FDA and state rules, for what you actually buy.
Search a drug, ingredient or device for its live FDA record, or pick your state and a category to see the federal rules and what your state adds — each answer with its citation and source.


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Healing & recovery peptides
FDA pathway: Not FDA-approved | Compounded 503A (only if an eligible bulk ingredient)
No FDA-approved products; BPC-157, TB-500, KPV and MOTs-C left Category 2 in April 2026 and won favorable PCAC votes in July 2026, but none is on the 503A bulks list or in Category 1 yet.
On MedGrid as: Healing & Recovery Peptides · Recovery Peptides · Research Peptides
The federal rules
BPC-157, TB-500 (thymosin beta-4 fragment), KPV, MOTs-C: out of Category 2, not yet permittedRemoved from Category 2 effective about April 22, 2026 after nominations were withdrawn; not on the 503A bulks list and not in Category 1.
FDA's safety-risk page still describes the concerns it had identified (e.g., BPC-157 'may pose risk for immunogenicity for certain routes of administration and may have complexities with regard to peptide-related impurities'). Law-firm analyses say removal from Category 2 does not by itself authorize compounding.
- Safety Risks Associated with Certain Bulk Drug Substances for Use in Compounding — FDA, 2026-04-22
- Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (Categories 1–3) — FDA, 2026-05-14
- FDA Announces Removal of 12 Peptides from Category 2 and Schedules PCAC Meetings — Orrick, 2026-04-16
PCAC July 2026 votes favored inclusion; FDA decision pendingPCAC voted to recommend BPC-157 (8–6), KPV (8–6), TB-500 (8–6) and MOTs-C (7–5) for the 503A bulks list; FDA staff had recommended against.
Uses reviewed: BPC-157 for ulcerative colitis, KPV for wound healing and inflammatory conditions, TB-500 for wound healing, MOTs-C for obesity and osteoporosis. Listing requires FDA notice-and-comment rulemaking; FDA could also announce interim enforcement discretion.
- July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee — FDA, 2026-08-06
- Bulk-list bound? PCAC backs majority of peptides in two-day public meeting — McDermott (law firm), 2026-07-27
- Pharmacy Compounding Advisory Committee; Notice of Meeting (July 23–24, 2026; 503A bulks nominations), 91 FR 20465 — FDA, Federal Register, 2026-04-16
GHK-Cu: topical in Category 1, injectable notGHK-Cu for non-injectable routes is back in Category 1; injectable GHK-Cu was withdrawn from Category 2 and is in no category, pending a PCAC meeting before end of Feb 2027.
FDA's May 14, 2026 list explains one nominator withdrew only its injectable-route nomination.
LL-37, PEG-MGF, thymosin alpha-1LL-37 and PEG-MGF left Category 2 in April 2026 and await a PCAC meeting before Feb 2027; thymosin alpha-1 left Category 2 in Sept 2024 and is in no category; mechano growth factor (MGF) is Category 3.
PCAC reviewed thymosin alpha-1 on Dec 4, 2024 and did not recommend it (vote reported by secondary sources; not confirmed from the transcript reviewed).
- Safety Risks Associated with Certain Bulk Drug Substances (withdrawn list) — FDA, 2026-04-22
- FDA Removes Certain Peptide Bulk Drug Substances From Category 2 Of Interim 503A Bulks List And Sets Dates For PCAC Review — Mondaq (law-firm article), 2024-10-04
- Bulk-list bound? PCAC backs majority of peptides — McDermott (law firm), 2026-07-27
RUO peptide sellers are a warning-letter target'Research use only' peptides sold with human dosing information are unapproved drugs; FDA issued multiple warning-letter rounds to peptide sellers in 2026.
See the general 'research-use-only' entry.
- Warning Letter: Royal Peptides LLC — FDA, 2026-08-24
Changing now
- FDA's decision and any interim enforcement discretion for BPC-157, TB-500, KPV and MOTs-C after the July 2026 PCAC votes. — Bulk-list bound? PCAC backs majority of peptides
- PCAC meeting before end of Feb 2027 on GHK-Cu, dihexa, LL-37, PEG-MGF and melanotan II. — Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (GHK-Cu note)
What Illinois adds
Out-of-state pharmacies shipping into the stateAn out-of-state pharmacy needs an Illinois nonresident pharmacy license from IDFPR to ship prescriptions to Illinois residents, and since January 1, 2026 its pharmacist-in-charge must hold an Illinois pharmacist license.License required
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?
225 ILCS 85/16a and 68 Ill. Adm. Code 1330.550 require nonresident pharmacies that dispense for Illinois residents and mail, ship or deliver prescription drugs into Illinois to hold an Illinois nonresident pharmacy license/registration from the Illinois Department of Financial and Professional Regulation (IDFPR). Conditions include a home-state license, disclosure of officers and dispensing pharmacists, cooperation with the Board, readily retrievable records of drugs dispensed to Illinois residents, and a toll-free pharmacist line (at least 6 days/40 hours per week) printed on every label. Rule 1330.550 states that beginning January 1, 2026 the pharmacist-in-charge of a nonresident pharmacy must be licensed in Illinois; other pharmacists need not be. The IDFPR application (packet updated 1/15/26) asks nonresident applicants for a home-state certification of licensure, home-state pharmacy and controlled-substance licenses, DEA registration and the most recent inspection report, and lists 'Sterile Compounding Pharmacy' as an operation type to check; nonresident pharmacies must follow Illinois law when filling for Illinois residents unless it directly conflicts with home-state law.
The official ILGA statute site blocked automated fetching; the statute text was confirmed from FindLaw's copy (current as of 2025-01-01) and the rule from Cornell LII. The Illinois-licensed PIC requirement for nonresident pharmacies took effect 2026-01-01 (68 Ill. Adm. Code 1330.550, 48 Ill. Reg. 10225). No separate nonresident sterile-compounding license beyond checking the sterile compounding operation type was found.
225 ILCS 85/16a; 68 Ill. Adm. Code 1330.550
- 225 ILCS 85/16a — Nonresident pharmacies (FindLaw copy, current as of 2025-01-01) — FindLaw (copy of Illinois Compiled Statutes), 2025-01-01
- 68 Ill. Adm. Code 1330.550 — Nonresident Pharmacies (amended 48 Ill. Reg. 10225, eff. 6/28/2024) — Legal Information Institute (Cornell) copy of Illinois Administrative Code, 2024-06-28
- Illinois Pharmacy License Application Instructions (IL486-0404, packet updated 1/15/26) — Illinois Department of Financial and Professional Regulation, 2026-01-15
Office-use compounding from 503A pharmaciesIllinois lets a pharmacy supply a reasonable quantity of NONSTERILE compounded drugs to a practitioner for office use, labeled 'For Office Use Only - Not for Resale'; sterile office-use compounding is prohibited unless the compounder is a 503B outsourcing facility with an Illinois wholesale drug distributor license.Allowed with limits
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.
