FDA and state rules, for what you actually buy.

Must a pharmacy located in another state hold a license/registration from this state to ship prescriptions (including patient-specific 503A compounded preparations) to patients or practitioners here?

RSA 318:37, II bars any pharmacy outside New Hampshire from shipping, mailing or delivering prescription drugs into the state unless it is registered and holds a permit from the NH Board of Pharmacy. Rule Ph 903.01 carries this requirement to delivery 'in any manner' (form MO-1). Applicants must provide a home-state permit and license, a PIC with a home-state license (a New Hampshire PIC is not required), and a home-state inspection from the past 18 months. They must also give unredacted FDA inspection reports and 483s, and a USP <795>/<797> compliance inspection from the past 18 months by the home-state board, NABP or a board-approved third party. Pharmacies shipping sterile compounded products (the form attestation is labeled 'Patient-Specific Only') must also send GAP analyses, equipment and hood certifications, environmental monitoring, and a 6-month inventory of shipments into NH. Each out-of-state location must be registered separately.

Ph 903.01 was last substantively revised on 5-26-22 (#13384). The rules compilation was updated July/Aug 2026. The OPLC board website (oplc.nh.gov) blocked automated access, so the current MO-1 form and fee were not checked. Renewal (Ph 906.03) needs an unredacted inspection report from the past 24 months or a certificate of accreditation.

May a 503A (traditional) pharmacy dispense or distribute compounded preparations to a practitioner for office use (administration in the office, not patient-specific)? The federal position is that 503A requires patient-specific prescriptions; this is what the state pharmacy act and board rules allow.

Under RSA 318:14-a, products that are not commercially available may be compounded for hospital or office use but may not be resold or dispensed. A pharmacist may supply compounded products to a practitioner in limited quantities for the practitioner to administer only, and must keep records of what went to each office. Board rules set 'limited quantities' at a batch of 50 or fewer dosage units. A compounder making more than 50 non-patient-specific dosage units must be FDA-registered as a manufacturer or 503B. A sterile compounder supplying office stock must also have a memorandum of understanding with the provider for each product and give the practitioner the test results for each lot. High-risk sterile batches must pass independent sterility, potency and endotoxin testing. These state limits go further than FDA's position that 503A compounding must be patient-specific.

The law does not directly say whether a nonresident pharmacy may ship office-use stock into NH. The mail-order permit form's sterile compounding attestation (Ph 903.01(d)(9)(b)) reads 'Sterile Compounded Drugs (Patient-Specific Only)', which suggests nonresident sterile shipments are expected to be patient-specific. Ph 404 shows effective date 4-18-15. NH rules generally expire after 10 years (RSA 541-A:17), but the July 2026 compilation still prints Ph 404 without an expiration note, so its current status needs checking with the board. RSA 318:14-a (last amended 2019) stands on its own.

Does the state require an FDA-registered 503B outsourcing facility located outside the state to hold a state license/registration (as an outsourcing facility, nonresident manufacturer, wholesaler or pharmacy) before shipping into the state?

RSA 318:51-c says no person acting as or employed by an outsourcing facility may supply compounded legend or controlled drugs without first getting a license from the Office of Professional Licensure and Certification. Board rules Ph 2000 carry this out with form Ph OF-1, 'Bulk Sterile & Non-Sterile Compounders (Including FDA Registered 503B Outsourcing Facilities)'. The fee is $500, with renewal every two years by June 15 of odd-numbered years. Applicants must hold current FDA outsourcing facility registration and submit their home-state license and inspection if any, the most recent FDA inspection report, the Form 483 and their response, and DEA registration if they ship controlled drugs. Every lot must be tested for sterility, endotoxin and potency before release, and copies of the results must go with each batch sent to NH customers. Outsourcing facilities may not distribute directly to patients.

Ph 2000 was adopted 7-22-17 and amended 10-15-20. The core rules date from 2017, so they could expire under RSA 541-A:17 in July 2027. New Hampshire did sign FDA's 2020 standard MOU (MOU 225-21-008, effective 2021-03-18, per FDA's Compounding MOUs page); see the fda_mou topic. The MOU governs 503A interstate distribution, not 503B licensing.

