Why we track regulation separately
Approval tells you a regulator reviewed a specific product for a specific use and judged the benefit–risk acceptable. It does not tell you the drug works for every use people put it to, and non-approval does not tell you a compound is ineffective — it may simply never have been submitted. That is why every page on this site shows regulatory status and an evidence level. On this hub, the "evidence" column grades how well the regulatory position itself is documented from primary sources.
The categories that matter in the U.S.
- FDA-approved drug: reviewed under an NDA/BLA; has a label with indications, warnings and dosing. Semaglutide, tirzepatide, tesamorelin and bremelanotide are in this group.
- Off-label use of an approved drug: legal for a prescriber, but the evidence for the off-label use may be thin. Tesamorelin for body composition outside HIV lipodystrophy is the clearest peptide example.
- Investigational: being studied under an IND in registered trials; not available for marketing.
- Compounding under 503A/503B: a pharmacy may compound from a bulk substance only if it has a USP/NF monograph, is a component of an approved drug, or is on the 503A bulks list. While nominations are evaluated, FDA sorts them into interim categories; category 2 holds substances it judges to present significant safety risks. Several popular peptides were placed there in September 2023; by the list current at 22 April 2026 most of those nominations had been withdrawn by the nominators, while ipamorelin acetate (503B) and kisspeptin-10 (503A) remain. None of it makes these peptides compoundable. Compounding of semaglutide and tirzepatide was separately permitted while those drugs were on the shortage list; both shortages have since been declared resolved.
- "Research use only" (RUO): a labelling convention, not an FDA category. Products sold this way for human use are unapproved drugs, and their manufacturing is not held to pharmaceutical standards.
What changed recently, and what we watch
- Shortage resolutions for tirzepatide (2024) and semaglutide (2025) closed the legal window for most compounded versions; the FDA has since acted against sellers of compounded and counterfeit GLP-1 products.
- The FDA's compounding-category lists change: the category 2 page was current as of 22 April 2026 at our last check, and the Pharmacy Compounding Advisory Committee met on 23–24 July 2026 to consider several peptides for 503A eligibility. We have not yet been able to verify the outcome of that meeting from a primary FDA document, so we do not state one. We re-check quarterly.
- State-level actions against peptide clinics and telehealth sellers are increasing.
Regulatory positions are dated on every profile. If a status here is more than a quarter old, verify it against the FDA source before relying on it.