68 Ill. Adm. Code 1330.640(b) defines office use as a practitioner administering a non-patient-specific compounded drug in the office or a health care facility/treatment setting. Under 1330.640(d) a pharmacist may dispense and deliver a reasonable quantity of a nonsterile compounded drug to a practitioner for office use if the quantity does not exceed what the practitioner expects to use before the beyond-use date, is reasonable for the practice, and does not exceed the pharmacy's capacity to compound to USP-consistent standards; the pharmacy must keep records for 5 years (practitioner, drug, compounding and delivery dates, lot number, BUD) and label the product with lot, BUD, storage and 'For Office Use Only - Not for Resale.' Under 1330.640(c) sterile compounding for office use is prohibited unless the pharmacy fully complies with 21 USC 353b, including registering as an outsourcing facility and being licensed as a wholesale drug distributor under 225 ILCS 120; sterile compounded drugs may still be delivered to the prescriber's office on a patient-specific prescription. IDFPR enforces. The nonsterile office-use allowance is broader than FDA's view that 503A compounding requires patient-specific prescriptions.
The rule does not say whether a nonresident pharmacy may ship nonsterile office-use stock into Illinois; nonresident pharmacies must follow Illinois law when serving Illinois (1330.550), so the same limits would apply, but this is not expressly addressed. The official ILGA/JCAR host blocked automated fetching; text confirmed via Cornell LII. Stale-source flag: the controlling text is dated 2024-06-28 (more than 2 years before 2026-09-23); it is the latest version found, but confirm with the board that it is still current.
68 Ill. Adm. Code 1330.640(b), (c), (d)
- 68 Ill. Adm. Code 1330.640 — Pharmaceutical Compounding Standards (amended 48 Ill. Reg. 10225, eff. 6/28/2024) — Legal Information Institute (Cornell) copy of Illinois Administrative Code, 2024-06-28
Prescribing by telehealthIllinois requires an Illinois license or permit to practice telemedicine on patients in Illinois, with narrow exceptions, and no Illinois telehealth-specific Schedule III limit was found.Allowed (standard rules)
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.
225 ILCS 60/49.5 makes practicing telemedicine on Illinois patients without an Illinois license or permit subject to penalties; excluded are periodic consultations with an Illinois licensee, second opinions, follow-up care after treatment in the provider's own state, and care for existing patients who are traveling. Telehealth prescribing follows the ordinary standard of care; no Illinois statute found adds an in-person requirement or a telehealth-specific controlled-substance limit. An Illinois controlled substance license is needed to prescribe testosterone. IMLC: member.
Section 49.5 is scheduled for repeal January 1, 2032 with the Medical Practice Act sunset.
225 ILCS 60/49.5
- 225 ILCS 60/49.5 - Telemedicine — Illinois General Assembly, 2026-09-23
- Illinois - Professional Requirements — Center for Connected Health Policy (CCHP), 2026-06-04
- IMLC Commission - Compact State Map (participating states) — Interstate Medical Licensure Compact Commission, 2026-09-23
Who may inject neuromodulators and fillersIllinois physicians may delegate patient-care tasks such as cosmetic injections to RNs and LPNs, by standing orders or protocols if they choose, within a physician-patient relationship; unlicensed staff may be used only with a licensed professional on site.RNs may inject under delegation
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?
Section 54.2 of the Medical Practice Act says nothing limits a physician's delegation of patient-care tasks to an RN, LPN or other licensee acting within their own licensing act, and that delegation may be made by any means, including standing orders, protocols, guidelines or verbal orders. In an office setting and within a physician-patient relationship, a physician may delegate to a trained unlicensed person only if a licensed health care professional is on site. Delegated tasks must be within the physician's own scope and training. No Illinois rule specific to neuromodulators or fillers was found.
Answer rests on the general delegation statute. IDFPR/Board of Nursing guidance on cosmetic injectables was not located.
225 ILCS 60/54.2 (as amended by P.A. 104-796, eff. 2026-08-07)
- 225 ILCS 60/54.2 – Physician delegation of authority — Illinois General Assembly, 2026-08-07
Compare every state: Out-of-state pharmacies shipping into the state · Office-use compounding from 503A pharmacies · Prescribing by telehealth · Who may inject neuromodulators and fillers
Illinois at a glance
Every topic we research, for Illinois. Open any line for the rule, its citation and the source.
Pharmacy & compounding
Out-of-state pharmacies shipping into the stateAn out-of-state pharmacy needs an Illinois nonresident pharmacy license from IDFPR to ship prescriptions to Illinois residents, and since January 1, 2026 its pharmacist-in-charge must hold an Illinois pharmacist license.License required
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?
225 ILCS 85/16a and 68 Ill. Adm. Code 1330.550 require nonresident pharmacies that dispense for Illinois residents and mail, ship or deliver prescription drugs into Illinois to hold an Illinois nonresident pharmacy license/registration from the Illinois Department of Financial and Professional Regulation (IDFPR). Conditions include a home-state license, disclosure of officers and dispensing pharmacists, cooperation with the Board, readily retrievable records of drugs dispensed to Illinois residents, and a toll-free pharmacist line (at least 6 days/40 hours per week) printed on every label. Rule 1330.550 states that beginning January 1, 2026 the pharmacist-in-charge of a nonresident pharmacy must be licensed in Illinois; other pharmacists need not be. The IDFPR application (packet updated 1/15/26) asks nonresident applicants for a home-state certification of licensure, home-state pharmacy and controlled-substance licenses, DEA registration and the most recent inspection report, and lists 'Sterile Compounding Pharmacy' as an operation type to check; nonresident pharmacies must follow Illinois law when filling for Illinois residents unless it directly conflicts with home-state law.
The official ILGA statute site blocked automated fetching; the statute text was confirmed from FindLaw's copy (current as of 2025-01-01) and the rule from Cornell LII. The Illinois-licensed PIC requirement for nonresident pharmacies took effect 2026-01-01 (68 Ill. Adm. Code 1330.550, 48 Ill. Reg. 10225). No separate nonresident sterile-compounding license beyond checking the sterile compounding operation type was found.