Has the state signed FDA's standard Memorandum of Understanding Addressing Certain Distributions of Compounded Human Drug Products (October 2020)? If not, FD&C Act §503A limits its 503A pharmacies' out-of-state distribution to 5% of total prescription orders (currently not enforced by FDA pending rulemaking).

Signing the standard MOU means the state board agrees to investigate complaints about compounded drugs its 503A pharmacies ship out of state and to identify and report to FDA pharmacies that distribute "inordinate amounts" interstate (more than 50% of their compounded prescriptions); in exchange, the statutory 5% out-of-state cap in FD&C Act §503A(b)(3)(B) does not apply to that state's pharmacies. The New Hampshire Office of Professional Licensure and Certification / Board of Pharmacy signed MOU 225-21-008, effective March 18, 2021; New Hampshire is one of only three signatories (with Colorado and Kentucky). FDA now considers the October 2020 standard MOU suspended (it does not expect signatory states to carry out MOU activities and will not sign new ones) and is not enforcing the 5% limit until a final rule and an updated MOU are published; FDA's rulemaking (RIN 0910-AI71) listed a proposed rule for 11/2026 in the Fall 2025 Unified Agenda.

The FDA list of signed MOUs (current as of 2023-01-23) is older than 2 years, but FDA stopped entering new agreements under the 2020 MOU in October 2022, so no state can have signed since. The FDA "Compounding Information for States" page (current as of 2026-08-28) still describes the MOU as awaiting rulemaking. Pending: FDA proposed rule on 503A distribution (RIN 0910-AI71, NPRM projected 11/2026); H.R. 5316 (introduced 2025-09-11, referred to House Energy & Commerce) would remove the MOU provision from §503A.

Besides DEA registration, does the state require practitioners to hold a separate state controlled substance registration, license or permit to prescribe, administer or dispense controlled substances (e.g. testosterone, Schedule III)? "Conditional" means a state registration is needed only in some settings, such as keeping controlled-substance stock in the office.

RSA 318-B:3 requires a state license only for manufacturers and wholesalers of controlled drugs, and RSA 318-B:10 authorizes a practitioner acting in good faith for a legitimate medical purpose to administer and prescribe controlled drugs (or have them administered by a nurse under supervision) without any separate state registration; the chapter's telemedicine provisions require compliance with DEA registration. Notably, RSA 318-B:10 limits practitioner dispensing of controlled drugs to bona fide emergencies, capped at a 48-hour supply of Schedule II or a 7-day supply of Schedule III-V. Prescribers with a DEA number must register with the state PDMP (controlled drug prescription health and safety program).

Based on a full read of the RSA 318-B section list (no practitioner registration provision found) plus the affirmative authority in 318-B:10; no NH board FAQ was found to confirm in plain terms. The 7-day emergency cap on dispensing C-III (e.g. testosterone) is a significant limit for take-home dispensing; in-office administering is not capped by that clause. RSA 318-B:10 does not distinguish MD/DO from APRN/PA ('practitioner' is defined in RSA 318-B:1).

Must a prescriber query the state Prescription Drug Monitoring Program before prescribing, and does the mandate cover Schedule III drugs such as testosterone? "Yes" means a mandate that reaches Schedule III; "conditional" means a mandate limited to certain drugs (e.g. opioids or benzodiazepines) or situations; "no" means no prescriber query mandate.

RSA 318-B:41, II(a)(4) directs the prescribing boards to adopt mandatory rules requiring prescribers to query the controlled drug prescription health and safety program (RSA 126-A:89 to 126-A:96) when writing an initial Schedule II, III or IV opioid prescription for the management or treatment of pain or substance use disorder, and then periodically, at least twice a year. Required exceptions are controlled substances administered in a health care setting, program outages, and emergency departments with higher-than-normal volume where a query would materially delay care (documented in the record). The statute directs the boards of medicine, dental examiners, nursing, optometry, podiatry and naturopathy to adopt these rules; PDMP TTAC lists them (e.g. Med 502.06, Nur 502.06).

