 18, 2025, and an out-of-state pharmacy must be registered under Education Law section 6808-b to ship it into New York.", "source_ids": [ "fda-glp1-compounding", "ny-6808-b" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in New York through telehealth?", "a": "Yes, from a New York-licensed provider. Public Health Law Article 29-G recognizes telemedicine, store-and-forward, remote monitoring, and audio-only calls, and semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "ny-phl-29-g" ] }, { "q": "Does New York's store-and-forward telehealth cover online questionnaires?", "a": "Not by its terms. New York defines store-and-forward as the asynchronous transmission of patient-specific digital images or pre-recorded videos, so questionnaire-only prescribing depends on professional standards rather than an express telehealth rule.", "source_ids": [ "ny-2999-cc" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in New York?", "a": "Only if it is registered with the State Education Department as a nonresident establishment under Education Law section 6808-b. Check the Office of the Professions registration lookup before ordering.", "source_ids": [ "ny-6808-b", "ny-63-8" ] }, { "q": "Can a New York pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ny-board", "type": "other", "title": "New York State Education Department, Office of the Professions: Pharmacy", "url": "https://www.op.nysed.gov/professions/pharmacy" }, { "id": "ny-phl-29-g", "type": "other", "title": "New York Public Health Law Article 29-G, Telehealth delivery of services", "url": "https://www.nysenate.gov/legislation/laws/PBH/A29-G" }, { "id": "ny-2999-cc", "type": "other", "title": "New York Public Health Law section 2999-cc, Telehealth definitions", "url": "https://www.nysenate.gov/legislation/laws/PBH/2999-CC" }, { "id": "ny-6808-b", "type": "other", "title": "New York Education Law section 6808-b, Registration of nonresident establishments", "url": "https://www.nysenate.gov/legislation/laws/EDN/6808-B" }, { "id": "ny-63-8", "type": "other", "title": "8 NYCRR 63.8, Registration of nonresident establishments", "url": "https://www.law.cornell.edu/regulations/new-york/8-NYCRR-63.8" }, { "id": "ny-part-63", "type": "other", "title": "8 NYCRR Part 63, Pharmacy (Regulations of the Commissioner of Education, including 63.7 continuing education)", "url": "https://www.op.nysed.gov/title8/regulations-commissioner-education/part-63" }, { "id": "ny-29-2", "type": "other", "title": "8 NYCRR Part 29, Unprofessional conduct (section 29.2, general provisions for health professions)", "url": "https://www.op.nysed.gov/title8/rules-board-regents/part-29" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "north-carolina", "name": "North Carolina", "abbreviation": "NC", "kind": "state", "summary": "Yes. A North Carolina resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a North Carolina-licensed prescriber, including by telemedicine; North Carolina has no general telehealth practice statute, and the North Carolina Medical Board's telemedicine position statement allows evaluation without an in-person visit when the technology is sufficient to meet the standard of care. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy permitted by the North Carolina Board of Pharmacy; out-of-state pharmacies must register annually under G.S. 90-85.21A. The Board's pharmacy FAQ says compounding copies of approved tirzepatide products is no longer allowed and that FDA's grace period for 503A copies of semaglutide ended April 22, 2025.", "telehealth": { "allowed": true, "notes": "North Carolina regulates telemedicine prescribing mainly through North Carolina Medical Board Position Statement 5.1.4 (Telemedicine) rather than a practice statute. The Board's position is that an evaluation need not be in person if the licensee uses technology sufficient to accurately diagnose and treat the patient in conformity with the standard of care, that licensees prescribing by telemedicine must follow state and federal law, and that some circumstances, such as treating chronic pain with controlled substances, are not suitable for telemedicine-only care. The prescriber must hold a North Carolina license. The position statement does not approve questionnaire-only prescribing, so this record leaves asynchronous prescribing unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "nc-ncmb-telemedicine" ] }, "compounding": { "board_name": "North Carolina Board of Pharmacy", "board_url": "https://www.ncbop.org/", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy issues pharmacy permits under the North Carolina Pharmacy Practice Act (G.S. Chapter 90, Article 4A) and adopts rules in 21 NCAC 46, including the compounding rule in Section .2800. Under G.S. 90-85.21A, any pharmacy outside North Carolina that ships, mails, or delivers dispensed legend drugs into the state must register with the Board every year, and the Board may deny registration to a pharmacy disciplined in its home state for compounding or dispensing violations that threaten public health. The Board's July 2023 newsletter (Vol. 45, No. 1, Item 2465, \"Statement Concerning Semaglutide Compounding\") announced a Board staff guidance document on when federal law permits compounding a copy of a commercially available drug and how that applies to semaglutide; the Board's general pharmacy FAQ says the statement was updated after FDA's April 2023 clarification of semaglutide's shortage status, but the linked statement itself could not be retrieved from the Board's site when this record was checked, so its specific terms are not summarized here. The same FAQ now says FDA found semaglutide injection shortages resolved and would not act against state-licensed 503A pharmacies only until April 22, 2025, and that compounding copies of approved tirzepatide products is no longer allowed. North Carolina has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nc-board", "nc-90-85-21a", "nc-article-4a", "nc-bop-newsletter-2023", "nc-bop-faq", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Any out-of-state pharmacy shipping compounded GLP-1s in must hold an annual G.S. 90-85.21A registration.", "source_ids": [ "fda-glp1-compounding", "nc-bop-newsletter-2023", "nc-90-85-21a" ] }, "research_peptide_sales": { "notes": "The North Carolina Food, Drug, and Cosmetic Act (G.S. 106-120 and following) prohibits selling adulterated or misbranded drugs, and the Pharmacy Practice Act restricts dispensing of legend drugs to permitted pharmacies.", "source_ids": [ "nc-106-120", "nc-article-4a", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telemedicine from a North Carolina-licensed prescriber. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025, the date the North Carolina Board of Pharmacy's FAQ gives for the end of FDA's grace period for 503A pharmacies.", "source_ids": [ "fda-glp1-compounding", "nc-bop-faq" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in North Carolina through telemedicine?", "a": "Yes, from a North Carolina-licensed prescriber. The North Carolina Medical Board's telemedicine position says an evaluation need not be in person if the technology is sufficient to diagnose and treat under the standard of care, and semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "nc-ncmb-telemedicine" ] }, { "q": "Does North Carolina have a telehealth statute?", "a": "Not a general practice statute. North Carolina relies on the Medical Board's telemedicine position statement and general licensing law, so the standard of care governs what evaluation is needed before prescribing.", "source_ids": [ "nc-ncmb-telemedicine" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in North Carolina?", "a": "Only if it registers annually with the North Carolina Board of Pharmacy under G.S. 90-85.21A. The Board can refuse registration to pharmacies disciplined at home for compounding violations.", "source_ids": [ "nc-90-85-21a", "nc-board" ] }, { "q": "What has the North Carolina Board of Pharmacy said about compounded semaglutide?", "a": "In 2023 Board staff issued a guidance statement on if, when, and how semaglutide may be compounded, announced in the Board's July 2023 newsletter. The Board's current FAQ says FDA found semaglutide injection shortages resolved and stopped extending enforcement discretion to 503A pharmacies after April 22, 2025, and that compounding copies of approved tirzepatide products is no longer allowed.", "source_ids": [ "nc-bop-newsletter-2023", "nc-bop-faq" ] }, { "q": "Can a North Carolina pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nc-board", "type": "other", "title": "North Carolina Board of Pharmacy", "url": "https://www.ncbop.org/" }, { "id": "nc-ncmb-telemedicine", "type": "other", "title": "North Carolina Medical Board Position Statement 5.1.4, Telemedicine", "url": "https://www.ncmedboard.org/resources-information/professional-resources/laws-rules-position-statements/position-statements/telemedicine" }, { "id": "nc-90-85-21a", "type": "other", "title": "N.C. G.S. 90-85.21A, Pharmacies outside North Carolina (nonresident registration)", "url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_90/GS_90-85.21A.html" }, { "id": "nc-article-4a", "type": "other", "title": "N.C. G.S. Chapter 90, Article 4A, North Carolina Pharmacy Practice Act", "url": "https://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_4A.html" }, { "id": "nc-bop-newsletter-2023", "type": "other", "title": "North Carolina Board of Pharmacy newsletter, July 2023 (semaglutide compounding)", "url": "https://www.ncbop.org/downloads/July2023.pdf" }, { "id": "nc-bop-faq", "type": "other", "title": "North Carolina Board of Pharmacy: General pharmacy FAQs (compounding GLP-1s and semaglutide)", "url": "https://www.ncbop.org/faqs/general-pharmacy-faqs.html" }, { "id": "nc-106-120", "type": "other", "title": "N.C. G.S. Chapter 106, Article 12, Food, Drug, and Cosmetic Act", "url": "https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_106/Article_12.html" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "north-dakota", "name": "North Dakota", "abbreviation": "ND", "kind": "state", "summary": "Yes. A North Dakota resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a North Dakota-licensed prescriber, including by telemedicine under NDCC 43-17-44, which requires a bona fide relationship, identity verification, and the same standard of care as in-person practice. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy holding a North Dakota State Board of Pharmacy permit. North Dakota is unusual in two ways: every out-of-state pharmacy shipping prescriptions into the state must hold a full North Dakota pharmacy permit, and in-state pharmacies must be majority owned by pharmacists under NDCC 43-15-35.", "telehealth": { "allowed": true, "notes": "NDCC 43-17-44 requires a physician or physician assistant practicing telemedicine to establish a bona fide relationship with the patient before diagnosis or treatment, verify the patient's identity, disclose their own identity and licensure, and meet the same standard of care and ethics as in-person practice. The Board of Medicine's telemedicine rules in NDAC chapter 50-02-15 implement the statute, and prescribing controlled substances over the internet requires a valid prescription. The prescriber must hold a North Dakota license. Neither source confirmed for this draft addresses whether a questionnaire-only asynchronous encounter can create the bona fide relationship, so asynchronous prescribing is left unconfirmed. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "nd-43-17-44", "nd-50-02-15" ] }, "compounding": { "board_name": "North Dakota State Board of Pharmacy", "board_url": "https://www.nodakpharmacy.com/", "follows_fda_503a_bulks": true, "notes": "The North Dakota State Board of Pharmacy licenses pharmacists and permits pharmacies under NDCC chapter 43-15 and adopts rules in NDAC Title 61. Under NDAC chapter 61-08-01, any pharmacy that ships, mails, or delivers prescription drugs into North Dakota must obtain and hold a North Dakota pharmacy permit and follow North Dakota law for the part of its operation that dispenses to North Dakota residents; permits are renewed each year by July 1. NDCC 43-15-35 requires in-state pharmacies to be majority owned by North Dakota-licensed pharmacists, a rule upheld by the U.S. Supreme Court in North Dakota State Board of Pharmacy v. Snyder's Drug Stores (1973). Compounding standards are in NDAC chapter 61-02-01 (pharmacy permits): section 61-02-01-03 requires nonsterile compounding to meet USP chapter 795 and sterile preparations to be compounded, and sterile compounding facilities and equipment to conform, according to USP chapter 797, with hazardous drugs handled under USP chapter 800, and the chapter issues a separate Class C permit to pharmacies that dispense sterile injectable products to the general public. North Dakota has no state bulks list; peptide eligibility follows the federal 503A framework.", "source_ids": [ "nd-board", "nd-61-08-01", "nd-43-15", "nd-61-02-01", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because North Dakota requires a full pharmacy permit for every out-of-state shipper, fewer national telehealth pharmacies serve the state, and patients should confirm the pharmacy's North Dakota permit before ordering.", "source_ids": [ "fda-glp1-compounding", "nd-61-08-01" ] }, "research_peptide_sales": { "notes": "The North Dakota Food, Drug, and Cosmetic Act (NDCC chapter 19-02.1) prohibits selling adulterated or misbranded drugs, and NDCC chapter 43-15 limits dispensing of prescription drugs to permitted pharmacies and licensed practitioners.", "source_ids": [ "nd-19-02-1", "nd-43-15", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including by telemedicine from a North Dakota-licensed prescriber who has established a bona fide relationship under NDCC 43-17-44. Compounded semaglutide is limited to the federal patient specific exception since April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "nd-43-17-44" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in North Dakota through telemedicine?", "a": "Yes, from a North Dakota-licensed prescriber who establishes a bona fide relationship, verifies your identity, and meets the in-person standard of care under NDCC 43-17-44. Semaglutide and tirzepatide are not controlled substances.", "source_ids": [ "nd-43-17-44" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in North Dakota?", "a": "Only if it holds a North Dakota pharmacy permit issued by the State Board of Pharmacy. North Dakota requires every pharmacy that ships prescription drugs into the state to hold a permit and follow North Dakota rules for that dispensing.", "source_ids": [ "nd-61-08-01", "nd-board" ] }, { "q": "Why are most North Dakota pharmacies independently owned?", "a": "NDCC 43-15-35 requires in-state pharmacies to be majority owned by North Dakota-licensed pharmacists. The U.S. Supreme Court upheld the law in 1973, and it continues to limit chain pharmacy ownership in the state.", "source_ids": [ "nd-43-15" ] }, { "q": "Can a North Dakota pharmacy compound BPC-157?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-503a", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "nd-board", "type": "other", "title": "North Dakota State Board of Pharmacy", "url": "https://www.nodakpharmacy.com/" }, { "id": "nd-43-17-44", "type": "other", "title": "NDCC 43-17-44, Telemedicine (in chapter 43-17, Physicians and physician assistants)", "url": "https://ndlegis.gov/cencode/t43c17.pdf" }, { "id": "nd-50-02-15", "type": "other", "title": "NDAC chapter 50-02-15, Telemedicine (North Dakota Board of Medicine)", "url": "https://ndlegis.gov/prod/acdata/pdf/50-02-15.pdf" }, { "id": "nd-61-08-01", "type": "other", "title": "NDAC chapter 61-08-01, Requirements for out-of-state pharmacies", "url": "https://ndlegis.gov/prod/acdata/pdf/61-08-01.pdf" }, { "id": "nd-61-02-01", "type": "other", "title": "NDAC chapter 61-02-01, Pharmacy permits (section 61-02-01-03, pharmaceutical compounding standards)", "url": "https://ndlegis.gov/prod/acdata/pdf/61-02-01.pdf" }, { "id": "nd-43-15", "type": "other", "title": "NDCC chapter 43-15, Pharmacy (including 43-15-35, pharmacist ownership)", "url": "https://ndlegis.gov/cencode/t43c15.pdf" }, { "id": "nd-19-02-1", "type": "other", "title": "NDCC chapter 19-02.1, Food, Drug, and Cosmetic Act", "url": "https://ndlegis.gov/cencode/t19c02-1.pdf" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "ohio", "name": "Ohio", "abbreviation": "OH", "kind": "state", "summary": "Yes. An Ohio resident can obtain FDA approved peptides such as semaglutide and tirzepatide from an Ohio-licensed prescriber, including by telehealth: Ohio Revised Code 4743.09 and State Medical Board rule 4731-37-01 let practitioners use synchronous or asynchronous technology, including for an initial visit, when the in-person standard of care can be met. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the State of Ohio Board of Pharmacy. Ohio is among the most specific states on GLP-1s: in July 2025 the Board published compounding FAQs treating copies of semaglutide and tirzepatide as no longer compoundable after the shortages ended.", "telehealth": { "allowed": true, "notes": "ORC 4743.09 (enacted by House Bill 122 of the 134th General Assembly, effective March 23, 2022) lets licensed health care professionals provide telehealth services, including initial and annual visits, using synchronous or asynchronous technology when the standard of care for an in-person visit is satisfied. The State Medical Board's rule OAC 4731-37-01 applies this to physicians and physician assistants, holds telehealth to the in-person standard of care, permits synchronous or asynchronous communication technology if that standard can be met for the patient's condition, and allows non-controlled prescription drugs to be prescribed through telehealth under the rule's requirements. The prescriber must hold an Ohio license. None of the peptides in this database are controlled substances.", "async_prescribing_allowed": true, "source_ids": [ "oh-4743-09", "oh-4731-37-01" ] }, "compounding": { "board_name": "State of Ohio Board of Pharmacy", "board_url": "https://www.pharmacy.ohio.gov/", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy licenses pharmacists and terminal distributors of dangerous drugs (which includes pharmacies) under ORC chapter 4729 and regulates pharmacy compounding through OAC chapter 4729:7-2 and prescriber compounding through OAC chapter 4729:7-3. On July 17, 2025 the Board issued GLP-1 compounding guidance with FAQs for licensees. It states that pharmacy and prescriber compounding of copies of tirzepatide ended February 18, 2025 and of semaglutide ended April 22, 2025; that retatrutide and cagrilintide cannot be used in compounding under federal and state law, with any inventory to be disposed of immediately; that research use only products may never be used for compounding; and that pharmacies, clinics, and outsourcing facilities in Ohio must buy all active ingredients from Ohio-licensed drug distributors. Ohio has no state bulks list beyond these positions; peptide eligibility follows the federal 503A framework. ORC 4729.54 directs the Board to license terminal distributors whether located within or outside Ohio, and OAC 4729:5-8-02 sets licensure requirements for nonresident pharmacies, including proof of a valid home-state license and the most recent inspection report. Starting February 1, 2027, amended OAC 4729:5-2-01 requires the responsible person on an Ohio terminal distributor license held by a clinic or med spa to work at least 8 hours a month at the licensed location or make a documented quarterly on-site visit (Board of Pharmacy guidance updated September 10, 2026).", "source_ids": [ "oh-board", "oh-glp1-faq", "oh-4729", "oh-4729-54", "oh-4729-5-8-02", "fda-503a", "oh-rp-requirements" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Compounded semaglutide and tirzepatide are limited to the federal exception for documented patient specific needs because the FDA shortage allowances ended in 2025, and the Ohio Board of Pharmacy's July 2025 GLP-1 FAQs reinforce that copies of the approved products are not routinely compoundable in Ohio. Ohio's asynchronous telehealth rule makes app-based prescribing lawful, so the main constraint for Ohio patients is the pharmacy side.", "source_ids": [ "fda-glp1-compounding", "oh-glp1-faq", "oh-4731-37-01" ] }, "research_peptide_sales": { "notes": "ORC chapter 4729 restricts the sale and distribution of dangerous drugs to licensed pharmacies, distributors, and prescribers, and the Board reminds licensees to verify that sellers are licensed. Board guidance for prescriber clinics and medical spas (updated December 8, 2025) says any drug labeled for research purposes only is unlawful for a clinic or med spa to possess, even with patient consent, and must be disposed of immediately, with patients advised to stop using it.", "source_ids": [ "oh-4729", "oh-board", "usc-331", "oh-clinic-medspa-violations" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including through synchronous or asynchronous telehealth under ORC 4743.09. The Ohio Board of Pharmacy's July 2025 GLP-1 FAQs and the end of the federal grace period on April 22, 2025 leave compounded semaglutide limited to documented patient specific needs.", "source_ids": [ "oh-4743-09", "oh-glp1-faq", "fda-glp1-compounding" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to the federal patient specific exception since February 18, 2025, and the Ohio Board's GLP-1 FAQs address it directly.", "source_ids": [ "fda-glp1-compounding", "oh-glp1-faq" ] }, { "slug": "retatrutide", "note": "Investigational and not FDA approved. The Ohio Board of Pharmacy's July 17, 2025 GLP-1 guidance states that retatrutide cannot be used in compounding under federal and state law and that licensees found compounding, selling, or administering it may face discipline, including summary suspension.", "source_ids": [ "oh-glp1-faq", "fda-glp1-compounding" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Ohio through an asynchronous telehealth app?", "a": "Yes, if the prescriber holds an Ohio license and the in-person standard of care can be met. ORC 4743.09 and OAC 4731-37-01 allow synchronous or asynchronous technology, including for initial visits, and non-controlled drugs like semaglutide may be prescribed through telehealth.", "source_ids": [ "oh-4743-09", "oh-4731-37-01" ] }, { "q": "What does the Ohio Board of Pharmacy say about compounded GLP-1s?", "a": "In July 2025 the Board published GLP-1 compounding FAQs for licensees explaining how state and federal law apply after the FDA shortages ended. They treat copies of approved semaglutide and tirzepatide as no longer routinely compoundable.", "source_ids": [ "oh-glp1-faq" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Ohio?", "a": "Only in limited, patient specific cases. The federal shortage allowances ended in 2025, and the Ohio Board of Pharmacy's FAQs reinforce that compounded copies are not a routine option.", "source_ids": [ "fda-glp1-compounding", "oh-glp1-faq" ] }, { "q": "Can an Ohio pharmacy compound retatrutide or BPC-157?", "a": "Retatrutide is an investigational drug, and the Ohio Board of Pharmacy's July 2025 GLP-1 guidance states that it cannot be used in compounding under federal and state law. BPC-157 is not yet on the final 503A bulks list, so compounding it carries regulatory risk, and Category 2 peptides cannot be compounded.", "source_ids": [ "oh-glp1-faq", "fda-category-2", "fda-pcac" ] }, { "q": "How do I check that a pharmacy is licensed to serve Ohio?", "a": "Search the Ohio eLicense system for the pharmacy's terminal distributor license from the State of Ohio Board of Pharmacy. Sellers without an Ohio license are not lawful sources of prescription drugs in Ohio.", "source_ids": [ "oh-board", "oh-4729" ] } ], "sources": [ { "id": "oh-board", "type": "other", "title": "State of Ohio Board of Pharmacy", "url": "https://www.pharmacy.ohio.gov/" }, { "id": "oh-4743-09", "type": "other", "title": "Ohio Revised Code 4743.09, Telehealth services", "url": "https://codes.ohio.gov/ohio-revised-code/section-4743.09" }, { "id": "oh-4731-37-01", "type": "other", "title": "Ohio Administrative Code 4731-37-01, Telehealth (State Medical Board of Ohio)", "url": "https://codes.ohio.gov/ohio-administrative-code/rule-4731-37-01" }, { "id": "oh-glp1-faq", "type": "other", "title": "State of Ohio Board of Pharmacy: Compounding of GLP-1 drug products in Ohio, guidance and FAQs (issued July 17, 2025)", "url": "https://www.pharmacy.ohio.gov/GLP1" }, { "id": "oh-4729", "type": "other", "title": "Ohio Revised Code chapter 4729, Pharmacists; dangerous drugs", "url": "https://codes.ohio.gov/ohio-revised-code/chapter-4729" }, { "id": "oh-4729-54", "type": "other", "title": "Ohio Revised Code 4729.54, Terminal distributor licenses", "url": "https://codes.ohio.gov/ohio-revised-code/section-4729.54" }, { "id": "oh-4729-5-8-02", "type": "other", "title": "Ohio Administrative Code 4729:5-8-02, Non-resident pharmacies: licensure", "url": "https://codes.ohio.gov/ohio-administrative-code/rule-4729:5-8-02" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "oh-clinic-medspa-violations", "type": "other", "title": "Ohio Board of Pharmacy: Ten Common Prescriber Clinic and Medical Spa Violations (updated 12/8/2025)", "url": "https://www.pharmacy.ohio.gov/documents/pubs/special/ivtherapy/ten%20common%20prescriber%20clinic%20and%20medical%20spa%20violations.pdf" }, { "id": "oh-rp-requirements", "type": "other", "title": "Ohio Board of Pharmacy: Responsible Person Requirements for Licensure (updated 9/10/2026)", "url": "https://www.pharmacy.ohio.gov/documents/licensing/wddd/general/responsible%20person%20requirements%20for%20licensure.pdf" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "oklahoma", "name": "Oklahoma", "abbreviation": "OK", "kind": "state", "summary": "Yes. An Oklahoma resident can obtain FDA approved peptides such as semaglutide and tirzepatide from any Oklahoma-licensed prescriber, including through telemedicine under the Oklahoma Telemedicine Act and title 59 section 478.1, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Oklahoma State Board of Pharmacy or holding an Oklahoma nonresident pharmacy license. Oklahoma has no state bulks list of its own, so eligibility of a peptide for compounding follows the FDA framework, and the Board's compounding rules in title 535 chapter 15 apply to every Oklahoma pharmacy that prepares injectable peptides.", "telehealth": { "allowed": true, "notes": "Oklahoma's telemedicine framework sits in two places. Title 36 section 6802 (the Oklahoma Telemedicine Act) defines telemedicine to include real-time interactive and store-and-forward technology, and title 59 section 478.1 sets the practice standard for physicians, allowing a valid physician-patient relationship to be established through telemedicine and allowing prescriptions to be issued from a telemedicine encounter without a prior in-person visit. Oklahoma State Board of Medical Licensure and Supervision rules (title 435, chapter 10) treat prescribing based only on an online questionnaire, without an adequate evaluation, as unprofessional conduct, so a compliant GLP-1 telehealth visit must include a real evaluation even if it is asynchronous. The prescriber must hold an Oklahoma license; Oklahoma participates in the Interstate Medical Licensure Compact, which is the usual route for out-of-state telehealth physicians. Peptides in this database are not controlled substances, so the federal Ryan Haight in-person requirement does not apply.", "async_prescribing_allowed": null, "source_ids": [ "ok-59-478-1", "ok-36-6802", "ok-med-board", "imlc-states" ] }, "compounding": { "board_name": "Oklahoma State Board of Pharmacy", "board_url": "https://oklahoma.gov/pharmacy.html", "follows_fda_503a_bulks": true, "notes": "The Oklahoma State Board of Pharmacy licenses pharmacies under the Oklahoma Pharmacy Act (title 59, section 353 and following) and regulates compounding through Oklahoma Administrative Code title 535, chapter 15. Subchapter 9 (OAC 535:15-9-1 through 535:15-9-12) requires a separate sterile compounding preparation permit, held on top of a retail or non-resident pharmacy license and renewed with it, for every pharmacy compounding sterile preparations such as injectable peptides. Subchapter 10 sets good compounding practices, part 1 for non-sterile preparations (535:15-10-1 and following) and part 3 for sterile preparations (535:15-10-50 and following), and requires every compounding pharmacist to be familiar with USP compounding standards. Oklahoma has not adopted a separate state list of compoundable bulk substances; the Board applies the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list). Title 59 section 353.18 makes it unlawful to sell prescription drugs or accept prescriptions without a Board license, including when the seller is out of state and the drug is delivered to patients in Oklahoma, and OAC 535:15-3-9 requires a non-resident pharmacy to hold an annual Oklahoma non-resident pharmacy license, keep its home-state license in good standing, submit an inspection report from the prior 24 months, and name an Oklahoma-licensed pharmacist in charge. The Board's license lookup confirms a pharmacy's status.", "source_ids": [ "ok-board", "ok-59-pharmacy-act", "ok-law-book", "ok-oac-535", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Patients using telehealth programs should confirm the dispensing pharmacy holds an Oklahoma pharmacy or nonresident pharmacy license.", "source_ids": [ "fda-glp1-compounding", "ok-board" ] }, "research_peptide_sales": { "notes": "Selling injectable peptides labeled \"for research use only\" to Oklahoma consumers is not a licensed pharmacy activity and is not authorized by the Oklahoma Pharmacy Act, which restricts dispensing of prescription drugs to licensed pharmacies. They carry no Oklahoma consumer protection and no pharmacist oversight.", "source_ids": [ "ok-59-pharmacy-act", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Oklahoma through telemedicine?", "a": "Yes. Title 59 section 478.1 allows an Oklahoma-licensed physician to establish a relationship and prescribe through telemedicine without a prior in-person visit, as long as the evaluation meets the same standard of care as an office visit. Semaglutide and tirzepatide are not controlled substances, so no additional in-person rule applies.", "source_ids": [ "ok-59-478-1", "ok-36-6802" ] }, { "q": "Does the telehealth prescriber have to be licensed in Oklahoma?", "a": "Yes. The physician must hold an Oklahoma license from the State Board of Medical Licensure and Supervision (or the relevant board for nurse practitioners and physician assistants). Oklahoma is a member of the Interstate Medical Licensure Compact, which is how many out-of-state telehealth physicians obtain an Oklahoma license.", "source_ids": [ "ok-med-board", "ok-59-478-1", "imlc-states" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Oklahoma?", "a": "Only if it holds an Oklahoma non-resident pharmacy license issued by the Oklahoma State Board of Pharmacy. Title 59 section 353.18 requires a Board license for out-of-state sellers delivering prescription drugs to Oklahoma patients, and OAC 535:15-3-9 sets the non-resident license requirements; a pharmacy compounding sterile injectables also needs a sterile compounding permit under OAC 535:15-9. Use the Board's license lookup to confirm the pharmacy before paying.", "source_ids": [ "ok-board", "ok-59-pharmacy-act", "ok-law-book" ] }, { "q": "Can an Oklahoma pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "fda-category-2", "fda-pcac", "ok-oac-535" ] } ], "sources": [ { "id": "ok-board", "type": "other", "title": "Oklahoma State Board of Pharmacy", "url": "https://oklahoma.gov/pharmacy.html" }, { "id": "ok-59-478-1", "type": "other", "title": "Oklahoma Statutes title 59, section 478.1, Establishment of physician-patient relationship through telemedicine", "url": "https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=481131" }, { "id": "ok-36-6802", "type": "other", "title": "Oklahoma Statutes title 36, section 6802, Telemedicine defined", "url": "https://law.justia.com/codes/oklahoma/title-36/section-36-6802v1/" }, { "id": "ok-med-board", "type": "other", "title": "Oklahoma State Board of Medical Licensure and Supervision (telemedicine rules, title 435 chapter 10)", "url": "https://www.okmedicalboard.org/" }, { "id": "ok-59-pharmacy-act", "type": "other", "title": "Oklahoma Pharmacy Act, Oklahoma Statutes title 59, section 353.1 (definitions) and following", "url": "https://law.justia.com/codes/oklahoma/title-59/section-59-353-1/" }, { "id": "ok-oac-535", "type": "other", "title": "Oklahoma Administrative Code 535:15-10, Good compounding practices (State Board of Pharmacy)", "url": "https://regulations.justia.com/states/oklahoma/title-535/chapter-15/subchapter-10/part-1/section-535-15-10-1" }, { "id": "ok-law-book", "type": "other", "title": "Oklahoma State Board of Pharmacy: Pharmacy Law Book (title 59 section 353.18; OAC 535:15-3-9, 535:15-9, 535:15-10), updated July 2026", "url": "https://oklahoma.gov/content/dam/ok/en/pharmacy/documents/laws-rules/Updated%20Pharmacy%20Law%20Book.docx" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "oregon", "name": "Oregon", "abbreviation": "OR", "kind": "state", "summary": "Yes. An Oregon resident can obtain FDA approved peptides such as semaglutide and tirzepatide from any prescriber licensed by the Oregon Medical Board or the relevant Oregon licensing board, including through telemedicine under Oregon Medical Board rules in Oregon Administrative Rules chapter 847, division 25, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy registered with the Oregon Board of Pharmacy as an in-state or out-of-state drug outlet. The Board of Pharmacy regulates compounding through OAR chapter 855, division 183 (adopted June 17, 2026), which incorporates USP standards and follows the FDA 503A bulks framework rather than a separate Oregon list.", "telehealth": { "allowed": true, "notes": "The Oregon Medical Board requires a physician who provides telemedicine to a patient located in Oregon to hold an Oregon license (or qualify for a narrow exception), to establish a physician-patient relationship, and to meet the same standard of care as in-person practice. The rules bar prescribing based solely on an online questionnaire without an adequate evaluation, but they do not require a prior in-person visit for non-controlled drugs, so a GLP-1 or compounded peptide prescription can be issued from a telemedicine visit. Oregon's payment