225 ILCS 85/16a; 68 Ill. Adm. Code 1330.550
- 225 ILCS 85/16a — Nonresident pharmacies (FindLaw copy, current as of 2025-01-01) — FindLaw (copy of Illinois Compiled Statutes), 2025-01-01
- 68 Ill. Adm. Code 1330.550 — Nonresident Pharmacies (amended 48 Ill. Reg. 10225, eff. 6/28/2024) — Legal Information Institute (Cornell) copy of Illinois Administrative Code, 2024-06-28
- Illinois Pharmacy License Application Instructions (IL486-0404, packet updated 1/15/26) — Illinois Department of Financial and Professional Regulation, 2026-01-15
Office-use compounding from 503A pharmaciesIllinois lets a pharmacy supply a reasonable quantity of NONSTERILE compounded drugs to a practitioner for office use, labeled 'For Office Use Only - Not for Resale'; sterile office-use compounding is prohibited unless the compounder is a 503B outsourcing facility with an Illinois wholesale drug distributor license.Allowed with limits
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.
68 Ill. Adm. Code 1330.640(b) defines office use as a practitioner administering a non-patient-specific compounded drug in the office or a health care facility/treatment setting. Under 1330.640(d) a pharmacist may dispense and deliver a reasonable quantity of a nonsterile compounded drug to a practitioner for office use if the quantity does not exceed what the practitioner expects to use before the beyond-use date, is reasonable for the practice, and does not exceed the pharmacy's capacity to compound to USP-consistent standards; the pharmacy must keep records for 5 years (practitioner, drug, compounding and delivery dates, lot number, BUD) and label the product with lot, BUD, storage and 'For Office Use Only - Not for Resale.' Under 1330.640(c) sterile compounding for office use is prohibited unless the pharmacy fully complies with 21 USC 353b, including registering as an outsourcing facility and being licensed as a wholesale drug distributor under 225 ILCS 120; sterile compounded drugs may still be delivered to the prescriber's office on a patient-specific prescription. IDFPR enforces. The nonsterile office-use allowance is broader than FDA's view that 503A compounding requires patient-specific prescriptions.
The rule does not say whether a nonresident pharmacy may ship nonsterile office-use stock into Illinois; nonresident pharmacies must follow Illinois law when serving Illinois (1330.550), so the same limits would apply, but this is not expressly addressed. The official ILGA/JCAR host blocked automated fetching; text confirmed via Cornell LII. Stale-source flag: the controlling text is dated 2024-06-28 (more than 2 years before 2026-09-23); it is the latest version found, but confirm with the board that it is still current.
68 Ill. Adm. Code 1330.640(b), (c), (d)
- 68 Ill. Adm. Code 1330.640 — Pharmaceutical Compounding Standards (amended 48 Ill. Reg. 10225, eff. 6/28/2024) — Legal Information Institute (Cornell) copy of Illinois Administrative Code, 2024-06-28
503B outsourcing facilities shipping into the stateIllinois has no separate outsourcing-facility license, but an out-of-state 503B shipping non-patient-specific drugs into Illinois needs an Illinois wholesale drug distributor license from IDFPR, plus a nonresident pharmacy license if it fills patient-specific prescriptions.State license required
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?
The Wholesale Drug Distribution Licensing Act requires every nonresident wholesale distributor that ships prescription drugs into Illinois to be licensed in Illinois (225 ILCS 120/25), and the Act's definitions include manufacturers within 'wholesale drug distributor' (225 ILCS 120/15). The pharmacy compounding rule ties office-use sterile compounding to both federal 503B registration and an Illinois wholesale drug distributor license (68 Ill. Adm. Code 1330.640(c)). The IDFPR wholesale application (packet updated 7/24/25) asks out-of-state facilities for a home-state certification of licensure, home-state distributor and controlled-substance licenses, DEA registration and the most recent inspection report, and offers a 'Manufacturer' distributor category; IDFPR's license list has no outsourcing-facility category. Dispensing patient-specific prescriptions to Illinois residents falls under the nonresident pharmacy license (225 ILCS 85/16a).
No Illinois statute or rule found that names an 'outsourcing facility' license; the wholesale-distributor route is inferred from 225 ILCS 120/25 plus the express reference in 1330.640(c). It is worth confirming the credential type with IDFPR's Drug Compliance Unit for a specific 503B. The official ILGA host blocked automated fetching; statute text confirmed from FindLaw's copy.
225 ILCS 120/15, 120/25; 68 Ill. Adm. Code 1330.640(c)
- 225 ILCS 120/25 — License required (FindLaw copy, current as of 2025-01-01) — FindLaw (copy of Illinois Compiled Statutes), 2025-01-01
- 225 ILCS 120/15 — Definitions (FindLaw copy, current as of 2025-01-01) — FindLaw (copy of Illinois Compiled Statutes), 2025-01-01
- 68 Ill. Adm. Code 1330.640 — Pharmaceutical Compounding Standards — Legal Information Institute (Cornell) copy of Illinois Administrative Code, 2024-06-28
- Application for Wholesale Drug Distributor License — Instructions (IL486-1650, packet updated 7/24/25) — Illinois Department of Financial and Professional Regulation, 2025-07-24
- IDFPR — Wholesale Drug Distributor licensing page — Illinois Department of Financial and Professional Regulation, 2026-09-23
FDA compounding MOUIllinois has not signed FDA's standard compounding MOU, so under the statute its 503A pharmacies are limited to 5% out-of-state distribution, although FDA is not enforcing that limit while it rewrites the MOU.Not signed
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. FDA lists only Colorado, Kentucky and New Hampshire as signatories; Illinois is not among them. For a non-signing state, FD&C Act §503A(b)(3)(B)(ii) caps a 503A pharmacy's out-of-state distribution of compounded drugs at 5% of its total prescription orders. 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.
FD&C Act §503A(b)(3)(B) (21 U.S.C. 353a(b)(3)(B))
- Compounding MOUs (list of signed standard MOUs) — U.S. Food and Drug Administration, 2023-01-23
- Memorandum of Understanding Addressing Certain Distributions of Compounded Drugs — U.S. Food and Drug Administration, 2022-10-20
- Compounding Information for States — U.S. Food and Drug Administration, 2026-08-28
- Federal Register 87 FR 63770 (Oct. 21, 2022), Doc. 2022-22876 — MOU suspension and extension of 5% enforcement period — Federal Register / GovInfo, 2022-10-21
Prescribing, dispensing & telehealth
State controlled-substance registrationIllinois requires every practitioner who prescribes, administers, stores or dispenses controlled substances to hold an Illinois Controlled Substance license from IDFPR, which is a prerequisite for the federal DEA registration.State CS registration required
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.