Latest amendment listed: 2025, 105:2, eff. June 17, 2025. The board rules themselves (Med 502.06 etc., listed by PDMP TTAC) were not opened; the statute sets the minimum scope (opioids only).

May physicians dispense prescription drugs (not just administer them) directly to patients from their practice? "Yes" means allowed under standard rules (labeling, records, and at most a simple notice to the board); "conditional" means a separate dispensing registration, permit or license, or quantity, day-supply or drug-category limits; "no" means prohibited except narrow exceptions.

RSA 318:42, II lets physicians, APRNs, PAs and certain others possess, compound, personally administer or distribute prescription drugs to meet the immediate medical needs of their patients, outside the pharmacy licensing requirement. Under RSA 318-B:10, practitioner dispensing of controlled drugs is limited to bona fide emergencies and capped at a 48-hour supply of Schedule II or a 7-day supply of Schedules III-V. Take-home testosterone supplies beyond these limits would need a pharmacy; in-office administration is not capped by these clauses. No separate dispensing permit was found.

Controlled-drug dispensing caps read in RSA 318-B:10 (cross-checked in the state_csr research); a vendor summary reports the same limits.

For a patient located in the state: must the prescriber hold this state's license (or a telehealth registration or special license), is an in-person exam required before prescribing (generally or for controlled substances), are there state limits on prescribing Schedule III drugs such as testosterone by telehealth, and is the state an Interstate Medical Licensure Compact member? "Yes" means a state license and the in-person standard of care apply (opioid-only or Schedule II-only limits are described but do not change the answer); "conditional" means extra state conditions such as a telehealth registration route, an in-person exam requirement, controlled-substance limits reaching Schedule III, or registration of telehealth businesses. Federal DEA rules apply on top.

(1) An out-of-state physician providing telemedicine is practicing medicine in New Hampshire and must be licensed there, except for consultations under RSA 329:21, II. (2) A physician-patient relationship may rest on an exam by telemedicine if the physician verifies identity, discloses name and license type, obtains consent and meets the standard of care, so no initial in-person exam is required (RSA 329:1-c). (3) RSA 318-B:2, XVI limits telemedicine prescribing of Schedule II-IV drugs (opioid and non-opioid) to licensed prescribers and requires subsequent in-person exams by a licensed practitioner at appropriate intervals but not less than annually; RSA 329:1-d, III, as amended in 2025, now refers to a 'subsequent evaluation' at least annually, so the two statutes currently differ in wording. (4) IMLC: member.

Change: 2025 amendments to RSA 329:1-d, III replaced the physician statute's 'subsequent in-person exam' with 'subsequent evaluation', but RSA 318-B:2, XVI (as posted, last amended 2022) and the APRN statute RSA 326-B:2 still say 'in-person'. CCHP's page (updated 2026-08-31) still quotes the older 'in-person' wording of 329:1-d. Classified conditional because the in-person wording remains in RSA 318-B:2, XVI; the New Hampshire Board of Medicine may interpret the two differently.

Who may administer botulinum toxin and dermal fillers (physicians, PAs, NPs, RNs, LPNs, estheticians, dentists), under what supervision (on-site vs available), and must a physician/NP/PA perform a prior good-faith exam?

The New Hampshire Board of Nursing (OPLC)'s website was checked on 2026-09-23 for a position statement, advisory opinion or FAQ on cosmetic injectables (neuromodulators, fillers) and none was found (the site blocked automated access). RN practice therefore falls under the state's general nurse practice act, which was not reviewed for this entry.

Board site returned HTTP 403 or did not resolve for automated requests on 2026-09-23; URL taken from the MedGrid agency directory.

What does the state require for elective IV hydration/vitamin (incl. NAD+) therapy: who may start IVs, is a patient-specific order or good-faith exam required before a patient's first IV, are standing orders allowed, and are there rules for mobile IV services?

The New Hampshire Board of Nursing (OPLC)'s website was checked on 2026-09-23 for guidance on IV hydration clinics (prior exams, standing orders, mobile services) and none was found (the site blocked automated access).

Board site returned HTTP 403 or did not resolve for automated requests on 2026-09-23; URL taken from the MedGrid agency directory.