parity statute (ORS 743A.058) defines telemedicine broadly, and the Medical Board treats asynchronous store-and-forward as telemedicine when it supports an adequate evaluation. Oregon is not a member of the Interstate Medical Licensure Compact; instead, OAR 847-025 lets an out-of-state physician hold an Oregon license for the practice of medicine across state lines. Peptides in this database are not controlled substances, so federal Ryan Haight limits do not apply.", "async_prescribing_allowed": null, "source_ids": [ "or-omb-telemedicine", "or-oar-847-025", "or-ors-743a-058", "imlc-states" ] }, "compounding": { "board_name": "Oregon Board of Pharmacy", "board_url": "https://www.oregon.gov/pharmacy/Pages/default.aspx", "follows_fda_503a_bulks": true, "notes": "The Oregon Board of Pharmacy registers drug outlets under ORS chapter 689: ORS 689.005 defines a drug outlet to include any establishment with facilities located within or out of Oregon that dispenses or delivers drugs in Oregon, and ORS 689.305 requires all drug outlets to register annually. OAR 855-041-1060 requires every non-resident pharmacy that provides drugs or services to a person in Oregon to register with the Board, to be registered in its home state, and to designate an Oregon-licensed pharmacist-in-charge. Compounding is governed by OAR chapter 855, division 183 (Drug Compounding), adopted effective June 17, 2026 in place of the former division 45. OAR 855-183-0001 applies the division to sterile and non-sterile compounding and requires any entity inside or outside Oregon that compounds for dispensing or delivery in Oregon to register as a drug outlet; OAR 855-183-0015 requires compliance with USP chapters 795, 797, and 800 and, from November 1, 2027, requires non-resident outlets that compound to show home-state inspection against current USP standards or an approved accreditation. Oregon has not created a state bulks list; eligibility follows the federal 503A framework (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "or-board", "or-ors-689", "or-oar-855-041-1060", "or-oar-855-183", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Telehealth GLP-1 patients should confirm the dispensing pharmacy appears in the Board of Pharmacy license lookup.", "source_ids": [ "fda-glp1-compounding", "or-board" ] }, "research_peptide_sales": { "notes": "ORS chapter 689 restricts dispensing of prescription drugs to registered pharmacies and licensed practitioners, and a seller of \"research use only\" injectable peptides to Oregon consumers is not a registered drug outlet. Oregon's Unlawful Trade Practices Act (ORS 646.608) also reaches misleading health claims made to consumers.", "source_ids": [ "or-ors-689", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Oregon through telemedicine?", "a": "Yes. Oregon Medical Board rules allow an Oregon-licensed physician (including a physician holding an OAR 847-025 license for practice across state lines) to establish a relationship and prescribe through telemedicine when the evaluation meets the in-person standard of care. Semaglutide and tirzepatide are not controlled substances, so no separate in-person requirement applies.", "source_ids": [ "or-oar-847-025", "or-omb-telemedicine" ] }, { "q": "Can an out-of-state telehealth doctor treat me in Oregon?", "a": "Only if the physician holds a full Oregon license or an Oregon license for the practice of medicine across state lines under OAR 847-025. Oregon is not a member of the Interstate Medical Licensure Compact, so a compact license does not cover Oregon patients. Look the prescriber up in the Oregon Medical Board license search before paying.", "source_ids": [ "or-oar-847-025", "or-omb-telemedicine", "imlc-states" ] }, { "q": "How do I check whether a mail-order pharmacy can ship compounded peptides to Oregon?", "a": "Search the Oregon Board of Pharmacy license lookup for the pharmacy. Under ORS 689.305 and OAR 855-041-1060 an out-of-state pharmacy must register with the Board as a non-resident pharmacy before shipping to Oregon patients. If the pharmacy is not listed, the shipment is not lawful in Oregon even if the prescriber is compliant.", "source_ids": [ "or-board", "or-ors-689", "or-oar-855-041-1060" ] }, { "q": "Can an Oregon pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "or-oar-855-183", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "or-board", "type": "other", "title": "Oregon Board of Pharmacy", "url": "https://www.oregon.gov/pharmacy/Pages/default.aspx" }, { "id": "or-omb-telemedicine", "type": "other", "title": "Oregon Medical Board (license search and board policies)", "url": "https://www.oregon.gov/omb/Pages/index.aspx" }, { "id": "or-oar-847-025", "type": "other", "title": "Oregon Administrative Rules chapter 847, division 25, Licensure to Practice Medicine Across State Lines (Oregon Medical Board)", "url": "https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3887" }, { "id": "or-ors-743a-058", "type": "other", "title": "ORS 743A.058, Telemedicine coverage and definitions", "url": "https://www.oregonlegislature.gov/bills_laws/ors/ors743A.html" }, { "id": "or-ors-689", "type": "other", "title": "ORS chapter 689, Pharmacists; Drug Outlets; Drug Sales", "url": "https://www.oregonlegislature.gov/bills_laws/ors/ors689.html" }, { "id": "or-oar-855-041-1060", "type": "other", "title": "Oregon Administrative Rule 855-041-1060, Non-Resident Pharmacies", "url": "https://secure.sos.state.or.us/oard/view.action?ruleNumber=855-041-1060" }, { "id": "or-oar-855-183", "type": "other", "title": "Oregon Administrative Rules chapter 855, division 183, Drug Compounding (Oregon Board of Pharmacy, effective June 17, 2026)", "url": "https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=8015" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "pennsylvania", "name": "Pennsylvania", "abbreviation": "PA", "kind": "state", "summary": "Yes. A Pennsylvania resident can obtain FDA approved peptides such as semaglutide and tirzepatide from any Pennsylvania-licensed prescriber, including through telemedicine under Act 42 of 2024, Pennsylvania's telemedicine statute, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy that holds a Pennsylvania pharmacy permit or a Pennsylvania nonresident pharmacy registration from the State Board of Pharmacy. Pennsylvania has no state bulks list, so eligibility of a peptide for compounding follows the FDA framework, and the Board's regulations in 49 Pa. Code chapter 27 govern how Pennsylvania pharmacies compound.", "telehealth": { "allowed": true, "notes": "Act 42 of 2024 (Senate Bill 739, signed July 2024) is Pennsylvania's first comprehensive telemedicine statute. It defines telemedicine to include synchronous and asynchronous (store-and-forward) technology, authorizes any Pennsylvania-licensed health care practitioner to provide telemedicine within the practitioner's scope of practice, requires the same standard of care as in-person practice, and requires insurers to cover telemedicine services. The Act allows a practitioner to prescribe from a telemedicine encounter, subject to the practitioner's licensing board regulations and federal law on controlled substances. Before Act 42, Pennsylvania had no telemedicine statute and boards relied on general practice standards. The prescriber must hold a Pennsylvania license (or an Interstate Medical Licensure Compact license issued through the Pennsylvania State Board of Medicine). None of the peptides in this database are controlled substances, so no additional in-person requirement applies.", "async_prescribing_allowed": true, "source_ids": [ "pa-act-42-2024", "pa-bpoa-medicine", "imlc-states" ] }, "compounding": { "board_name": "Pennsylvania State Board of Pharmacy (Department of State, Bureau of Professional and Occupational Affairs)", "board_url": "https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/pharmacy", "follows_fda_503a_bulks": true, "notes": "The State Board of Pharmacy licenses pharmacies under the Pharmacy Act (63 P.S. section 390-1 and following) and regulates practice through 49 Pa. Code chapter 27. The compounding rules at 49 Pa. Code sections 27.601 to 27.606 (effective June 22, 2019) require sterile and non-sterile compounding to follow section 503A of the federal Food, Drug, and Cosmetic Act, its regulations, and the current USP compounding chapters; section 27.602 bars pharmacists from compounding drugs FDA has withdrawn for safety or effectiveness, essentially copies of commercially available drugs except as 503A allows, and drugs FDA has identified as not compoundable. Pennsylvania has not adopted a separate list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list). Section 4.1 of the Pharmacy Act (63 P.S. section 390-4.1, added in 2015) requires a nonresident pharmacy to register with the Board every two years, hold a valid home-state license, submit its most recent home-state or national inspection report, and provide a toll-free pharmacist line, and it bars shipping legend drugs into Pennsylvania without that certificate of registration. The Board's license verification confirms registration.", "source_ids": [ "pa-board", "pa-pharmacy-act", "pa-49-code-27", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Telehealth GLP-1 patients should confirm the dispensing pharmacy holds a Pennsylvania pharmacy permit or nonresident pharmacy registration.", "source_ids": [ "fda-glp1-compounding", "pa-board" ] }, "research_peptide_sales": { "notes": "The Pennsylvania Pharmacy Act restricts dispensing of prescription drugs to licensed pharmacies, and the Controlled Substance, Drug, Device and Cosmetic Act (35 P.S. section 780-101 and following) prohibits the sale of adulterated, misbranded, or unapproved new drugs in the Commonwealth.", "source_ids": [ "pa-pharmacy-act", "pa-35-780", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Pennsylvania through telemedicine?", "a": "Yes. Act 42 of 2024 authorizes Pennsylvania-licensed practitioners to evaluate and prescribe through synchronous or asynchronous telemedicine, as long as the care meets the in-person standard. Semaglutide and tirzepatide are not controlled substances, so no separate in-person requirement applies.", "source_ids": [ "pa-act-42-2024" ] }, { "q": "Does the telemedicine prescriber need a Pennsylvania license?", "a": "Yes. Act 42 applies to health care practitioners licensed in Pennsylvania. Physicians in other states can obtain a Pennsylvania license through the Interstate Medical Licensure Compact via the State Board of Medicine. Verify the prescriber in the Department of State license lookup before paying.", "source_ids": [ "pa-act-42-2024", "pa-bpoa-medicine", "imlc-states" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Pennsylvania?", "a": "Only if it holds a certificate of registration from the Pennsylvania State Board of Pharmacy as a nonresident pharmacy. Section 4.1 of the Pharmacy Act (63 P.S. section 390-4.1) bars a nonresident pharmacy from shipping legend drugs into Pennsylvania without one. Search the Department of State license verification for the pharmacy name; if it is not registered, the shipment is not lawful in Pennsylvania even if the prescriber is compliant.", "source_ids": [ "pa-board", "pa-pharmacy-act" ] }, { "q": "Can a Pennsylvania pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "pa-49-code-27", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "pa-board", "type": "other", "title": "Pennsylvania State Board of Pharmacy", "url": "https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/pharmacy" }, { "id": "pa-act-42-2024", "type": "other", "title": "Pennsylvania Act 42 of 2024 (Senate Bill 739), telemedicine", "url": "https://www.legis.state.pa.us/cfdocs/legis/li/uconsCheck.cfm?yr=2024&sessInd=0&act=42" }, { "id": "pa-bpoa-medicine", "type": "other", "title": "Pennsylvania State Board of Medicine (licensure and Interstate Medical Licensure Compact)", "url": "https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/medicine" }, { "id": "pa-pharmacy-act", "type": "other", "title": "Pennsylvania Pharmacy Act, Act of Sept. 27, 1961, P.L. 1700, No. 699 (63 P.S. section 390-1 and following), including section 4.1, Nonresident pharmacies", "url": "https://www.legis.state.pa.us/WU01/LI/LI/US/HTM/1961/0/0699..HTM" }, { "id": "pa-49-code-27", "type": "other", "title": "49 Pa. Code chapter 27, State Board of Pharmacy regulations (compounding, sections 27.601 to 27.606)", "url": "https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter27/chap27toc.html" }, { "id": "pa-35-780", "type": "other", "title": "Pennsylvania Controlled Substance, Drug, Device and Cosmetic Act, 35 P.S. section 780-101 and following (Act 1972-64)", "url": "https://www.legis.state.pa.us/cfdocs/legis/li/uconsCheck.cfm?yr=1972&sessInd=0&act=64" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "rhode-island", "name": "Rhode Island", "abbreviation": "RI", "kind": "state", "summary": "Yes. A Rhode Island resident can obtain FDA approved peptides such as semaglutide and tirzepatide from any Rhode Island-licensed prescriber, including through telemedicine under Rhode Island General Laws section 5-37-22 and the Telemedicine Coverage Act (chapter 27-81), and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Rhode Island Department of Health, which houses the Board of Pharmacy, or holding a Rhode Island nonresident pharmacy license. Rhode Island has no state bulks list, so eligibility of a peptide for compounding follows the FDA framework, and the Department of Health's pharmacy regulations (216-RICR-40-15) govern how licensed pharmacies compound.", "telehealth": { "allowed": true, "notes": "Rhode Island General Laws section 5-37-22 sets the practice standard for physicians using telemedicine: a physician-patient relationship may be established through telemedicine, the physician must be licensed in Rhode Island, the standard of care is the same as for in-person care, and the physician may issue a prescription from a telemedicine encounter subject to federal and state controlled substance law. The Telemedicine Coverage Act (chapter 27-81) defines telemedicine for coverage purposes and, after 2021 amendments, includes audio-only and store-and-forward modalities. Rhode Island is a member of the Interstate Medical Licensure Compact. Because the peptides in this database are not controlled substances, the federal in-person requirement for telemedicine prescribing of controlled substances does not apply.", "async_prescribing_allowed": null, "source_ids": [ "ri-5-37-22", "ri-27-81", "ri-doh", "imlc-states" ] }, "compounding": { "board_name": "Rhode Island Board of Pharmacy (Rhode Island Department of Health)", "board_url": "https://health.ri.gov/licensing/pharmacy", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy sits within the Rhode Island Department of Health. Under Rhode Island General Laws section 5-19.1-5 the Board, subject to the Director of Health's approval, regulates pharmacy practice and adopts rules, and the Department issues pharmacy licenses under chapter 5-19.1 (Pharmacies). The Department's regulation 216-RICR-40-15-1 (Pharmacists, Pharmacies, and Manufacturers, Wholesalers, and Distributors, current version effective April 12, 2026) covers compounding in section 1.8 (Compounding of Pharmaceuticals) and, in section 1.2, incorporates USP chapter 797 (sterile, 2023), chapter 795 (non-sterile, 2023), and chapter 800 (hazardous drugs, 2020) by reference. Rhode Island has not adopted a separate list of compoundable bulk substances; a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list). Section 5-19.1-11 makes any pharmacy outside Rhode Island that ships, mails, or delivers legend drugs or devices into the state a nonresident pharmacy that must be licensed by the Department, keep a valid home-state license, and follow Rhode Island pharmacy regulations when dispensing to Rhode Island residents; section 1.7.3 of 216-RICR-40-15-1 adds licensure conditions, including a Rhode Island agent for service of process. The Department's license lookup confirms a pharmacy's license.", "source_ids": [ "ri-board", "ri-5-19-1", "ri-5-19-1-11", "ri-ricr-40-15", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Telehealth GLP-1 patients should confirm the dispensing pharmacy holds a Rhode Island pharmacy or nonresident pharmacy license.", "source_ids": [ "fda-glp1-compounding", "ri-doh" ] }, "research_peptide_sales": { "notes": "Rhode Island General Laws chapter 5-19.1 restricts dispensing of prescription drugs to licensed pharmacies, and the Rhode Island Food, Drugs, and Cosmetics Act (chapter 21-31) prohibits the sale of adulterated, misbranded, or unapproved new drugs in the state.", "source_ids": [ "ri-5-19-1", "ri-21-31", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Rhode Island through telemedicine?", "a": "Yes. Section 5-37-22 allows a Rhode Island-licensed physician to establish a relationship and prescribe through telemedicine when the care meets the in-person standard. Semaglutide and tirzepatide are not controlled substances, so no separate in-person requirement applies.", "source_ids": [ "ri-5-37-22", "ri-27-81" ] }, { "q": "Does the telemedicine prescriber need a Rhode Island license?", "a": "Yes. Section 5-37-22 applies to physicians licensed in Rhode Island, and the Department of Health licenses nurse practitioners and physician assistants who