720 ILCS 570/302(a) requires every person who dispenses controlled substances in Illinois to obtain a registration from the Department of Financial and Professional Regulation, and 'dispense' is defined to include prescribing and administering (570/102). IDFPR's application instructions state that every person who prescribes and/or stores or dispenses controlled substances in Illinois must obtain the license, that a separate registration is required for each place of practice where controlled substances are stored or dispensed, that the fee is $5, and that the state registration is a prerequisite for federal DEA registration with the same address. Separate CS license types exist for physicians, PAs, APRNs and full-practice APRNs; the physician CS license renews with the physician license (the 2026 renewal deadline was extended to Aug. 31, 2026).
Since July 2024 IDFPR lets physicians, PAs and APRNs apply for the CS license at the same time as the professional license. A CS registration is not issued on a temporary license. Per-location: separate registration where controlled substances are stored or dispensed.
720 ILCS 570/302; 720 ILCS 570/102
- 720 ILCS 570/302 (Illinois Controlled Substances Act - registration) — Illinois General Assembly, 2026-09-23
- 720 ILCS 570/102 (definitions - 'Dispense') — Illinois General Assembly, 2026-09-23
- Instructions and Application for State Controlled Substances Registration (Physician, form IL486-0500) — Illinois Department of Financial and Professional Regulation, 2024-05-28
- IDFPR - Physicians (renewal notice) — Illinois Department of Financial and Professional Regulation, 2026-09-23
- IDFPR - Controlled Substances — Illinois Department of Financial and Professional Regulation, 2026-09-23
PDMP check before prescribingIllinois requires a documented PMP check only for initial Schedule II narcotic (e.g., opioid) prescriptions, expanding on Jan 1, 2027 to Schedule II stimulants, Schedule II opioids and Schedule IV benzodiazepines - testosterone is not covered.Required for some drugs only
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.
Every prescriber with an Illinois controlled substance license must register with the PMP. Under current 720 ILCS 570/314.5(c-5), the prescriber or designee must document an attempt to access the PMP when providing an initial prescription for Schedule II narcotics such as opioids, except for oncology or palliative care or a 7-day or less supply from a hospital emergency department for an acute, traumatic condition. The section does not apply to hospital or institutional inpatients/residents. P.A. 104-512 (effective 1-1-2027) changes the trigger to initial prescriptions for Schedule II stimulants and all prescriptions for Schedule II opioids and Schedule IV benzodiazepines.
Testosterone (C-III) is not caught under either version. Change pending: P.A. 104-512 effective January 1, 2027 widens the mandate (Schedule II stimulants initial Rx; every Schedule II opioid and Schedule IV benzodiazepine Rx) and adds a safe harbor for registration failures caused by technical problems.
720 ILCS 570/314.5(c-5), (f); P.A. 104-512 (eff. 1-1-27)
- 720 ILCS 570/314.5 - Medication shopping; pharmacy shopping (text before and after amendment by P.A. 104-512) — Illinois General Assembly, 2026-09-23
Physicians dispensing from the officeIllinois physicians may buy and dispense legend drugs in the regular course of practice, with labeling, recordkeeping and a required offer of a written prescription.Allowed
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.
225 ILCS 60/33 authorizes physicians licensed in all branches to purchase and dispense legend drugs; dispensing must be the physician's personal act or be directly supervised. Except for samples or up to a 72-hour supply, the physician keeps a prescription file as the Pharmacy Practice Act requires. Labels must show date, patient, dispenser's last name, directions, and drug name, dose and quantity. Before dispensing, the physician must offer a written prescription the patient may fill anywhere. Controlled substances also require an Illinois controlled substance license.
Section last amended by P.A. 98-1140 (eff. 12-30-14) and is scheduled for repeal January 1, 2032 with the Medical Practice Act sunset. Source older than 2 years but still the current text at access.
225 ILCS 60/33
- 225 ILCS 60/33 - Legend drugs (Medical Practice Act of 1987) — Illinois General Assembly, 2014-12-30
Prescribing by telehealthIllinois requires an Illinois license or permit to practice telemedicine on patients in Illinois, with narrow exceptions, and no Illinois telehealth-specific Schedule III limit was found.Allowed (standard rules)
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.
225 ILCS 60/49.5 makes practicing telemedicine on Illinois patients without an Illinois license or permit subject to penalties; excluded are periodic consultations with an Illinois licensee, second opinions, follow-up care after treatment in the provider's own state, and care for existing patients who are traveling. Telehealth prescribing follows the ordinary standard of care; no Illinois statute found adds an in-person requirement or a telehealth-specific controlled-substance limit. An Illinois controlled substance license is needed to prescribe testosterone. IMLC: member.
Section 49.5 is scheduled for repeal January 1, 2032 with the Medical Practice Act sunset.
225 ILCS 60/49.5
- 225 ILCS 60/49.5 - Telemedicine — Illinois General Assembly, 2026-09-23
- Illinois - Professional Requirements — Center for Connected Health Policy (CCHP), 2026-06-04
- IMLC Commission - Compact State Map (participating states) — Interstate Medical Licensure Compact Commission, 2026-09-23
Aesthetics, IV therapy & practice ownership
Who may inject neuromodulators and fillersIllinois physicians may delegate patient-care tasks such as cosmetic injections to RNs and LPNs, by standing orders or protocols if they choose, within a physician-patient relationship; unlicensed staff may be used only with a licensed professional on site.RNs may inject under delegation
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?
Section 54.2 of the Medical Practice Act says nothing limits a physician's delegation of patient-care tasks to an RN, LPN or other licensee acting within their own licensing act, and that delegation may be made by any means, including standing orders, protocols, guidelines or verbal orders. In an office setting and within a physician-patient relationship, a physician may delegate to a trained unlicensed person only if a licensed health care professional is on site. Delegated tasks must be within the physician's own scope and training. No Illinois rule specific to neuromodulators or fillers was found.
Answer rests on the general delegation statute. IDFPR/Board of Nursing guidance on cosmetic injectables was not located.
225 ILCS 60/54.2 (as amended by P.A. 104-796, eff. 2026-08-07)
- 225 ILCS 60/54.2 – Physician delegation of authority — Illinois General Assembly, 2026-08-07
IV hydration and vitamin therapyNo Illinois IV-hydration rule was found; physicians may delegate IV administration to RNs and LPNs, including by standing orders or protocols, within a physician-patient relationship.Standard medical/nursing rules
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?