Does the state enforce the corporate practice of medicine doctrine (non-physicians may not own medical practices or employ physicians), and how does that affect med spa ownership?

Permit Health's 2025 guide lists New Hampshire as permitted, citing the professional corporation statute (RSA 294-A); MedPath Compliance (reviewed 2026-06-20) also lists New Hampshire as 'No'.

Who may perform laser/IPL/RF aesthetic procedures (laser hair removal, resurfacing): physicians only, delegated to RNs/PAs, or licensed electrologists/estheticians/laser technicians with state certification?

No New Hampshire statute, rule or board policy on delegation of cosmetic laser/IPL procedures or a laser-operator credential was located on 2026-09-23 (the board site blocked automated access).

Board site returned HTTP 403 or did not resolve for automated requests on 2026-09-23; URL taken from the MedGrid agency directory.

Does the state license clinical laboratories itself, beyond federal CLIA certification, including out-of-state labs that test specimens from the state?

RSA 151:2, I(c) lists 'laboratories performing tests or analyses of human samples' and collection stations among the facilities that must be licensed by DHHS. Physicians' offices, offices of other licensed practitioners and community health clinics are exempt (RSA 151:2, II). The statute addresses facilities in New Hampshire; out-of-state lab coverage was not confirmed.

Out-of-state labs: not confirmed. NH DHHS also serves as the CLIA agency for Vermont labs.

May consumers order their own lab tests without a practitioner order (direct access testing)? A practitioner-ordered panel is always fine; this matters for take-home and consumer test kits.

ADLM (formerly AACC) reported in 2019 that 37 states and DC let consumers order some or all tests directly, but it did not publish the state list, and this research did not confirm New Hampshire's rule. New Hampshire's lab regulator (CLIA state agency) is New Hampshire DHHS, Health Facilities Administration (CLIA@dhhs.nh.gov, 603-271-9048). The question matters for take-home and consumer test kits, not for panels a clinician orders.

New Hampshire licenses labs under RSA 151; its rule on who may order tests was not confirmed. The ADLM figure dates from 2019 (older than 2 years).

Has the state enacted a law or rule specifically about stem cell, exosome or regenerative-medicine therapies (notice/disclosure duties, permission for certain non-FDA-approved uses, or Right to Try extensions covering them)?

Compilations of state stem-cell laws from 2024 to 2026 list about a dozen states with specific laws (California, Florida, Georgia, Mississippi, Nevada, North Carolina, Tennessee, Texas, Utah, Vermont, Washington and Wyoming), plus Montana's general experimental-treatment law and Kansas's state stem cell center. New Hampshire is not among them. Without a state-specific law, regenerative products are governed by federal FDA rules plus the state's general medical practice, advertising and consumer-protection laws, enforced by its medical board. Federal FDA rules still apply regardless of state law: stem cell, birth-tissue and exosome products are regulated by FDA, and a state law cannot make an unapproved biologic FDA-approved.

HB 1735 (2026, Chapter 311) broadened New Hampshire's Right to Try Act to 'qualifying severe illness' (chronic and debilitating conditions) and individualized investigational treatments. It does not mention stem cells or regenerative therapies, and it applies only to investigational products under Right to Try conditions. The finding of no law rests on multi-state compilations (a commercial one from Aug 2026 and a peer-reviewed one from Feb 2024, which is older than 2 years) and targeted searches, not a statute-by-statute review, and neither compilation is exhaustive. General Right to Try laws for terminal patients, where they exist, were not reviewed here.

Does the state have cosmetic or sunscreen requirements beyond federal MoCRA, such as ingredient bans (PFAS, formaldehyde, phthalates), ingredient reporting, sunscreen-ingredient bans, or bans on selling animal-tested cosmetics?

HB 1649 (2024) makes it illegal to sell, offer for sale or distribute cosmetics with intentionally added PFAS in New Hampshire beginning Jan 1, 2027, alongside other consumer-product PFAS restrictions.

The RSA section was not confirmed from the primary text. Federal MoCRA and FDA cosmetic and OTC sunscreen rules apply in every state.