prescribe. Rhode Island is a member of the Interstate Medical Licensure Compact. Verify the prescriber in the Department of Health license lookup before paying.", "source_ids": [ "ri-5-37-22", "ri-doh", "imlc-states" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to me in Rhode Island?", "a": "Only if it holds a Rhode Island nonresident pharmacy license. Section 5-19.1-11 requires any pharmacy outside Rhode Island that ships legend drugs into the state to be licensed by the Department of Health, and section 1.7.3 of 216-RICR-40-15-1 sets the licensure conditions. Search the Department of Health license verification for the pharmacy name; if it is not listed, the shipment is not lawful in Rhode Island even if the prescriber is compliant.", "source_ids": [ "ri-5-19-1-11", "ri-ricr-40-15", "ri-board" ] }, { "q": "Can a Rhode Island pharmacy compound BPC-157 or other unapproved peptides?", "a": "No, not from bulk today. BPC-157 is not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk. State boards cannot authorize what federal law does not. Peptides still in FDA Category 2 cannot be compounded either.", "source_ids": [ "ri-ricr-40-15", "fda-category-2", "fda-pcac" ] } ], "sources": [ { "id": "ri-doh", "type": "other", "title": "Rhode Island Department of Health (Board of Pharmacy and professional licensing)", "url": "https://health.ri.gov/" }, { "id": "ri-board", "type": "other", "title": "Rhode Island Department of Health: Pharmacy licensing (Board of Pharmacy)", "url": "https://health.ri.gov/licensing/pharmacy" }, { "id": "ri-5-37-22", "type": "other", "title": "Rhode Island General Laws section 5-37-22, Telemedicine", "url": "http://webserver.rilegislature.gov/Statutes/TITLE5/5-37/5-37-22.htm" }, { "id": "ri-27-81", "type": "other", "title": "Rhode Island General Laws chapter 27-81, Telemedicine Coverage Act", "url": "http://webserver.rilegislature.gov/Statutes/TITLE27/27-81/INDEX.htm" }, { "id": "ri-5-19-1", "type": "other", "title": "Rhode Island General Laws chapter 5-19.1, Pharmacies", "url": "http://webserver.rilegislature.gov/Statutes/TITLE5/5-19.1/INDEX.htm" }, { "id": "ri-5-19-1-11", "type": "other", "title": "Rhode Island General Laws section 5-19.1-11, Nonresident pharmacy", "url": "https://webserver.rilegislature.gov/Statutes/TITLE5/5-19.1/5-19.1-11.htm" }, { "id": "ri-ricr-40-15", "type": "other", "title": "216-RICR-40-15-1, Pharmacists, Pharmacies, and Manufacturers, Wholesalers, and Distributors (Rhode Island Department of Health regulations)", "url": "https://rules.sos.ri.gov/regulations/part/216-40-15-1" }, { "id": "ri-21-31", "type": "other", "title": "Rhode Island General Laws chapter 21-31, Rhode Island Food, Drugs, and Cosmetics Act", "url": "http://webserver.rilegislature.gov/Statutes/TITLE21/21-31/INDEX.htm" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "imlc-states", "type": "other", "title": "Interstate Medical Licensure Compact Commission: participating states", "url": "https://imlcc.com/participating-states/" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "south-carolina", "name": "South Carolina", "abbreviation": "SC", "kind": "state", "summary": "Yes. A South Carolina resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a South Carolina-licensed prescriber, including by telemedicine under section 40-47-37 of the South Carolina Code, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy holding a South Carolina Board of Pharmacy permit. Out-of-state pharmacies that mail prescriptions into South Carolina need a nonresident permit under section 40-43-83, and the Board reviews compounding practices before issuing one. South Carolina has no state bulks list, so peptide compounding eligibility follows the FDA framework.", "telehealth": { "allowed": true, "notes": "Section 40-47-37 of the South Carolina Code sets the rules for physicians practicing solely by telemedicine. The physician must hold a South Carolina medical license, meet the in-person standard of care, verify the patient's identity and location, and provide an appropriate evaluation before treating, which need not be in person if the physician can accurately diagnose and treat through telehealth. At each encounter the prescribing physician must obtain the threshold information needed for an accurate diagnosis in a medical history interview that the prescriber conducts, and a physician may not establish a relationship by telemedicine for prescribing when an in-person physical examination is necessary. Schedule II and III narcotic prescriptions are barred by telemedicine outside narrow exceptions; GLP-1 medicines and the peptides in this database are not scheduled. Because the statute requires a medical history interview conducted by the prescriber, a questionnaire-only asynchronous model does not clearly satisfy it, so this record marks asynchronous prescribing as unresolved.", "async_prescribing_allowed": null, "source_ids": [ "sc-40-47-37", "sc-med-board" ] }, "compounding": { "board_name": "South Carolina Board of Pharmacy (South Carolina Department of Labor, Licensing and Regulation)", "board_url": "https://llr.sc.gov/bop/", "follows_fda_503a_bulks": true, "notes": "The Board of Pharmacy regulates pharmacies under the South Carolina Pharmacy Practice Act (title 40, chapter 43). Section 40-43-83 requires a permit for in-state facilities and for each permittee outside South Carolina that ships, mails, or delivers prescription drugs into the state, and allows the Board to refuse a permit that is not in the public interest. Section 40-43-86 sets facility and practice requirements, including compounding; subsection (CC)(2) bars pharmacists from offering compounded medications to other pharmacies for resale. The Board's non-resident pharmacy permit application states that South Carolina has no separate sterile or non-sterile compounding permit, but any applicant that compounds must submit its compounding documentation even if it does not plan to ship compounds into the state: for non-sterile work, 6 hours of initial and 4 hours of annual compounding education for pharmacists and technicians, a diagram and photographs of the compounding area, and temperature, humidity, and cleaning logs; for sterile work, compounding training records, a diagram and photographs of the sterile area, a month of pressure differential, temperature, humidity, and cleaning logs, and the last certification of hoods and clean areas. The Board's permit page adds that under Regulation 99-43(G)(3)(b) the pharmacist-in-charge or permit holder must appear before the Non-Resident Application Review Committee in lieu of an in-person inspection. South Carolina has not adopted a separate state list of compoundable bulk substances, so eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "sc-board", "sc-40-43", "sc-40-43-83", "sc-40-43-86", "sc-pnp-application", "sc-permits", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Telehealth GLP-1 patients should confirm that the prescriber holds a South Carolina license and that any mail order pharmacy holds a South Carolina nonresident permit under section 40-43-83.", "source_ids": [ "fda-glp1-compounding", "sc-40-43-83", "sc-40-47-37" ] }, "research_peptide_sales": { "notes": "The South Carolina Pharmacy Practice Act limits dispensing of prescription drugs to permitted pharmacies and licensed practitioners, so an online seller shipping \"research use only\" injectable peptides to South Carolina consumers is not operating as a pharmacy under chapter 43. The South Carolina Board of Medical Examiners has also issued a notice that a physician may not compound, administer, prescribe, or dispense research-grade or FDA-ineligible peptides, may not delegate those acts to APRNs or PAs, and cannot rely on a patient consent form. The notice states that facilities inside or outside South Carolina may not sell or dispense drugs without a Board of Pharmacy license (S.C. Code 40-43-83 and 40-43-89), that physicians, APRNs, PAs, and pharmacists must buy all prescription products and compounding ingredients from Board of Pharmacy permitted entities, and that buying from an unpermitted source can be misconduct under S.C. Code 40-47-110(B).", "source_ids": [ "sc-40-43", "usc-331", "sc-bme-peptide-notice" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in South Carolina through telemedicine?", "a": "Yes, from a physician licensed in South Carolina who meets section 40-47-37. The physician must perform an appropriate evaluation, which can be remote, and must obtain your medical history in an interview they conduct at each encounter. Semaglutide and tirzepatide are not controlled substances, so the Schedule II and III telemedicine limits do not apply.", "source_ids": [ "sc-40-47-37" ] }, { "q": "Will a South Carolina telehealth doctor prescribe from an online form alone?", "a": "It is unlikely to be compliant. Section 40-47-37 requires the prescribing licensee to collect the information needed for an accurate diagnosis in a medical history interview at each encounter, which is hard to satisfy with a static questionnaire. Expect a video or phone visit or a live exchange with the prescriber.", "source_ids": [ "sc-40-47-37", "sc-med-board" ] }, { "q": "Does an out-of-state pharmacy need a South Carolina permit to mail me compounded peptides?", "a": "Yes. Section 40-43-83 requires out-of-state pharmacies that ship or deliver prescription drugs to South Carolina residents to hold a Board of Pharmacy permit, and the Board can refuse a permit it finds is not in the public interest. The Board's non-resident application requires any pharmacy that compounds to document compounding training, submit a diagram and photographs of its compounding areas, and provide environmental and cleaning logs, and its pharmacist-in-charge or permit holder must appear before the Board's Non-Resident Application Review Committee.", "source_ids": [ "sc-40-43-83", "sc-board", "sc-pnp-application", "sc-permits" ] }, { "q": "Can a South Carolina pharmacy compound peptides that are not on the FDA bulks list?", "a": "Generally no. South Carolina has no state bulks list of its own, so the federal 503A test applies: the substance must be a component of an approved drug, have a USP or NF monograph, or be on the FDA 503A bulks list. Peptides in FDA Category 2 cannot be compounded.", "source_ids": [ "fda-503a", "fda-category-2", "sc-40-43-86" ] } ], "sources": [ { "id": "sc-board", "type": "other", "title": "South Carolina Board of Pharmacy (Department of Labor, Licensing and Regulation)", "url": "https://llr.sc.gov/bop/" }, { "id": "sc-med-board", "type": "other", "title": "South Carolina Board of Medical Examiners", "url": "https://llr.sc.gov/med/" }, { "id": "sc-40-47-37", "type": "other", "title": "South Carolina Code section 40-47-37, Practice of telemedicine, requirements (title 40, chapter 47)", "url": "https://www.scstatehouse.gov/code/t40c047.php" }, { "id": "sc-40-43", "type": "other", "title": "South Carolina Code title 40, chapter 43, South Carolina Pharmacy Practice Act", "url": "https://www.scstatehouse.gov/code/t40c043.php" }, { "id": "sc-40-43-83", "type": "other", "title": "South Carolina Code section 40-43-83, In-state facilities and out-of-state mail order pharmacy service permits", "url": "https://law.justia.com/codes/south-carolina/title-40/chapter-43/section-40-43-83/" }, { "id": "sc-40-43-86", "type": "other", "title": "South Carolina Code section 40-43-86, Facility requirements for pharmacies, including compounding", "url": "https://law.justia.com/codes/south-carolina/title-40/chapter-43/section-40-43-86/" }, { "id": "sc-pnp-application", "type": "other", "title": "South Carolina Board of Pharmacy: Non-Resident Pharmacy Permit Application, including non-sterile and sterile compounding requirements (revised February 2019)", "url": "https://www.llr.sc.gov/bop/PFORMS/Non-Resident%20Pharmacy%20Application-PNP.pdf" }, { "id": "sc-permits", "type": "other", "title": "South Carolina Board of Pharmacy: facility permit types and non-resident application review", "url": "https://llr.sc.gov/bop/permit2.aspx" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" }, { "id": "sc-bme-peptide-notice", "type": "other", "title": "South Carolina Board of Medical Examiners: Notice Concerning the Prescribing of Research-Grade Peptides and FDA-Ineligible Peptides", "url": "https://llr.sc.gov/med/news/BME%20Notice%20re%20Peptides.pdf" } ], "last_verified": "2026-09-27", "review_status": "draft", "version": 1 }, { "slug": "south-dakota", "name": "South Dakota", "abbreviation": "SD", "kind": "state", "summary": "Yes. A South Dakota resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a South Dakota-licensed prescriber, including through telehealth under SDCL chapter 34-52, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the South Dakota Board of Pharmacy, including a licensed nonresident pharmacy. SDCL 34-52 requires a proper provider-patient relationship with a diagnosis based on an examination before telehealth treatment, and South Dakota has no state bulks list, so peptide compounding eligibility follows the FDA framework.", "telehealth": { "allowed": true, "notes": "SDCL chapter 34-52 (Telehealth Utilization by Health Care Professionals, enacted 2021) defines telehealth to include interactive audio-video, audio combined with store-and-forward technology, and remote monitoring, and it defines store-and-forward as information stored for asynchronous delivery of care. The professional must be licensed in South Dakota (or work for a qualifying facility), and telehealth may not be used without a proper provider-patient relationship, which under SDCL 34-52-3 includes verifying the patient's identity, disclosing the provider's credentials, obtaining consent, establishing a diagnosis through examination and any needed testing, discussing treatment options, arranging follow-up, and using technology adequate to evaluate the condition. SDCL 34-52-6 bars prescribing a controlled substance solely in response to an internet questionnaire or telephone consult without such a relationship; GLP-1 medicines and the peptides in this database are not controlled, but the examination element of 34-52-3 still applies. Whether a purely asynchronous encounter can establish the relationship is not expressly resolved, so this record marks it as unresolved.", "async_prescribing_allowed": null, "source_ids": [ "sd-34-52" ] }, "compounding": { "board_name": "South Dakota Board of Pharmacy (South Dakota Department of Health)", "board_url": "https://doh.sd.gov/licensing-and-records/boards/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The South Dakota Board of Pharmacy licenses pharmacies and pharmacists under SDCL chapter 36-11 and regulates practice through Administrative Rules of South Dakota article 20:51, with compounding practices in chapter 20:51:31. SDCL 36-11-19.3 requires any nonresident pharmacy to be licensed before doing business in South Dakota, to be licensed and in good standing in its home state, and to submit its most recent home-state inspection report, so an out-of-state pharmacy shipping to South Dakota patients needs a South Dakota nonresident license. The compounding chapter was rewritten effective June 2, 2024, when the older sterile compounding rules (20:51:31:02 to 20:51:31:31) were repealed, and amended again effective September 15, 2025 (52 SDR 27): rule 20:51:31:32 now requires all sterile and nonsterile compounding to follow federal law and the February 1, 2024 USP chapters 797, 795, 800, and 825, and rules 20:51:31:33 and 20:51:31:34 require a compounding policy and procedure manual with a quality assurance program and USP physical, equipment, and environmental standards. South Dakota has not adopted its own list of compoundable bulk substances; the federal 503A test applies (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "sd-board", "sd-36-11", "sd-36-11-19-3", "sd-arsd-20-51-31", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "South Dakota has not published a state rule that is looser than FDA policy. Because many South Dakota patients use mail order, confirming that the dispensing pharmacy holds a South Dakota nonresident license is the main practical check.", "source_ids": [ "fda-glp1-compounding", "sd-36-11", "sd-board" ] }, "research_peptide_sales": { "notes": "SDCL chapter 36-11 reserves dispensing of prescription drugs to licensed pharmacies and pharmacists, so shipping \"research use only\" injectable peptides to South Dakota consumers is not a licensed pharmacy activity.", "source_ids": [ "sd-36-11", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in South Dakota through telehealth?", "a": "Yes, from a provider licensed in South Dakota who first establishes a proper provider-patient relationship under SDCL 34-52-3. That relationship requires identity verification, consent, a diagnosis based on examination and any needed tests, a discussion of options, and follow-up care.", "source_ids": [ "sd-34-52" ] }, { "q": "Does South Dakota allow prescribing from an online questionnaire?", "a": "SDCL 34-52-6 expressly bars prescribing a controlled substance solely from an internet questionnaire or telephone consult without an established relationship. GLP-1 drugs are not controlled, but SDCL 34-52-3 still requires an examination-based diagnosis, so a questionnaire-only model is unlikely to meet South Dakota's