225 ILCS 60/54.2 allows delegation of patient-care tasks to RNs and LPNs within their licensing act, by any method including standing orders and protocols, and requires delegated tasks to be within the context of a physician-patient relationship. APRNs without full practice authority collaborate with physicians under written agreements (§54.5). No IDFPR statement on elective IV hydration, prior exams or mobile IV services was located.
The 'physician-patient relationship' condition still implies an individual relationship with each patient. Check IDFPR for IV-hydration guidance.
225 ILCS 60/54.2; 225 ILCS 60/54.5
- 225 ILCS 60/54.2 – Physician delegation of authority — Illinois General Assembly, 2026-08-07
- 225 ILCS 60/54.5 – Physician delegation to PAs, APRNs and prescribing psychologists — Illinois General Assembly, 2026-09-23
Corporate practice of medicine / med spa ownershipIllinois strictly applies the corporate practice of medicine doctrine (with a hospital exception), so med spas' medical services must be in physician-owned entities, typically paired with an MSO.Strong CPOM
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 classifies Illinois as strict, citing 225 ILCS 60/22, Dr. Allison, Dentist, Inc. v. Allison (1935) and Berlin v. Sarah Bush Lincoln Health Center (which recognized a licensed-hospital exception). MedPath Compliance (reviewed 2026-06-20) also rates Illinois strict and reports that HB 5000, a health-care transaction notice bill, passed both chambers on 2026-05-28.
Year of the Berlin decision is from general knowledge of the case; Permit Health cites it without a year.
225 ILCS 60/22; Berlin v. Sarah Bush Lincoln Health Ctr. (Ill. 1996) (as reported by Permit Health)
- The Corporate Practice of Medicine 50-State Guide — Permit Health, 2025-12-23
- Corporate Practice of Medicine (CPOM) Across the 50 States and D.C. — MedPath Compliance Group, 2026-06-20
Who may operate aesthetic lasersIllinois lets physicians delegate non-ablative laser procedures such as hair removal to trained RNs and LPNs; a prior on-site physician exam can be skipped only if an APRN examines the patient, a delegation protocol is followed and a physician is reachable by phone.Delegable with licensing/training rules
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?
225 ILCS 60/54.2(e) authorizes IDFPR rules on physician delegation, including the use of light-emitting devices, and provides that an on-site physician examination before a non-ablative laser procedure is not required when (1) the laser hair removal facility follows a physician delegation protocol available to the Department, (2) the exam is done by an APRN, (3) the procedure is delegated by a physician and performed by an RN or LPN with documented training on each system, and (4) a physician is available by phone or electronically. Unlicensed persons may perform delegated tasks only in an office setting with a licensed professional on site (§54.2(b)).
The underlying IDFPR rule that otherwise requires an on-site physician exam was not fetched. The section was amended by P.A. 104-796 effective 2026-08-07; the specific change was not compared.
225 ILCS 60/54.2(b), (e) (as amended by P.A. 104-796, eff. 2026-08-07)
- 225 ILCS 60/54.2 – Physician delegation of authority — Illinois General Assembly, 2026-08-07
Labs, regenerative medicine & cosmetics
State clinical laboratory licensing (beyond CLIA)Not confirmed. No Illinois lab license beyond CLIA was found in the sources reviewed, but its absence was not verified.Not confirmed
Does the state license clinical laboratories itself, beyond federal CLIA certification, including out-of-state labs that test specimens from the state?
Most states rely on federal CLIA certification alone. The states confirmed in this research as issuing their own lab licenses are California, New York, Pennsylvania, Maryland and Rhode Island (which also reach out-of-state labs testing specimens from their residents), plus Nevada, Washington, Massachusetts, New Jersey and New Hampshire (labs located in the state). Illinois was not among them, but this research did not confirm its statutes. Illinois's CLIA state agency is Illinois Dept. of Public Health, Division of Health Care Facilities & Programs (DPH.CLIA@illinois.gov, 217-782-6747); it can confirm whether any state license or permit applies, including to out-of-state labs.
Absence of a state license was not verified against the state's statutes or rules.
Not confirmed
- CLIA State Agency Contacts (updated May 2026) — Centers for Medicare & Medicaid Services, 2026-05-01
Direct-to-consumer lab testingNot confirmed whether Illinois consumers may order lab tests without a practitioner order. Practitioner-ordered panels are not affected.Not confirmed
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 Illinois's rule. Illinois's lab regulator (CLIA state agency) is Illinois Dept. of Public Health, Division of Health Care Facilities & Programs (DPH.CLIA@illinois.gov, 217-782-6747). The question matters for take-home and consumer test kits, not for panels a clinician orders.
A commercial 2026 guide (Just Labs) groups Illinois with partially restrictive states; not confirmed against state law. The ADLM figure dates from 2019 (older than 2 years).
Not confirmed
- Direct-to-consumer laboratory testing (position statement, 2019): '37 states and the District of Columbia permit consumers to order some or all of their laboratory tests directly' — Association for Diagnostics & Laboratory Medicine (formerly AACC), 2026-09-23
- CLIA State Agency Contacts (updated May 2026) — Centers for Medicare & Medicaid Services, 2026-05-01
- Direct-Access Lab Testing: Complete State Guide 2026 (commercial blog; names only ~13 states) — Just Labs, 2026-04-24
State laws on stem cell / regenerative therapiesNo Illinois law specific to stem cell, exosome or regenerative therapies was found, so FDA rules and general medical-practice rules apply.No state-specific law (FDA rules apply)
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. Illinois 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.
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.
None found
- State Stem Cell Laws: Accurate 2026 Map Update (lists 12 states with statutes; commercial source) — SaveMyFat, 2026-08-06
- U.S. State Laws on Medical Freedom and Investigational Stem Cell Procedures: A call to focus on state-based legislation (Cytotherapy) — Cytotherapy / PubMed Central, 2024-02-03
State rules for cosmetics and sunscreenIllinois bans the sale of animal-tested cosmetics and will ban cosmetics with intentionally added PFAS from Jan 1, 2032.State cosmetic/sunscreen rules
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?
Illinois is listed among the states banning the sale of cosmetics tested on animals. Under SB 561 as amended by HB 2516, selling, offering or distributing cosmetics with intentionally added PFAS will be prohibited from Jan 1, 2032.