standard.", "source_ids": [ "sd-34-52" ] }, { "q": "Does an out-of-state pharmacy need a South Dakota license to ship me compounded peptides?", "a": "Yes. SDCL 36-11-19.2 and 36-11-19.3 define nonresident pharmacies and require them to be licensed by the South Dakota Board of Pharmacy, with proof of good standing in their home state. Check the Board's license lookup before ordering.", "source_ids": [ "sd-36-11-19-3", "sd-36-11", "sd-board" ] }, { "q": "Which rules govern compounding in South Dakota?", "a": "Compounding is governed by SDCL chapter 36-11 and Administrative Rules of South Dakota chapter 20:51:31, which since September 15, 2025 requires compounding to follow federal law and the February 1, 2024 USP compounding chapters. South Dakota has no state bulks list, so a peptide must be an approved drug component, have a USP or NF monograph, or be on the FDA 503A bulks list.", "source_ids": [ "sd-arsd-20-51-31", "sd-36-11", "fda-503a" ] } ], "sources": [ { "id": "sd-board", "type": "other", "title": "South Dakota Board of Pharmacy (South Dakota Department of Health)", "url": "https://doh.sd.gov/licensing-and-records/boards/pharmacy/" }, { "id": "sd-34-52", "type": "other", "title": "South Dakota Codified Laws chapter 34-52, Telehealth utilization by health care professionals", "url": "https://sdlegislature.gov/Statutes/34-52" }, { "id": "sd-36-11", "type": "other", "title": "South Dakota Codified Laws chapter 36-11, Pharmacists and pharmacies (including nonresident pharmacy licensure, 36-11-19.2 and 36-11-19.3)", "url": "https://sdlegislature.gov/Statutes/36-11" }, { "id": "sd-36-11-19-3", "type": "other", "title": "South Dakota Codified Laws 36-11-19.3, Nonresident pharmacy licensure", "url": "https://sdlegislature.gov/Statutes/36-11-19.3" }, { "id": "sd-arsd-20-51-31", "type": "other", "title": "Administrative Rules of South Dakota chapter 20:51:31, Compounding practices (amended effective September 15, 2025)", "url": "https://sdlegislature.gov/Rules/Administrative/20:51:31" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "tennessee", "name": "Tennessee", "abbreviation": "TN", "kind": "state", "summary": "Yes. A Tennessee resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Tennessee-licensed prescriber, including by telehealth under Tennessee Code section 63-1-155, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Tennessee Board of Pharmacy. Tennessee tightened compounding oversight after the 2012 fungal meningitis outbreak: section 63-10-216 requires out-of-state compounding pharmacies to submit a home-state inspection from the previous 12 months before licensure, and Board rule chapter 1140-07 sets sterile compounding standards that cover injectable peptides.", "telehealth": { "allowed": true, "notes": "Tennessee Code section 63-1-155 governs telehealth and telemedicine for licensed health care providers. A provider-patient relationship can be created through telehealth by mutual consent and communication, but it is not created simply because a provider receives a patient's health information, and the provider is held to the same standard of practice as in person. The statute also bars licensing boards from imposing a stricter standard for telehealth than the provider's practice act allows. Under Board of Medical Examiners rules a physician must perform an appropriate history and physical examination, make a diagnosis, discuss a treatment plan, and arrange follow-up before prescribing, and the Board's telemedicine FAQ explains how those steps can be met remotely. The prescriber must hold a Tennessee license. The statute does not expressly decide whether an asynchronous exchange alone satisfies the examination standard, so this record marks it as unresolved.", "async_prescribing_allowed": null, "source_ids": [ "tn-63-1-155", "tn-bme-telemedicine-faq" ] }, "compounding": { "board_name": "Tennessee Board of Pharmacy (Tennessee Department of Health)", "board_url": "https://www.tn.gov/health/licensure/pharm.html", "follows_fda_503a_bulks": true, "notes": "The Tennessee Board of Pharmacy licenses pharmacies under title 63, chapter 10 of the Tennessee Code. Section 63-10-216 is a compounding-specific statute: an out-of-state pharmacy must be inspected by its home-state regulator and provide the most recent inspection (within the previous 12 months) before initial Tennessee licensure as a compounding pharmacy, licensed compounding pharmacies must report disciplinary action by other regulators to the Board within 14 business days, compounding must follow the USP chapters the Board adopts by rule, and sterile compounders must report the quantity of sterile compounded products dispensed. Board rule chapter 1140-07 sets the sterile compounding standards. Tennessee has no separate state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "tn-board", "tn-63-10-216", "tn-rules-1140-07", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Tennessee has not adopted a looser rule, and because injectable GLP-1s are sterile preparations, a pharmacy compounding them for a Tennessee patient must also meet rule chapter 1140-07 and, if out of state, the section 63-10-216 inspection requirement.", "source_ids": [ "fda-glp1-compounding", "tn-63-10-216", "tn-rules-1140-07" ] }, "research_peptide_sales": { "notes": "Under title 63, chapter 10, only licensed pharmacies may dispense prescription drugs to Tennessee patients, so a seller shipping \"research use only\" injectable peptides to Tennessee consumers is not operating under Board of Pharmacy licensure.", "source_ids": [ "tn-board", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Tennessee through telehealth?", "a": "Yes. Section 63-1-155 lets a Tennessee-licensed provider establish a relationship and treat you by telehealth under the same standard of practice as an office visit. Before prescribing, the provider still has to take a history, perform an appropriate examination, make a diagnosis, and plan follow-up.", "source_ids": [ "tn-63-1-155", "tn-bme-telemedicine-faq" ] }, { "q": "Can a Tennessee licensing board make telehealth rules stricter than in-person rules?", "a": "No. Section 63-1-155 bars the board governing a provider from setting a more restrictive standard of practice for telehealth than the provider's practice act allows. Telehealth care is held to the same standard as in-person care, not a lower or higher one.", "source_ids": [ "tn-63-1-155" ] }, { "q": "What does an out-of-state compounding pharmacy need to ship peptides to Tennessee?", "a": "A Tennessee pharmacy license issued after the pharmacy submits an inspection by its home-state regulator from the previous 12 months, as section 63-10-216 requires. It must also report outside disciplinary actions to the Tennessee Board within 14 business days and follow Board-adopted USP compounding standards.", "source_ids": [ "tn-63-10-216", "tn-board" ] }, { "q": "Can a Tennessee pharmacy compound peptides that are not on the FDA bulks list?", "a": "Generally no. Tennessee has no state bulks list, so the federal 503A test applies: the substance must be a component of an approved drug, have a USP or NF monograph, or be on the FDA 503A bulks list. Peptides placed in FDA Category 2 cannot be compounded.", "source_ids": [ "fda-503a", "fda-category-2", "tn-63-10-216" ] } ], "sources": [ { "id": "tn-board", "type": "other", "title": "Tennessee Board of Pharmacy (Tennessee Department of Health)", "url": "https://www.tn.gov/health/licensure/pharm.html" }, { "id": "tn-63-1-155", "type": "other", "title": "Tennessee Code section 63-1-155, Telehealth and telemedicine services, provider-patient relationship, standard of practice", "url": "https://law.justia.com/codes/tennessee/title-63/chapter-1/part-1/section-63-1-155/" }, { "id": "tn-bme-telemedicine-faq", "type": "other", "title": "Tennessee Board of Medical Examiners: Telemedicine FAQ", "url": "https://www.tn.gov/content/dam/tn/health/documents/Telemedicine_FAQs.pdf" }, { "id": "tn-63-10-216", "type": "other", "title": "Tennessee Code section 63-10-216, Compounding pharmacies", "url": "https://law.justia.com/codes/tennessee/title-63/chapter-10/part-2/section-63-10-216/" }, { "id": "tn-rules-1140-07", "type": "other", "title": "Rules of the Tennessee Board of Pharmacy chapter 1140-07, sterile compounding standards", "url": "https://publications.tnsosfiles.com/rules/1140/1140-07.20240501.pdf" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "texas", "name": "Texas", "abbreviation": "TX", "kind": "state", "summary": "Yes. A Texas resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Texas-licensed prescriber, including by telemedicine under Texas Occupations Code chapter 111, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Texas State Board of Pharmacy. Out-of-state pharmacies need a Texas Class E license, and those shipping sterile compounded preparations such as injectable peptides need the Class E-S designation and must meet the Board's sterile compounding rule, 22 Texas Administrative Code 291.133.", "telehealth": { "allowed": true, "notes": "Texas Occupations Code section 111.005 lists the ways a valid practitioner-patient relationship can exist for a telemedicine medical service: a preexisting relationship, call coverage for the patient's physician, or a telemedicine visit using synchronous audiovisual interaction, asynchronous store-and-forward technology (clinically relevant images or patient records, which may be combined with synchronous audio), or another audiovisual technology that lets the practitioner meet the standard of care. For services established by telemedicine the practitioner must give follow-up guidance and, with consent, notify the patient's primary care physician. The Texas Medical Board treats telemedicine care as held to the same standard as in-person care and requires a Texas license. Store-and-forward prescribing is therefore expressly recognized, but it must rest on clinically relevant images or records; a static questionnaire alone is not one of the listed methods. GLP-1 medicines and the peptides in this database are not controlled substances.", "async_prescribing_allowed": true, "source_ids": [ "tx-oc-111", "tx-tmb" ] }, "compounding": { "board_name": "Texas State Board of Pharmacy", "board_url": "https://www.pharmacy.texas.gov/", "follows_fda_503a_bulks": true, "notes": "The Texas State Board of Pharmacy licenses pharmacies under the Texas Pharmacy Act (Occupations Code title 3, subtitle J), with license classes set in Occupations Code chapter 560. Compounding is governed by Board rules in 22 Texas Administrative Code chapter 291, including section 291.131 (non-sterile preparations) and section 291.133 (sterile preparations). Out-of-state pharmacies that dispense to Texas residents hold a Class E (nonresident) license under sections 291.101 to 291.104, and a nonresident pharmacy that compounds sterile preparations for Texas patients must hold the Class E-S designation and comply with section 291.133. Texas has no separate state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "tx-board", "tx-oc-560", "tx-tac-291-133", "tx-tac-291-101", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Texas is a large market for telehealth weight-loss programs and med spas; a compliant program uses a Texas-licensed prescriber and a pharmacy holding a Texas license (Class E-S if it ships sterile compounded injectables from out of state).", "source_ids": [ "fda-glp1-compounding", "tx-tac-291-133", "tx-board" ] }, "research_peptide_sales": { "notes": "The Texas Food, Drug, and Cosmetic Act (Health and Safety Code chapter 431) prohibits introducing adulterated or misbranded drugs into commerce in Texas and requires licensure for drug distributors, and only Board-licensed pharmacies may dispense prescription drugs to Texas patients.", "source_ids": [ "tx-hs-431", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including from a Texas-licensed prescriber using synchronous video or qualifying store-and-forward telemedicine under Occupations Code section 111.005. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "tx-oc-111" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Texas without a video visit?", "a": "Possibly. Texas Occupations Code section 111.005 allows a telemedicine relationship to be established through asynchronous store-and-forward technology that uses clinically relevant images or patient records, not only live video. A bare online questionnaire is not one of the listed methods, and the prescriber must hold a Texas license.", "source_ids": [ "tx-oc-111", "tx-tmb" ] }, { "q": "What must a Texas telemedicine prescriber do after a first visit?", "a": "For a relationship established through telemedicine, section 111.005 requires the practitioner to give the patient guidance on appropriate follow-up care and, with the patient's consent, to notify the patient's primary care physician about the treatment provided.", "source_ids": [ "tx-oc-111" ] }, { "q": "What license does an out-of-state pharmacy need to ship compounded peptides to Texas?", "a": "A Texas Class E (nonresident) pharmacy license, and for sterile compounded preparations such as injectable peptides, the Class E-S designation with compliance with the Board's sterile compounding rule, 22 Texas Administrative Code 291.133. You can check a license in the Texas State Board of Pharmacy verification tool.", "source_ids": [ "tx-tac-291-101", "tx-tac-291-133", "tx-board" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Texas?", "a": "Only in limited, patient specific cases, for example a documented allergy to an inactive ingredient in the approved product. The FDA shortage allowances ended in 2025, and Texas follows the federal framework rather than a looser state rule.", "source_ids": [ "fda-glp1-compounding", "tx-board" ] }, { "q": "Is it legal to buy research peptides online in Texas?", "a": "Not for human use. The Texas Food, Drug, and Cosmetic Act bars distributing adulterated or misbranded drugs in Texas, and injectable \"research use only\" peptides are unapproved new drugs under federal law. They are not dispensed by a licensed pharmacist.", "source_ids": [ "tx-hs-431", "usc-331" ] } ], "sources": [ { "id": "tx-board", "type": "other", "title": "Texas State Board of Pharmacy", "url": "https://www.pharmacy.texas.gov/" }, { "id": "tx-tmb", "type": "other", "title": "Texas Medical Board", "url": "https://www.tmb.state.tx.us/" }, { "id": "tx-oc-111", "type": "other", "title": "Texas Occupations Code chapter 111, Telemedicine, teledentistry, and telehealth (section 111.005, practitioner-patient relationship)", "url": "https://statutes.capitol.texas.gov/Docs/OC/htm/OC.111.htm" }, { "id": "tx-oc-560", "type": "other", "title": "Texas Occupations Code chapter 560, Licensing of pharmacies", "url": "https://statutes.capitol.texas.gov/Docs/OC/htm/OC.560.htm" }, { "id": "tx-tac-291-133", "type": "other", "title": "22 Texas Administrative Code 291.133, Pharmacies compounding sterile preparations", "url": "https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-291-133" }, { "id": "tx-tac-291-101", "type": "other", "title": "22 Texas Administrative Code 291.101 to 291.104, Nonresident (Class E) pharmacy", "url": "https://www.law.cornell.edu/regulations/texas/22-Tex-Admin-Code-SS-291-101" }, { "id": "tx-hs-431", "type": "other", "title": "Texas Health and Safety Code chapter 431, Texas Food, Drug, and Cosmetic Act", "url": "https://statutes.capitol.texas.gov/Docs/HS/htm/HS.431.htm" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "utah", "name": "Utah", "abbreviation": "UT", "kind": "state", "summary": "Yes. A Utah resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Utah-licensed prescriber, including by telehealth under Utah Code section 26B-4-704, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Utah Division of Professional Licensing. Out-of-state mail order and online pharmacies need a Utah Class D pharmacy license, and Utah rule R156-17b-616 requires Class D pharmacies that compound to follow USP chapters 795 and 797.", "telehealth": { "allowed": true, "notes": "Utah's telehealth provisions are in Utah Code title 26B, chapter 4, part 7 (recodified in 2023 from the former Telehealth Act). The definitions include asynchronous store and forward transfer, meaning transmission of a patient's health information from an originating site to a provider at a distant site. Section 26B-4-704 requires a provider offering telehealth to act within the scope of the provider's license, to be held to the same standards of practice as in a traditional setting, and, before providing treatment or prescribing a prescription drug, to establish a diagnosis and identify underlying conditions and contraindications to the recommended treatment. The prescriber must hold a Utah license issued through the Division of Professional Licensing. The statute does not expressly say whether a diagnosis can rest on asynchronous information alone, so this record marks asynchronous prescribing as unresolved. GLP-1 medicines and the peptides in this database are not controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "ut-26b-4-704", "ut-dopl" ] }, "compounding": { "board_name": "Utah State Board of Pharmacy (Utah Division of Professional Licensing, Department of Commerce)", "board_url": "https://dopl.utah.gov/pharmacy/", "follows_fda_503a_bulks": true, "notes": "Utah licenses pharmacies through the Division of Professional Licensing (DOPL) with the Utah State Board of Pharmacy under the Pharmacy Practice Act, Utah Code title 58, chapter 17b, and rule R156-17b. Utah uses lettered pharmacy classes: a Class D pharmacy is a nonresident pharmacy located outside Utah that is authorized as a mail order or online retail pharmacy to compound or dispense drugs to the public. Rule R156-17b-616 requires a Class D pharmacy that compounds to follow USP chapter 795 (non-sterile) and chapter 797 (sterile), and the Class D application requires a recent home-state or NABP inspection. Utah has no separate state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "ut-dopl", "ut-58-17b", "ut-r156-17b-616", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Patients using an out-of-state telehealth program should confirm the shipping pharmacy holds a Utah Class D license, which the DOPL license lookup shows.", "source_ids": [ "fda-glp1-compounding", "ut-r156-17b-616", "ut-dopl" ] }, "research_peptide_sales": { "notes": "The Utah Pharmacy Practice Act (title 58, chapter 17b) limits dispensing of prescription drugs to licensed pharmacies, so a seller shipping \"research use only\" injectable peptides to Utah consumers is not a licensed pharmacy.", "source_ids": [ "ut-58-17b", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including from a Utah-licensed telehealth provider who establishes a diagnosis and screens for contraindications as section 26B-4-704 requires. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "ut-26b-4-704" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Utah through telehealth?", "a": "Yes. Utah Code section 26B-4-704 allows a Utah-licensed provider to treat and prescribe by telehealth under the same standards as an office visit, provided the provider first establishes a diagnosis and identifies underlying conditions and contraindications to the treatment.", "source_ids": [ "ut-26b-4-704" ] }, { "q": "Does Utah allow asynchronous (store and forward) telehealth?", "a": "Utah's telehealth definitions include asynchronous store and forward transfer of health information to a distant provider. Whether a prescription can rest on asynchronous information alone depends on whether the provider can meet the diagnosis and contraindication requirements of section 26B-4-704 and the in-person standard of care.", "source_ids": [ "ut-26b-4-704" ] }, { "q": "What license does an online pharmacy need to ship compounded peptides to Utah?", "a": "A Utah Class D pharmacy license, which covers nonresident mail order and online retail pharmacies. A Class D pharmacy that compounds must follow USP chapters 795 and 797 under rule R156-17b-616, and applicants submit a recent state or NABP inspection.", "source_ids": [ "ut-r156-17b-616", "ut-dopl" ] }, { "q": "Can a Utah pharmacy compound peptides that are not on the FDA bulks list?", "a": "Generally no. Utah has no state bulks list, so the federal 503A test applies: the substance must be a component of an approved drug, have a USP or NF monograph, or be on the FDA 503A bulks list. Peptides in FDA Category 2 cannot be compounded.", "source_ids": [ "fda-503a", "fda-category-2", "ut-58-17b" ] } ], "sources": [ { "id": "ut-dopl", "type": "other", "title": "Utah Division of Professional Licensing: Pharmacy (Utah State Board of Pharmacy)", "url": "https://dopl.utah.gov/pharmacy/" }, { "id": "ut-26b-4-704", "type": "other", "title": "Utah Code section 26B-4-704, Scope of telehealth practice", "url": "https://le.utah.gov/xcode/Title26B/Chapter4/26B-4-S704.html" }, { "id": "ut-58-17b", "type": "other", "title": "Utah Code title 58, chapter 17b, Pharmacy Practice Act", "url": "https://le.utah.gov/xcode/Title58/Chapter17B/58-17b.html" }, { "id": "ut-r156-17b-616", "type": "other", "title": "Utah Administrative Code R156-17b-616, Operating standards, Class D pharmacy, out of state mail service pharmacies", "url": "https://www.law.cornell.edu/regulations/utah/Utah-Admin-Code-R156-17b-616" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "vermont", "name": "Vermont", "abbreviation": "VT", "kind": "state", "summary": "Yes. A Vermont resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a prescriber authorized to practice in Vermont, including by telemedicine or store-and-forward means under 18 V.S.A. section 9361, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a drug outlet licensed by the Vermont Board of Pharmacy. Under 26 V.S.A. section 2061 every drug outlet must hold a Board license in the right classification, and compounding is its own license class; Vermont has no state bulks list, so peptide compounding eligibility follows the FDA framework.", "telehealth": { "allowed": true, "notes": "18 V.S.A. section 9361 lets a Vermont-licensed health care provider prescribe, dispense, or administer drugs after an appropriate examination performed in person, through telemedicine, or by instrumentation and diagnostic equipment that transmits images and medical records electronically, and it holds electronic prescribing to the same standards as a traditional setting. The section also covers services delivered by store-and-forward means, requires the originating site to obtain informed consent for store-and-forward services, and preserves the patient's right to a later real-time or in-person visit. Definitions follow 8 V.S.A. section 4098a (telemedicine and store-and-forward). The prescriber must be licensed in Vermont or practice under Vermont's telehealth licensure or registration pathway administered by the Office of Professional Regulation. Because the statute expressly recognizes examination through transmitted images and records and store-and-forward delivery, this record marks asynchronous prescribing as allowed, subject to the standard of care. GLP-1 medicines and the peptides in this database are not controlled substances.", "async_prescribing_allowed": true, "source_ids": [ "vt-18-9361", "vt-8-4098a", "vt-opr" ] }, "compounding": { "board_name": "Vermont Board of Pharmacy (Office of Professional Regulation, Vermont Secretary of State)", "board_url": "https://sos.vermont.gov/pharmacy/", "follows_fda_503a_bulks": true, "notes": "The Vermont Board of Pharmacy, administered by the Office of Professional Regulation, licenses pharmacists and drug outlets under 26 V.S.A. chapter 36. Section 2061 requires every drug outlet to register and hold a license in one or more classifications, including retail, compounding, outsourcing, and home infusion, and the Board sets the criteria for each by rule. The Board's administrative rules effective February 1, 2026 settle both points. Rule 10-9 requires a drug outlet physically located outside Vermont but doing business in Vermont to register for the applicable license type; rule 7-4(b) requires a nonresident outlet to submit an inspection report assessing compliance with applicable law and USP standards, done by its home-state board, the national pharmacy boards association, FDA, or another recognized third party within 2 years before application for a compounding or home infusion pharmacy; and rule 6-2 requires a qualifying inspection at each renewal. Rule 10-4 requires a pharmacy that compounds to register as a compounding pharmacy in addition to its retail license and to comply with 21 U.S.C. 353a, USP chapter 795 for non-sterile compounding, USP chapter 797 for sterile compounding, and USP chapter 800 for hazardous drugs, and to compound only on a patient-specific order or in limited quantities based on regularly observed prescribing patterns. Vermont has not adopted its own list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "vt-board", "vt-26-2061", "vt-26-36", "vt-rules-2026", "vt-board-rules", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "A pharmacy compounding a GLP-1 for a Vermont patient must hold the appropriate Vermont drug outlet license, including a nonresident license if it ships from out of state.", "source_ids": [ "fda-glp1-compounding", "vt-26-2061", "vt-board" ] }, "research_peptide_sales": { "notes": "Under 26 V.S.A. chapter 36, drugs may be dispensed to Vermont patients only by licensed pharmacists working in licensed drug outlets, so a seller shipping \"research use only\" injectable peptides to Vermont consumers is not a licensed outlet.", "source_ids": [ "vt-26-36", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription, including from a Vermont-authorized prescriber after a telemedicine or store-and-forward examination under 18 V.S.A. 9361. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "vt-18-9361" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Vermont through telemedicine?", "a": "Yes. 18 V.S.A. section 9361 allows a Vermont-licensed provider to prescribe after an appropriate examination done in person, through telemedicine, or with equipment that transmits images and medical records electronically, held to the same standard as an office visit.", "source_ids": [ "vt-18-9361" ] }, { "q": "Does Vermont allow store-and-forward telehealth?", "a": "Yes. Section 9361 covers services delivered by store-and-forward means, requires informed consent at the originating site, and keeps the patient's right to a later real-time or in-person visit. Definitions come from 8 V.S.A. section 4098a.", "source_ids": [ "vt-18-9361", "vt-8-4098a" ] }, { "q": "Does a compounding pharmacy need a Vermont license to ship to me?", "a": "Yes. 26 V.S.A. section 2061 requires every drug outlet to hold a Vermont Board of Pharmacy license in the correct classification. Under the Board's 2026 rules, an outlet outside Vermont doing business in the state must register for the applicable license type (rule 10-9), a pharmacy that compounds must also register as a compounding pharmacy (rule 10-4), and a nonresident compounding pharmacy must submit an inspection report from the prior 2 years (rule 7-4). Check the Office of Professional Regulation license lookup before ordering.", "source_ids": [ "vt-26-2061", "vt-rules-2026", "vt-board-rules" ] }, { "q": "Can a Vermont pharmacy compound peptides that are not on the FDA bulks list?", "a": "Generally no. Vermont has no state bulks list, so the federal 503A test applies: the substance must be a component of an approved drug, have a USP or NF monograph, or be on the FDA 503A bulks list. Peptides in FDA Category 2 cannot be compounded.", "source_ids": [ "fda-503a", "fda-category-2" ] } ], "sources": [ { "id": "vt-board", "type": "other", "title": "Vermont Board of Pharmacy (Office of Professional Regulation)", "url": "https://sos.vermont.gov/pharmacy/" }, { "id": "vt-board-rules", "type": "other", "title": "Vermont Board of Pharmacy: statutes, rules, and resources", "url": "https://sos.vermont.gov/pharmacy/statutes-rules-resources" }, { "id": "vt-rules-2026", "type": "other", "title": "Administrative Rules for the Vermont Board of Pharmacy, effective February 1, 2026 (rules 6-2, 7-4, 10-4, 10-9)", "url": "https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/pharmacy/pharmacy_administrative_rules_effective_2026_0201.pdf" }, { "id": "vt-opr", "type": "other", "title": "Vermont Office of Professional Regulation", "url": "https://sos.vermont.gov/opr/" }, { "id": "vt-18-9361", "type": "other", "title": "18 V.S.A. section 9361, Health care providers delivering health care services through telemedicine or by store-and-forward means", "url": "https://legislature.vermont.gov/statutes/section/18/219/09361" }, { "id": "vt-8-4098a", "type": "other", "title": "8 V.S.A. section 4098a, Coverage of health care services delivered through telemedicine and by store-and-forward means (definitions)", "url": "https://legislature.vermont.gov/statutes/section/08/107/04098a" }, { "id": "vt-26-36", "type": "other", "title": "26 V.S.A. chapter 36, Pharmacy", "url": "https://legislature.vermont.gov/statutes/chapter/26/036" }, { "id": "vt-26-2061", "type": "other", "title": "26 V.S.A. section 2061, Registration and licensure of drug outlets", "url": "https://legislature.vermont.gov/statutes/section/26/036/02061" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "virginia", "name": "Virginia", "abbreviation": "VA", "kind": "state", "summary": "Yes. A Virginia resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Virginia-licensed prescriber, including by telemedicine under the bona fide practitioner-patient relationship rules in Virginia Code section 54.1-3303, and can obtain a compounded peptide when it is dispensed by a pharmacy permitted or registered by the Virginia Board of Pharmacy and meets both federal 503A rules and Virginia's own compounding statute, section 54.1-3410.2. Nonresident pharmacies must register under section 54.1-3434.1, name a Virginia-licensed pharmacist in charge, and submit a recent home-state inspection showing USP compliance.", "telehealth": { "allowed": true, "notes": "Virginia Code section 54.1-3303 requires a bona fide practitioner-patient relationship for every prescription: the practitioner must obtain a medical and drug history, discuss the benefits and risks of the treatment, perform an appropriate examination, and initiate follow-up care as needed. The statute allows the examination to be done by face-to-face interactive, two-way, real-time communication or by store-and-forward technologies when the standard of care does not require an in-person examination. Virginia classifies all prescription-only drugs that are not otherwise controlled as Schedule VI under the Drug Control Act, so GLP-1 medicines and prescription peptides fall within the Schedule II through VI telemedicine provisions of section 54.1-3303, which also expect the prescriber to maintain a practice location in Virginia or be able to make an appropriate referral. The prescriber must hold a Virginia license. Because the statute expressly names store-and-forward technologies, this record marks asynchronous prescribing as allowed, subject to the standard of care.", "async_prescribing_allowed": true, "source_ids": [ "va-54-1-3303", "va-dhp-medicine", "va-54-1-3455" ] }, "compounding": { "board_name": "Virginia Board of Pharmacy (Virginia Department of Health Professions)", "board_url": "https://www.dhp.virginia.gov/Boards/Pharmacy/", "follows_fda_503a_bulks": false, "notes": "The Virginia Board of Pharmacy regulates pharmacies under the Drug Control Act (Virginia Code title 54.1, chapter 34) and regulations at 18VAC110-20; regulation 18VAC110-20-321 requires compounding to follow USP-NF compounding standards and section 54.1-3410.2. That statute allows compounding for specific patient prescriptions or in anticipation of prescriptions based on an observed prescribing pattern, and subsection F sets Virginia's own two-part test for bulk drug substances: the substance must meet an applicable USP or NF monograph (if one exists) and the USP compounding chapter, or be a component of an FDA approved drug, or be otherwise approved by FDA, or be made by an FDA-registered establishment; and it must come from a licensed or registered wholesale distributor or a supplier approved by the Board and FDA. Neither section 54.1-3410.2 nor 18VAC110-20-321 mentions the FDA 503A bulks list, so the state test does not turn on that list; federal 503A limits, including the bulks list, still apply to every Virginia compounder, and the state sourcing and USP requirements add to them. Section 54.1-3434.1 requires nonresident pharmacies to register, designate a pharmacist in charge licensed in Virginia, and submit a home-state inspection (within six months for a new registration, two years for renewal) showing USP compliance for compounding.", "source_ids": [ "va-board", "va-54-1-3410-2", "va-18vac110-20-321", "va-54-1-3434-1", "va-18vac110-20", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Out-of-state telehealth programs must dispense through a pharmacy registered under section 54.1-3434.1 with a Virginia-licensed pharmacist in charge.", "source_ids": [ "fda-glp1-compounding", "va-54-1-3410-2", "va-54-1-3434-1" ] }, "research_peptide_sales": { "notes": "The Virginia Drug Control Act restricts the sale and dispensing of Schedule VI (prescription-only) drugs to licensed practitioners and permitted or registered pharmacies, so injectable peptides sold to Virginia consumers as \"research use only\" are outside the licensed supply chain.", "source_ids": [ "va-54-1-3455", "va-board", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "A Schedule VI drug in Virginia, available branded by prescription, including after a real-time or store-and-forward telemedicine examination under section 54.1-3303. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "va-54-1-3303" ] }, { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. Virginia's own bulk substance criteria in section 54.1-3410.2 add a second hurdle.", "source_ids": [ "fda-category-2", "fda-pcac", "va-54-1-3410-2" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Virginia through telemedicine?", "a": "Yes. Virginia Code section 54.1-3303 lets a Virginia-licensed prescriber establish a bona fide practitioner-patient relationship through real-time two-way communication or store-and-forward technology, as long as the standard of care does not require an in-person exam. The prescriber must still take a history, discuss risks and benefits, and arrange follow-up.", "source_ids": [ "va-54-1-3303" ] }, { "q": "Why does Virginia call GLP-1 drugs Schedule VI?", "a": "Virginia's Drug Control Act places every prescription-only drug that is not in Schedules I to V into Schedule VI. It does not mean the drug is a controlled substance in the federal sense; it simply means a prescription is required, and the telemedicine rules in section 54.1-3303 apply.", "source_ids": [ "va-54-1-3455", "va-54-1-3303" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Virginia?", "a": "Registration as a nonresident pharmacy under section 54.1-3434.1, a pharmacist in charge licensed in Virginia, and a current home-state inspection report showing compliance with USP-NF standards for sterile and non-sterile compounding. The Department of Health Professions license lookup shows registration status.", "source_ids": [ "va-54-1-3434-1", "va-board" ] }, { "q": "Is compounded semaglutide or tirzepatide still available in Virginia?", "a": "Only in limited, patient specific cases. The FDA shortage allowances ended in 2025, and Virginia pharmacies must also meet the state's compounding statute, section 54.1-3410.2, so a GLP-1 can be compounded only for a documented need the approved product cannot meet.", "source_ids": [ "fda-glp1-compounding", "va-54-1-3410-2" ] }, { "q": "Does Virginia have its own compounding law?", "a": "Yes. Section 54.1-3410.2 governs compounding in Virginia: it limits compounding to patient prescriptions or observed prescribing patterns, requires USP-NF compliance, sets bulk substance sourcing criteria, and regulates compounded products supplied for office administration. Federal 503A limits apply on top of it.", "source_ids": [ "va-54-1-3410-2", "fda-503a" ] } ], "sources": [ { "id": "va-board", "type": "other", "title": "Virginia Board of Pharmacy (Department of Health Professions)", "url": "https://www.dhp.virginia.gov/Boards/Pharmacy/" }, { "id": "va-dhp-medicine", "type": "other", "title": "Virginia Board of Medicine (Department of Health Professions)", "url": "https://www.dhp.virginia.gov/Boards/Medicine/" }, { "id": "va-54-1-3303", "type": "other", "title": "Virginia Code section 54.1-3303, Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only", "url": "https://law.lis.virginia.gov/vacode/title54.1/chapter34/section54.1-3303/" }, { "id": "va-54-1-3410-2", "type": "other", "title": "Virginia Code section 54.1-3410.2, Compounding", "url": "https://law.lis.virginia.gov/vacode/title54.1/chapter34/section54.1-3410.2/" }, { "id": "va-54-1-3434-1", "type": "other", "title": "Virginia Code section 54.1-3434.1, Nonresident pharmacies to register with Board", "url": "https://law.lis.virginia.gov/vacode/title54.1/chapter34/section54.1-3434.1/" }, { "id": "va-54-1-3455", "type": "other", "title": "Virginia Code section 54.1-3455, Schedule VI", "url": "https://law.lis.virginia.gov/vacode/title54.1/chapter34/section54.1-3455/" }, { "id": "va-18vac110-20", "type": "other", "title": "18VAC110-20, Regulations governing the practice of pharmacy", "url": "https://law.lis.virginia.gov/admincode/title18/agency110/chapter20/" }, { "id": "va-18vac110-20-321", "type": "other", "title": "18VAC110-20-321, Compounding", "url": "https://law.lis.virginia.gov/admincode/title18/agency110/chapter20/section321/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "washington", "name": "Washington", "abbreviation": "WA", "kind": "state", "summary": "Yes. A Washington resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Washington-licensed prescriber, including by telehealth under the Uniform Telehealth Act (chapter 18.134 RCW, enacted 2024), and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Washington Pharmacy Quality Assurance Commission. Nonresident pharmacies need a Washington license under RCW 18.64.360 backed by an approved inspection report, and every licensee that compounds must follow the USP chapters adopted in WAC 246-945-100.", "telehealth": { "allowed": true, "notes": "Washington adopted the Uniform Telehealth Act in 2024 (chapter 18.134 RCW). RCW 18.134.010 defines telehealth as synchronous or asynchronous telecommunication technology used to provide care to a patient at a different location. Under RCW 18.134.030 a practitioner-patient relationship may be established through telehealth, but not through email, instant messaging, text messaging, or fax. RCW 18.134.040 holds telehealth care to the same professional practice standards as comparable in-person care and bars disciplining authorities from adopting different standards just because care is delivered by telehealth. RCW 18.134.050 generally requires an out-of-state practitioner to hold a Washington license, with narrow exceptions for consultation and follow-up care of established patients who are temporarily in Washington. Asynchronous technology is within the definition, but because the relationship cannot be formed by messaging or a text-based exchange, whether a first prescription can rest on an asynchronous intake alone is not settled, so this record marks it as unresolved. GLP-1 medicines and the peptides in this database are not controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "wa-rcw-18-134" ] }, "compounding": { "board_name": "Washington Pharmacy Quality Assurance Commission (Washington State Department of Health)", "board_url": "https://doh.wa.gov/licenses-permits-and-certificates/facilities-z/pharmacies-and-pharmaceutical-firms/commission-information", "follows_fda_503a_bulks": true, "notes": "In Washington the pharmacy regulator is a commission rather than a board: the Pharmacy Quality Assurance Commission (PQAC) regulates the practice of pharmacy and the distribution of drugs within and into the state under chapter 18.64 RCW and its consolidated rule chapter, WAC 246-945. WAC 246-945-100 requires every licensee that compounds sterile or non-sterile preparations to comply with the applicable USP chapters (795, 797, 800, and 825). RCW 18.64.360 requires nonresident pharmacies to be licensed and to submit a current inspection report from an approved state or third-party program; the Commission accepts reports from non-approved states only for pharmacies that do not compound. Washington has no separate state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "wa-pqac", "wa-rcw-18-64", "wa-rcw-18-64-360", "wa-wac-246-945", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because a nonresident pharmacy that compounds must supply an inspection report from an approved program to keep its Washington license, patients can confirm eligibility through the Department of Health provider credential search.", "source_ids": [ "fda-glp1-compounding", "wa-rcw-18-64-360", "wa-pqac" ] }, "research_peptide_sales": { "notes": "Chapter 69.41 RCW makes it unlawful to sell, deliver, or possess a legend (prescription) drug except on a valid prescription or as otherwise authorized (RCW 69.41.030), and pharmacy distribution into Washington requires Commission licensure under chapter 18.64 RCW.", "source_ids": [ "wa-rcw-69-41-030", "wa-rcw-18-64", "usc-331" ] }, "peptide_notes": [ { "slug": "bpc-157", "note": "Not FDA approved and not on the 503A bulks list. PCAC's July 2026 recommendation is advisory, and until FDA publishes a final rule a 503A pharmacy has no federal basis to compound it from bulk; a state board cannot authorize what federal law does not. The Pharmacy Quality Assurance Commission has not published a peptide-specific rule.", "source_ids": [ "fda-category-2", "fda-pcac", "wa-pqac" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Washington through telehealth?", "a": "Yes. Under the Uniform Telehealth Act (chapter 18.134 RCW) a Washington-licensed practitioner can establish a relationship with you through telehealth and prescribe under the same standards as an in-person visit.", "source_ids": [ "wa-rcw-18-134" ] }, { "q": "Can a Washington telehealth relationship start over text or email?", "a": "No. RCW 18.134.030 says a practitioner-patient relationship may not be established through email, instant messaging, text messaging, or fax.", "source_ids": [ "wa-rcw-18-134" ] }, { "q": "Does an out-of-state telehealth prescriber need a Washington license?", "a": "Generally yes. RCW 18.134.050 requires a Washington license, with narrow exceptions for consultation, specialty assessment, or follow-up care for established patients who are temporarily in Washington. A new GLP-1 patient in Washington needs a Washington-licensed prescriber.", "source_ids": [ "wa-rcw-18-134" ] }, { "q": "What does an out-of-state compounding pharmacy need to ship to Washington?", "a": "A Washington nonresident pharmacy license under RCW 18.64.360, supported by a current inspection report from an approved state or third-party program. Pharmacies that compound cannot rely on reports from non-approved states, and all compounding must follow the USP chapters in WAC 246-945-100.", "source_ids": [ "wa-rcw-18-64-360", "wa-wac-246-945" ] }, { "q": "Is it legal to buy research peptides online in Washington?", "a": "Not for human use. RCW 69.41.030 bars selling or delivering a legend drug without a valid prescription, and \"research use only\" injectable peptides are unapproved new drugs under federal law that are not dispensed by a licensed pharmacy.", "source_ids": [ "wa-rcw-69-41-030", "usc-331" ] } ], "sources": [ { "id": "wa-pqac", "type": "other", "title": "Washington Pharmacy Quality Assurance Commission (Department of Health)", "url": "https://doh.wa.gov/licenses-permits-and-certificates/facilities-z/pharmacies-and-pharmaceutical-firms/commission-information" }, { "id": "wa-rcw-18-134", "type": "other", "title": "Chapter 18.134 RCW, Uniform Telehealth Act", "url": "https://app.leg.wa.gov/RCW/default.aspx?cite=18.134" }, { "id": "wa-rcw-18-64", "type": "other", "title": "Chapter 18.64 RCW, Pharmacists", "url": "https://app.leg.wa.gov/RCW/default.aspx?cite=18.64" }, { "id": "wa-rcw-18-64-360", "type": "other", "title": "RCW 18.64.360, Nonresident pharmacies", "url": "https://app.leg.wa.gov/rcw/default.aspx?cite=18.64.360" }, { "id": "wa-wac-246-945", "type": "other", "title": "Chapter 246-945 WAC, Pharmacy Quality Assurance Commission (including WAC 246-945-100, compounding minimum standards)", "url": "https://app.leg.wa.gov/WAC/default.aspx?cite=246-945" }, { "id": "wa-rcw-69-41-030", "type": "other", "title": "RCW 69.41.030, Sale, delivery, or possession of legend drug without prescription or order prohibited", "url": "https://app.leg.wa.gov/RCW/default.aspx?cite=69.41.030" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "west-virginia", "name": "West Virginia", "abbreviation": "WV", "kind": "state", "summary": "Yes, with stricter telehealth rules than most states. A West Virginia resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a West Virginia-licensed physician, but under West Virginia Code section 30-3-13a a first telemedicine relationship must be set up by real-time video or audio, and a prescription based solely on an online questionnaire is not acceptable care. Compounded peptides are available when eligible under federal 503A rules and dispensed by a pharmacy licensed or registered by the West Virginia Board of Pharmacy; out-of-state pharmacies register as mail-order pharmacies, and sterile compounding requires a separate Board permit.", "telehealth": { "allowed": true, "notes": "West Virginia Code section 30-3-13a governs telemedicine by allopathic physicians and podiatrists (section 30-14-12d is the osteopathic counterpart). Telemedicine includes electronic communication, store-and-forward telecommunication, and audio-only calls, and store-and-forward is defined as asynchronous transmission of medical data or images. For an initial encounter the physician-patient relationship must be established through interactive communication: real-time video, or real-time audio-only calls, with store-and-forward accepted only for pathology and radiology. The statute states that treatment, including issuing a prescription, based solely on an online questionnaire does not meet the standard of care. Once a relationship exists, any appropriate telemedicine technology can be used for follow-up. The physician must be licensed in West Virginia because the practice of medicine occurs where the patient is located, and Schedule II controlled substances generally cannot be prescribed by telemedicine to new patients; GLP-1 medicines are not scheduled.", "async_prescribing_allowed": false, "source_ids": [ "wv-30-3-13a", "wv-30-14-12d" ] }, "compounding": { "board_name": "West Virginia Board of Pharmacy", "board_url": "https://www.wvbop.com/", "follows_fda_503a_bulks": true, "notes": "The West Virginia Board of Pharmacy regulates pharmacies under the Larry W. Border Pharmacy Practice Act (West Virginia Code chapter 30, article 5) and legislative rules in title 15 of the Code of State Rules. A West Virginia pharmacy that compounds sterile preparations must hold a Sterile Pharmaceutical Compounding Permit in addition to its pharmacy license, issued after a satisfactory Board inspection, under section 15-1-12 (Sterile Pharmaceutical Compounding) of the Board's legislative rule 15CSR1. The amended rule, passed March 14, 2026 and effective July 1, 2026, keeps sterile compounding at section 15-1-12 and requires the compounding environment to meet the 2023 USP chapter 797 (sterile preparations) and chapter 800 (hazardous drugs) standards and a recognized certification guide for sterile compounding facilities or a substantially similar standard. A nonresident pharmacy that dispenses to West Virginia residents is registered in the same manner as a mail-order pharmacy (15 CSR 6), must keep records available to the Board, report to the West Virginia Controlled Substances Monitoring Program, and provide toll-free pharmacist counseling. Rule 15CSR1 does not set a state list of compoundable bulk substances and does not mention the 503A bulks list, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "wv-board", "wv-30-5", "wv-15csr1-12", "wv-15csr6-3", "wv-nonresident", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "The practical West Virginia constraint is on the prescribing side: questionnaire-only GLP-1 programs do not meet section 30-3-13a, so a compliant first visit is live video or a real-time phone call with a West Virginia-licensed physician.", "source_ids": [ "fda-glp1-compounding", "wv-30-3-13a" ] }, "research_peptide_sales": { "notes": "Under the Pharmacy Practice Act (chapter 30, article 5), prescription drugs may be dispensed to West Virginia patients only by licensed pharmacies or registered mail-order pharmacies, so a seller shipping \"research use only\" injectable peptides to West Virginia consumers is outside the licensed channel.", "source_ids": [ "wv-30-5", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription after a real-time video or audio telemedicine visit with a West Virginia-licensed physician; a questionnaire-only prescription does not meet section 30-3-13a. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "wv-30-3-13a" ] }, { "slug": "tirzepatide", "note": "Available branded by prescription. Compounded tirzepatide is limited to the federal patient specific exception since the 503A grace period ended February 18, 2025, and an in-state compounder of injectables needs a West Virginia Sterile Pharmaceutical Compounding Permit.", "source_ids": [ "fda-glp1-compounding", "wv-15csr1-12" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in West Virginia from an online questionnaire?", "a": "No. West Virginia Code section 30-3-13a says treatment, including a prescription, based solely on an online questionnaire does not meet the standard of care. The first visit must use real-time video or a real-time audio call.", "source_ids": [ "wv-30-3-13a" ] }, { "q": "Can my first West Virginia telehealth visit be a phone call?", "a": "Yes. Section 30-3-13a allows the physician-patient relationship to be established through real-time audio-only calls as well as video. Store-and-forward can establish a relationship only for pathology and radiology. After the relationship exists, other telemedicine tools can be used for follow-up.", "source_ids": [ "wv-30-3-13a" ] }, { "q": "Does the telehealth physician need a West Virginia license?", "a": "Yes. Under section 30-3-13a the practice of medicine occurs where the patient is located, so a physician treating a patient in West Virginia by telemedicine must be licensed in West Virginia.", "source_ids": [ "wv-30-3-13a", "wv-30-14-12d" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to West Virginia?", "a": "A West Virginia mail-order pharmacy registration from the Board of Pharmacy, which is how nonresident pharmacies are registered. It must keep records available to the Board, report to the Controlled Substances Monitoring Program, and offer toll-free pharmacist counseling.", "source_ids": [ "wv-15csr6-3", "wv-nonresident" ] } ], "sources": [ { "id": "wv-board", "type": "other", "title": "West Virginia Board of Pharmacy", "url": "https://www.wvbop.com/" }, { "id": "wv-nonresident", "type": "other", "title": "West Virginia Board of Pharmacy: non-resident facilities", "url": "https://www.wvbop.com/facilities/nonresidentoverview.asp" }, { "id": "wv-30-3-13a", "type": "other", "title": "West Virginia Code section 30-3-13a, Telemedicine practice; requirements; exceptions; definitions", "url": "https://code.wvlegislature.gov/30-3-13A/" }, { "id": "wv-30-14-12d", "type": "other", "title": "West Virginia Code section 30-14-12d, Telemedicine practice (osteopathic physicians)", "url": "https://code.wvlegislature.gov/30-14-12D/" }, { "id": "wv-30-5", "type": "other", "title": "West Virginia Code chapter 30, article 5, Larry W. Border Pharmacy Practice Act", "url": "https://code.wvlegislature.gov/30-5/" }, { "id": "wv-15csr1-12", "type": "other", "title": "West Virginia legislative rule 15CSR1 (Board of Pharmacy), as amended effective July 1, 2026, section 15-1-12, Sterile pharmaceutical compounding", "url": "https://apps.sos.wv.gov/adlaw/csr/readfile.aspx?DocId=58920&Format=PDF" }, { "id": "wv-15csr6-3", "type": "other", "title": "West Virginia Code of State Rules 15-6-3, Registrations for mail-order pharmacies", "url": "https://www.law.cornell.edu/regulations/west-virginia/W-Va-C-S-R-SS-15-6-3" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "wisconsin", "name": "Wisconsin", "abbreviation": "WI", "kind": "state", "summary": "Yes. A Wisconsin resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Wisconsin-licensed prescriber, including by telehealth under Medical Examining Board rule chapter Med 24, and can obtain a compounded peptide when it is eligible under federal 503A rules and dispensed by a pharmacy licensed through the Wisconsin Pharmacy Examining Board. Med 24.07 says a prescription based only on a static electronic questionnaire does not meet the minimum standard of practice, and Wisconsin Statutes section 450.065 bars any out-of-state pharmacy from shipping prescription drugs to Wisconsin residents without a Wisconsin license.", "telehealth": { "allowed": true, "notes": "Wisconsin regulates physician telehealth through Wisconsin Administrative Code chapter Med 24, which uses the statutory definition of telehealth in Wisconsin Statutes section 440.01(1)(hm). Med 24.03 allows a physician-patient relationship to be established through telemedicine, and Med 24.04 requires a physician who diagnoses or treats a patient located in Wisconsin by telemedicine to hold a Wisconsin license from the Medical Examining Board. Med 24.07(1) requires a physician who prescribes through a website to be licensed, disclose their identity, obtain informed consent, perform a documented patient evaluation including history and examination as needed, and keep health records, and Med 24.07(2) states that issuing a prescription based only on a static electronic questionnaire does not meet the standard of minimally competent practice. The rules do not expressly address other asynchronous formats, so this record marks asynchronous prescribing as unresolved; questionnaire-only prescribing is clearly not compliant. GLP-1 medicines and the peptides in this database are not controlled substances.", "async_prescribing_allowed": null, "source_ids": [ "wi-med-24", "wi-440-01" ] }, "compounding": { "board_name": "Wisconsin Pharmacy Examining Board (Wisconsin Department of Safety and Professional Services)", "board_url": "https://dsps.wi.gov/Pages/BoardsCouncils/Pharmacy/Default.aspx", "follows_fda_503a_bulks": true, "notes": "The Pharmacy Examining Board, administered by the Department of Safety and Professional Services, licenses pharmacists and pharmacies under Wisconsin Statutes chapter 450. Compounding is governed by Wisconsin Administrative Code chapter Phar 15 (pharmaceutical compounding, safe handling of hazardous drugs, and radiopharmaceuticals), which in Phar 15.02 adopts USP general chapters 795 (non-sterile), 797 (sterile), 800 (hazardous drugs), and 825 (radiopharmaceuticals). Section 450.065 provides that no pharmacy in another state may ship, mail, or otherwise deliver a prescribed drug to persons in Wisconsin unless it holds a Wisconsin license, which requires proof of home-state licensure, a signed statement that the owner or managing pharmacist knows Wisconsin pharmacy law, and a toll-free line open at least 40 hours a week. Wisconsin has no separate state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "wi-board", "wi-450", "wi-450-065", "wi-phar-15", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Two Wisconsin checks apply to telehealth GLP-1 programs: the prescriber must do more than review a static questionnaire (Med 24.07), and any out-of-state pharmacy must hold a Wisconsin license under section 450.065.", "source_ids": [ "fda-glp1-compounding", "wi-med-24", "wi-450-065" ] }, "research_peptide_sales": { "notes": "Wisconsin Statutes chapter 450 limits dispensing of prescription drugs to licensed pharmacies and practitioners, and section 450.065 bars out-of-state pharmacies from delivering prescribed drugs into Wisconsin without a license, so sellers shipping \"research use only\" injectable peptides to Wisconsin consumers are outside the licensed channel.", "source_ids": [ "wi-450", "wi-450-065", "usc-331" ] }, "peptide_notes": [ { "slug": "semaglutide", "note": "Available branded by prescription from a Wisconsin-licensed prescriber who performs a documented evaluation; a static questionnaire alone does not meet Med 24.07. Compounded semaglutide is limited to the federal patient specific exception since the 503A grace period ended April 22, 2025.", "source_ids": [ "fda-glp1-compounding", "wi-med-24" ] } ], "faqs": [ { "q": "Can I get a GLP-1 prescription in Wisconsin through telehealth?", "a": "Yes. Med 24.03 allows a physician-patient relationship to be established through telemedicine, and a Wisconsin-licensed physician can prescribe after a documented evaluation that meets the same standard as in-person care.", "source_ids": [ "wi-med-24" ] }, { "q": "Can a Wisconsin telehealth doctor prescribe from an online form?", "a": "Not from a static form alone. Med 24.07(2) states that issuing a prescription based only on a static electronic questionnaire does not meet the standard of minimally competent medical practice. The physician must document a patient evaluation, including history and an examination as needed.", "source_ids": [ "wi-med-24" ] }, { "q": "Does the telehealth doctor need a Wisconsin license?", "a": "Yes. Med 24.04 requires a physician who uses telemedicine to diagnose or treat a patient located in Wisconsin to be licensed by the Wisconsin Medical Examining Board.", "source_ids": [ "wi-med-24" ] }, { "q": "Can an out-of-state pharmacy ship compounded peptides to Wisconsin?", "a": "Only with a Wisconsin license. Section 450.065 bars an out-of-state pharmacy from shipping or delivering a prescribed drug to anyone in Wisconsin unless it is licensed by the Pharmacy Examining Board, and compounding must follow the USP chapters adopted in Phar 15.", "source_ids": [ "wi-450-065", "wi-phar-15" ] } ], "sources": [ { "id": "wi-board", "type": "other", "title": "Wisconsin Pharmacy Examining Board (Department of Safety and Professional Services)", "url": "https://dsps.wi.gov/Pages/BoardsCouncils/Pharmacy/Default.aspx" }, { "id": "wi-med-24", "type": "other", "title": "Wisconsin Administrative Code chapter Med 24, Telemedicine", "url": "https://docs.legis.wisconsin.gov/code/admin_code/med/24" }, { "id": "wi-440-01", "type": "other", "title": "Wisconsin Statutes section 440.01, Definitions (including telehealth)", "url": "https://docs.legis.wisconsin.gov/statutes/statutes/440/i/01" }, { "id": "wi-450", "type": "other", "title": "Wisconsin Statutes chapter 450, Pharmacy examining board", "url": "https://docs.legis.wisconsin.gov/statutes/statutes/450" }, { "id": "wi-450-065", "type": "other", "title": "Wisconsin Statutes section 450.065, Out-of-state pharmacies", "url": "https://docs.legis.wisconsin.gov/statutes/statutes/450/065" }, { "id": "wi-phar-15", "type": "other", "title": "Wisconsin Administrative Code chapter Phar 15, Pharmaceutical compounding, safe handling of hazardous drugs, and radiopharmaceuticals", "url": "https://docs.legis.wisconsin.gov/code/admin_code/phar/15" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 }, { "slug": "wyoming", "name": "Wyoming", "abbreviation": "WY", "kind": "state", "summary": "Yes. A Wyoming resident can obtain FDA approved peptides such as semaglutide and tirzepatide from a Wyoming-licensed physician, including by telemedicine, which Wyoming Statutes section 33-26-102(a)(xxix) defines as the practice of medicine and which the Wyoming Board of Medicine regulates under section 33-26-202. A compounded peptide is available when it is eligible under federal 503A rules and dispensed by a pharmacy licensed by the Wyoming State Board of Pharmacy; out-of-state pharmacies need a Wyoming nonresident pharmacy license under section 33-24-152. Wyoming has no state bulks list, so peptide compounding eligibility follows the FDA framework.", "telehealth": { "allowed": true, "notes": "Wyoming Statutes section 33-26-102(a)(xxix) defines telemedicine as the practice of medicine by electronic communication or other means from a physician in one location to a patient in another, with or without an intervening provider, and section 33-26-202 authorizes the Wyoming Board of Medicine to adopt telemedicine rules. Because telemedicine is the practice of medicine, the physician generally needs a Wyoming license. Board of Medicine rules chapter 1, section 7 (Exemption from licensure) carves out narrow exceptions: section 7(a) lets an out-of-state physician brought in for consultation by a Wyoming-licensed physician, in person or through telemedicine, practice for up to 12 days in any 52-week period after written notice to the Board; and section 7(e) lets an out-of-state physician or physician assistant who first saw a Wyoming resident in person in a state where they are licensed continue that care by telehealth for up to six months, after which another in-person visit is required, with new conditions referred to a Wyoming-licensed provider. Section 33-26-402 treats initially prescribing controlled substances over the internet without an established physician-patient relationship as grounds for discipline; GLP-1 medicines and the peptides in this database are not controlled. The Board of Medicine rules do not address whether an asynchronous encounter alone can support a new prescription, so this record leaves that question open.", "async_prescribing_allowed": null, "source_ids": [ "wy-title-33", "wy-med-board", "wy-med-rules" ] }, "compounding": { "board_name": "Wyoming State Board of Pharmacy", "board_url": "https://pharmacyboard.wyo.gov/", "follows_fda_503a_bulks": true, "notes": "The Wyoming State Board of Pharmacy licenses pharmacies under the Wyoming Pharmacy Act (Wyoming Statutes title 33, chapter 24) and the Board's rules. Section 33-24-152 requires a nonresident pharmacy that dispenses to Wyoming patients to hold a Wyoming license, stay licensed in its home state, keep readily retrievable records of controlled substances and dangerous drugs dispensed to Wyoming patients, comply with the Wyoming generic substitution requirements, and offer a toll-free pharmacist line at least six days and 40 hours a week; the Board may deny, suspend, or revoke the license and assess penalties of up to $2,000 per violation. Compounding is governed by chapter 22 (Compounding) of the Board's Pharmacy Act rules, effective August 19, 2025, which replaced the repealed chapter 13 (non-sterile compounding) and chapter 17 (sterile compounding). Chapter 22 applies to all licensees and adopts by reference USP-NF general chapters 795 (non-sterile), 797 (sterile), 800 (hazardous drugs), and 825 (radiopharmaceuticals) as minimum standards; a 2026 amendment proposed by the Board only fixes the reference date to USP-NF 2024, Issue 1 (official May 1, 2024). Chapter 22 does not set a state list of compoundable bulk substances, so a peptide's eligibility follows the federal 503A test (approved drug component, USP or NF monograph, or FDA 503A bulks list).", "source_ids": [ "wy-board", "wy-board-laws", "wy-ch22", "wy-ch22-proposed", "wy-title-33", "wy-33-24-152", "fda-503a" ] }, "glp1_access": { "compounded_available": "limited", "notes": "Because rural Wyoming patients often rely on mail order, the practical check is that the shipping pharmacy holds a Wyoming nonresident pharmacy license under section 33-24-152.", "source_ids": [ "fda-glp1-compounding", "wy-33-24-152", "wy-board" ] }, "research_peptide_sales": { "notes": "The Wyoming Pharmacy Act (title 33, chapter 24) limits dispensing of prescription drugs to licensed pharmacies, including licensed nonresident pharmacies, so a seller shipping \"research use only\" injectable peptides to Wyoming consumers is outside the licensed channel.", "source_ids": [ "wy-title-33", "usc-331" ] }, "peptide_notes": [], "faqs": [ { "q": "Can I get a GLP-1 prescription in Wyoming through telemedicine?", "a": "Yes. Wyoming treats telemedicine as the practice of medicine under section 33-26-102, so a Wyoming-licensed physician can evaluate you and prescribe remotely under the same standard of care that applies in person, subject to Board of Medicine rules.", "source_ids": [ "wy-title-33", "wy-med-board" ] }, { "q": "Does an out-of-state telehealth doctor need a Wyoming license?", "a": "Generally yes, because telemedicine is the practice of medicine where the patient is located. Board of Medicine rules allow narrow exceptions, such as consultation with a Wyoming-licensed physician and limited continuation of an existing relationship, but a new GLP-1 patient should expect a Wyoming-licensed prescriber.", "source_ids": [ "wy-med-rules", "wy-med-board", "wy-title-33" ] }, { "q": "What does an out-of-state pharmacy need to ship compounded peptides to Wyoming?", "a": "A Wyoming nonresident pharmacy license under section 33-24-152. The pharmacy must remain licensed in its home state, keep records of drugs dispensed to Wyoming patients, and provide a toll-free line to a pharmacist at least 40 hours a week. The Board can fine violations up to $2,000 each.", "source_ids": [ "wy-33-24-152", "wy-board" ] }, { "q": "Can a Wyoming pharmacy compound peptides that are not on the FDA bulks list?", "a": "Generally no. Wyoming has no state bulks list, so the federal 503A test applies: the substance must be a component of an approved drug, have a USP or NF monograph, or be on the FDA 503A bulks list. Peptides in FDA Category 2 cannot be compounded.", "source_ids": [ "fda-503a", "fda-category-2", "wy-board-laws" ] } ], "sources": [ { "id": "wy-board", "type": "other", "title": "Wyoming State Board of Pharmacy", "url": "https://pharmacyboard.wyo.gov/" }, { "id": "wy-board-laws", "type": "other", "title": "Wyoming State Board of Pharmacy: laws and rules", "url": "https://pharmacyboard.wyo.gov/laws" }, { "id": "wy-med-board", "type": "other", "title": "Wyoming Board of Medicine", "url": "https://wyomedboard.wyo.gov/" }, { "id": "wy-med-rules", "type": "other", "title": "Wyoming Board of Medicine: rules and regulations (chapter 1, section 7, Exemption from licensure)", "url": "https://wyomedboard.wyo.gov/resources/rules-and-regulations" }, { "id": "wy-ch22", "type": "other", "title": "Wyoming State Board of Pharmacy rules, chapter 22, Compounding (effective August 19, 2025)", "url": "https://rules.wyo.gov/Search.aspx?RefNum=%20059.0001.22.08192025" }, { "id": "wy-ch22-proposed", "type": "other", "title": "Wyoming State Board of Pharmacy: chapter 22 Compounding, notice and text of proposed 2026 revisions", "url": "https://drive.google.com/file/d/1GQ5X46wswVybqawX7o9WFIUD98fQ8b0o/view?usp=sharing" }, { "id": "wy-title-33", "type": "other", "title": "Wyoming Statutes title 33, Professions and occupations (including 33-26-102(a)(xxix) telemedicine definition, 33-26-202 board powers, and chapter 24 Pharmacy Act)", "url": "https://wyoleg.gov/statutes/compress/title33.pdf" }, { "id": "wy-33-24-152", "type": "other", "title": "Wyoming Statutes section 33-24-152, Nonresident pharmacy registration and licensure", "url": "https://law.justia.com/codes/wyoming/title-33/chapter-24/article-1/section-33-24-152/" }, { "id": "fda-503a", "type": "fda", "title": "FDA: Section 503A of the Federal Food, Drug, and Cosmetic Act", "url": "https://www.fda.gov/drugs/human-drug-compounding/section-503a-federal-food-drug-and-cosmetic-act" }, { "id": "fda-category-2", "type": "fda", "title": "FDA: Certain bulk drug substances for use in compounding may present significant safety risks (503A and 503B category lists)", "url": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks" }, { "id": "fda-pcac", "type": "fda", "title": "FDA: Pharmacy Compounding Advisory Committee", "url": "https://www.fda.gov/advisory-committees/human-drug-advisory-committees/pharmacy-compounding-advisory-committee" }, { "id": "fda-glp1-compounding", "type": "fda", "title": "FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding grace periods", "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss" }, { "id": "usc-331", "type": "other", "title": "21 U.S.C. 331, Prohibited acts", "url": "https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section331&num=0&edition=prelim" } ], "last_verified": "2026-09-22", "review_status": "draft", "version": 1 } ], "meta": { "dataset": "jurisdictions", "generated_at": "2026-09-28T02:14:37.172Z", "data_as_of": "2026-09-27", "records": 51, "license": "CC BY 4.0, attribution required: PeptideAgent (https://peptideagent.ai)", "license_url": "https://creativecommons.org/licenses/by/4.0/", "attribution": "Data from PeptideAgent (https://peptideagent.ai), licensed under CC BY 4.0.", "version": "1", "source": "https://peptideagent.ai/data" } }