The animal-testing list is Wikipedia's 'as of 2023' compilation (older than 2 years); effective dates were not confirmed. Federal MoCRA and FDA cosmetic and OTC sunscreen rules apply in every state.
Illinois PFAS law (SB 561, amended by HB 2516), per 2026 compilations; Illinois cosmetic animal-testing law (citation not confirmed)
- PFAS in Cosmetics: US State Bans and Compliance Deadlines - 2026 Update — Adherent (formerly Compliance & Risks), 2026-03-13
- State PFAS Bans in Cosmetics Expand Ahead of 2026 (updated Jan. 14, 2026) — Morgan, Lewis & Bockius LLP, 2026-01-14
- Testing cosmetics on animals (US state bans 'as of 2023') — Wikipedia, 2026-09-23
Compare every state
Who may inject neuromodulators and fillers. 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 federal floor, for every category
Two federal compounding lanes: §503A pharmacies vs §503B outsourcing facilitiesA §503A pharmacy (or physician) compounds for an identified patient on a prescription; a §503B outsourcing facility is FDA-registered, follows CGMP, and is the only federal lane for non-patient-specific office stock.
Under §503A, a state-licensed pharmacist or physician may compound for an identified individual patient on a valid prescription, or in limited anticipatory quantities (no more than a 30-day supply based on the compounder's own prescription history). 503A compounders are not required to follow CGMP and are not required to report adverse events to FDA. Under §503B, an outsourcing facility registers with FDA, compounds under CGMP, is inspected on a risk-based schedule, must report adverse events, and may distribute non-patient-specific product to hospitals, clinics and practitioners for office use. Neither lane makes a compounded drug 'FDA-approved'. Both lanes restrict 'essentially copies' of approved or marketed drugs and restrict which bulk ingredients may be used. FDA keeps a public list of registered outsourcing facilities (content current as of 09/08/2026).
- Prescription Requirement Under Section 503A of the FD&C Act — Guidance for Industry — FDA/CDER, 2016-12-01
- Registered Outsourcing Facilities — FDA, 2026-09-08
- FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss (503A adverse events not required to be reported) — FDA, 2026-09-01
'Essentially a copy' of an approved or commercially available drugFDA treats a compounded drug with the same active ingredient, a similar strength and a usable route as a marketed product as 'essentially a copy' unless the prescriber documents a patient-specific significant difference on the prescription.
503A (final guidance, Jan 2018): a drug is not 'commercially available' if it is discontinued or is in 'currently in shortage' status on FDA's drug shortage list. FDA generally considers a compounded drug a copy if it has the same API in the same, similar or easily substitutable strength by a route the commercial product can be used by. The prescriber's determination must name the change and the significant difference for that patient; a patient name plus formulation is not enough, and lower price does not count. FDA does not consider copies to be made 'regularly or in inordinate amounts' if the compounder fills four or fewer such prescriptions per calendar month. 503B (final guidance, Jan 2018): outsourcing facilities may not compound drugs identical or nearly identical to an approved drug unless it is on the shortage list; otherwise a prescriber's determination of a clinical difference must be noted on the prescription or order.
- Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A — Guidance for Industry — FDA/CDER, 2018-01-01
- Compounded Drug Products That Are Essentially Copies of Approved Drug Products Under Section 503B — Guidance for Industry — FDA/CDER, 2018-01-01
Office use / office stock of compounded drugs (federal position)FDA's position is that §503A compounding requires a prescription for an identified patient; clinics wanting non-patient-specific office stock are directed to §503B outsourcing facilities.
FDA's final 503A prescription-requirement guidance (Dec 2016) says hospitals, clinics and practitioners can obtain non-patient-specific compounded drugs from outsourcing facilities registered under §503B, which may distribute sterile and non-sterile office-use product. 503A anticipatory compounding is limited to no more than a 30-day supply based on the compounder's own prescription history. Some states allow limited 503A office use under state law, but the federal 503A exemptions still depend on patient-specific prescriptions (see state topic office_use_503a).
503B products may not be resold by anyone other than the outsourcing facilitySection 503B(a)(8) bars anyone other than the outsourcing facility from selling or transferring its compounded drugs, so a clinic, distributor or marketplace that takes ownership may not resell 503B product.
FDA's June 2023 draft guidance (still draft) says the drug should go from the outsourcing facility to the entity that dispenses or administers it. FDA does not intend to apply the prohibition to transfers to common carriers, third-party logistics providers, regulators, returns processors, waste handlers or contract test labs, or to recall-related transfers. A state-licensed pharmacy may dispense 503B product against a patient-specific prescription. Clinic-to-clinic resale is the core concern.
- Prohibition on Wholesaling Under Section 503B of the FD&C Act — Draft Guidance for Industry — FDA/CDER, 2023-06-27
Which bulk ingredients compounders may use (503A Categories 1/2/3; 503B bulks list)A 503A compounder may use a bulk ingredient only if it has a USP/NF monograph, is a component of an FDA-approved drug, or is on the 503A bulks list; FDA tolerates interim 'Category 1' substances, flags 'Category 2' as significant safety risks, and treats 'Category 3' as lacking support.
FDA's category list was updated May 14, 2026. 503A Category 2 now contains only cesium chloride, domperidone, germanium sesquioxide, ibutamoren mesylate, kisspeptin-10 and quinacrine (intrauterine use). Category 1 includes glutathione, methylcobalamin, NAD, NADH, enclomiphene citrate, GHK-Cu (non-injectable routes only), vasoactive intestinal peptide and others. GHRP-2, GHRP-6, mechano growth factor and thymulin are in Category 3. BPC-157, TB-500, CJC-1295, ipamorelin, AOD-9604, Selank, Semax, epitalon, MOTs-C, dihexa, KPV and thymosin alpha-1 are in no category, so they do not get Category 1 enforcement discretion. FDA does not intend to categorize substances nominated on or after Jan 7, 2025. The final 503B bulks list is short (e.g., diphenylcyclopropenone, glycolic acid topical up to 70%, quinacrine oral, squaric acid dibutyl ester, trichloroacetic acid); 503B Category 2 includes GHRP-2, GHRP-6, ipamorelin acetate, ibutamoren, tranilast and others.
- Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (Categories 1–3) — FDA, 2026-05-14
- Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act — FDA, 2026-05-14
- Safety Risks Associated with Certain Bulk Drug Substances for Use in Compounding (Category 2) — FDA, 2026-04-22
- 503B Bulk Drug Substances List — FDA, 2024-05-16
- Bulk Drug Substances Used in Compounding Under Section 503B of the FD&C Act — FDA, 2025-01-07
Biologics (including hCG, tesamorelin, somatropin) cannot be compounded under 503A/503BSince March 23, 2020, protein products approved as drugs became licensed biologics, and FDA says biological products are not eligible for the 503A or 503B compounding exemptions.
The BPCI Act transition on March 23, 2020 deemed approved NDAs for biological products to be BLAs. FDA's transition list includes chorionic gonadotropin (Pregnyl, Novarel, Fresenius chorionic gonadotropin, Ovidrel), menotropins, follitropins, hyaluronidase, somatropin and tesamorelin acetate (Egrifta/Egrifta SV). FDA's notice to compounders states that 'biological products will not be eligible for the exemptions for compounded drugs under sections 503A and 503B'. Separate FDA guidance (Jan 2018) describes limited conditions for mixing, diluting or repackaging licensed biologics outside their labeling.
'Research Use Only' / 'not for human consumption' productsFDA treats RUO-labeled peptides and GLP-1s as unapproved drugs when marketing, dosing information or bundled syringes/bacteriostatic water show human use; the disclaimer does not make them lawful to administer to patients.
FDA's GLP-1 safety page says companies sold products falsely labeled 'for research purposes' or 'not for human consumption' with dosing instructions for human use. FDA has issued repeated warning-letter rounds to peptide/RUO sellers in 2026 (e.g., letters dated March 31, 2026 to Gram Peptides and others; June 17, 2026 to Wholesale Peptide; August 24, 2026 to Royal Peptides and others). Import Alert 66-41 (unapproved new drugs promoted in the U.S.) has listed, for example, a firm offering PT-141 peptide. RUO material is not a USP-grade or approved-drug-component bulk ingredient for compounding and is not a prescription drug a clinician can lawfully buy for patient use.
- FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss — FDA, 2026-09-01
- Warning Letter: Gram Peptides (MARCS-CMS 721806) — FDA, 2026-03-31
- Warning Letter: Wholesale Peptide (MARCS-CMS 729447) — FDA, 2026-06-17
- Warning Letter: Royal Peptides LLC (MARCS-CMS 734884) — FDA, 2026-08-24
- Import Alert 66-41: Detention Without Physical Examination of Unapproved New Drugs Promoted in the U.S. — FDA, 2026-09-11
FDA drug shortage list and why it matters for compoundingA drug in 'currently in shortage' status is not 'commercially available', so 503A/503B compounders may make copies of it; when FDA marks the shortage resolved, that permission ends (503B facilities may finish existing orders for up to 60 days).
The 503A copies guidance says a drug appears on the shortage list only if it is in 'currently in shortage' status, not 'resolved'. FDA's shortage-compounding page says compounders must still meet all other 503A conditions (including a valid patient-specific prescription), and FDA 'may take action if an outsourcing facility continues to fill new orders after the approved drug is removed from FDA's drug shortage list, or if it continues to fill existing orders more than 60 days after the drug has been removed.' The GLP-1 episode shows the effect: large-scale semaglutide and tirzepatide compounding depended on shortage status and ended after FDA resolved the shortages. A prescriber or compounder relying on a shortage should note on the prescription that the drug was on the list and the date checked.
FDA Standard MOU on interstate distribution of 503A compounded drugsThe October 2020 standard MOU is suspended after a 2021 court remand; FDA is not enforcing the statutory 5% out-of-state limit and plans a new rule, with a proposed rule projected for November 2026.
Section 503A limits a pharmacy in a state without an FDA MOU to distributing no more than 5% of its compounded prescriptions out of state. FDA published a final standard MOU in October 2020, but a federal court remanded it in September 2021. FDA 'considers the standard MOU published in October 2020 to be suspended' and, per its Oct 21, 2022 Federal Register notice, will not enforce the 5% limit until a final rule and updated MOU are published. The Fall 2025 Unified Agenda lists RIN 0910-AI71 ('Distribution of Compounded Drug Products Under Section 503A') at the proposed-rule stage with an NPRM projected for 11/2026. State nonresident-pharmacy licensing still applies (see state topics nonresident_pharmacy and fda_mou).
- Memorandum of Understanding Addressing Certain Distributions of Compounded Drugs — FDA, 2022-10-20
- Extension of the Period Before FDA Intends To Begin Enforcing the Statutory 5 Percent Limit on Out-of-State Distribution of Compounded Human Drug Products (87 FR, Oct 21, 2022) — Federal Register, 2022-10-21
- Unified Agenda, RIN 0910-AI71: Distribution of Compounded Drug Products Under Section 503A (Fall 2025) — OMB/OIRA, 2025-10-01
DEA telemedicine prescribing of controlled substances (Ryan Haight Act flexibilities)Through December 31, 2026, DEA-registered practitioners may prescribe Schedule II–V controlled substances by telemedicine without a prior in-person visit under a fourth temporary extension; the permanent special-registration rule is still pending.
The Ryan Haight Act generally requires an in-person medical evaluation before prescribing controlled substances over the internet. DEA and HHS published the Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities (90 FR 61301, Dec 31, 2025), effective Jan 1 – Dec 31, 2026. Prescriptions must still be for a legitimate medical purpose and comply with federal and state law; state telehealth and controlled-substance rules still apply (see telehealth_rx, state_csr, pdmp_mandate). The separate buprenorphine (opioid use disorder) telemedicine final rule and the VA continuity-of-care final rule, both published Jan 17, 2025, took effect Dec 31, 2025 after two delays (90 FR 13410). A Federal Register search on 2026-09-23 found no DEA special-registration final rule published in 2026. The Special Registrations for Telemedicine final rule was reported to be in OMB review as of late August 2026, with a final rule forecast for November 2026. Without a new rule or another extension, the in-person requirement returns on Jan 1, 2027.
- Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, 90 FR 61301 (Federal Register API record: effective Jan 1 – Dec 31, 2026) — DEA/HHS, Federal Register, 2025-12-31
- Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (FR Doc. 2025-24123) — DEA/HHS, Federal Register, 2025-12-31
- Expansion of Buprenorphine Treatment via Telemedicine Encounter and Continuity of Care via Telemedicine for VA Patients — effective Dec 31, 2025, 90 FR 13410 (API record) — DEA/HHS, Federal Register, 2025-03-24
- DEA and HHS Extend Telemedicine Prescribing Flexibilities Through 2026 — Holland & Knight, 2026-01-13
- DEA Prescribing of Controlled Substances (tracker) — Alliance for Connected Care, 2026-08-26
- Expansion of Buprenorphine Treatment via Telemedicine Encounter and Continuity of Care via Telemedicine for VA Patients — delay of effective date (FR Doc. 2025-05007) — DEA/HHS, Federal Register, 2025-03-24
FTC health-claim substantiation (advertising)The FTC requires competent and reliable scientific evidence, generally randomized controlled human trials, before a marketer makes health-benefit claims for any health product, including devices, tests, supplements and apps.
The FTC's Health Products Compliance Guidance (Dec 2022) replaced the 1998 supplement advertising guide. Marketers must have substantiation for every objective claim, express or implied, before it runs; for health benefits this generally means randomized, controlled human clinical testing. Qualifying disclosures must be clear and conspicuous, and advertisers are liable for misleading testimonials and endorsements. This sits alongside FDA's rules: FDA regulates labeling and intended use, and FDA warning letters in 2025–2026 target 'same as brand' and 'FDA-approved' claims for compounded drugs.
- Health Products Compliance Guidance — Federal Trade Commission, 2022-12-01
- FDA to Telehealth Companies: What to Know When Promoting Compounded Drugs — FDA, 2026-06-15
Adverse event reporting (MedWatch; 503B mandatory reporting)Clinicians and patients can report problems with drugs, biologics, devices and cosmetics to FDA's MedWatch voluntarily; 503B outsourcing facilities must report adverse events, while 503A pharmacies are not federally required to.
MedWatch accepts voluntary reports for prescription and OTC drugs, biologics (including human cell and tissue products), medical devices, combination products and cosmetics. Manufacturers, packers and distributors named on a marketed prescription drug label must file 15-day 'Alert reports' for serious and unexpected adverse experiences under 21 CFR 310.305; FDA's final guidance (Oct 2015) applies adverse event reporting to 503B outsourcing facilities. FDA notes that federal law does not require state-licensed 503A pharmacies to report adverse events, so compounded-drug events are likely under-reported. Under MoCRA, cosmetic 'responsible persons' must report serious adverse events within 15 business days.
- MedWatch: The FDA Safety Information and Adverse Event Reporting Program — FDA, 2026-09-21
- Adverse Event Reporting for Outsourcing Facilities Under Section 503B — Guidance for Industry — FDA/CDER, 2015-10-01
- 21 CFR 310.305 — Records and reports concerning adverse drug experiences on marketed prescription drugs — eCFR, 2026-09-01
- Modernization of Cosmetics Regulation Act of 2022 (MoCRA) — FDA, 2026-08-10
Where FDA enforcement shows up: warning letters, import alerts, recallsFDA posts warning letters in a searchable database, detains risky imports through import alerts (e.g., 66-80 for GLP-1 APIs, 66-41 for unapproved drugs, 80-04 for gloves, 53-21 for adulterated cosmetics), and publishes recalls in its enforcement reports.
Import alerts let FDA detain products without physical examination. Import Alert 66-80 (GLP-1 receptor agonist bulk drug substances) detains semaglutide, tirzepatide, liraglutide, exenatide, orforglipron, retatrutide and dulaglutide APIs unless the manufacturer is on FDA's 'Green List'; FDA cited that 21% of inspected GLP-1 API makers were noncompliant with CGMP. Import Alert 66-41 covers unapproved new drugs promoted in the U.S. and has listed firms offering unapproved botulinum toxin and PT-141 peptide. Recalls, including Class I recalls of compounded glutathione in July–August 2026, appear in FDA enforcement reports and openFDA.
- FDA Warning Letters (searchable database) — FDA, 2026-09-23
- Import Alert 66-80: GLP-1 Receptor Agonist Bulk Drug Substances (Green List) — FDA, 2026-09-21
- Import Alert 66-41: Unapproved New Drugs Promoted in the U.S. — FDA, 2026-09-11
- openFDA drug enforcement (recall) query: sterile water / glutathione recalls 2023–2026 — FDA (openFDA), 2026-09-16
Compounded peptides: where things stand in September 2026FDA pulled 12 peptides out of Category 2 in April 2026 after nominators withdrew them, and its advisory committee voted in July 2026 to recommend six for the 503A bulks list, but none is on the list or in Category 1 yet, so none has federal compounding permission today.
On April 15, 2026 FDA announced that 12 peptides (BPC-157, cathelicidin LL-37, dihexa acetate, emideltide/DSIP, epitalon, GHK-Cu injectable, KPV, PEG-MGF, melanotan II, MOTs-C, Semax, TB-500) would leave Category 2 after seven days because their nominations were withdrawn; FDA's list shows the change effective April 22, 2026. Law-firm analyses stress that leaving Category 2 does not place a substance on the 503A bulks list or in Category 1. At the July 23–24, 2026 PCAC meeting, members voted to recommend BPC-157 (8–6), KPV (8–6), TB-500 (8–6), MOTs-C (7–5), epitalon (7–4) and Semax (8–5), and against emideltide (6–7); FDA staff had recommended against all of them. FDA must still decide and complete notice-and-comment rulemaking. GHK-Cu, dihexa, LL-37, PEG-MGF and melanotan II are slated for a PCAC meeting before the end of February 2027. Earlier, AOD-9604, CJC-1295, ipamorelin, thymosin alpha-1 and Selank left Category 2 in September 2024, and PCAC voted against CJC-1295 and AOD-9604 on Dec 4, 2024.
- Safety Risks Associated with Certain Bulk Drug Substances for Use in Compounding (Category 2; withdrawn list) — FDA, 2026-04-22
- July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee — FDA, 2026-08-06
- Bulk-list bound? PCAC backs majority of peptides in two-day public meeting — McDermott (law firm), 2026-07-27
- FDA Announces Removal of 12 Peptides from Category 2 and Schedules PCAC Meetings — Orrick, 2026-04-16
- FDA to Remove 12 Popular Peptides from the Category 2 'Do Not Compound' List — Frier Levitt, 2026-09-23
- Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (Categories 1–3) — FDA, 2026-05-14
- Pharmacy Compounding Advisory Committee; Notice of Meeting (July 23–24, 2026; 503A bulks nominations), 91 FR 20465 — FDA, Federal Register, 2026-04-16
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Educational summaries of public law and agency guidance, not legal advice. Researched 2026-09-23 from the sources linked on each answer; laws, board rules and FDA policy change, so confirm with the linked agency or your counsel before you rely on an answer. Found something out of date? Tell our compliance desk.
