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?

La. R.S. 37:1232 requires a nonresident pharmacy permit. The pharmacy must disclose its officers and pharmacist in charge (PIC) and submit its most recent home-state inspection report, plus any inspection reports from other states, FDA or DEA. LAC 46:LIII §2301-2317 apply to any pharmacy outside Louisiana that dispenses prescription drugs to Louisiana residents. Under §2307 (amended October 2025), the PIC must hold an active Louisiana pharmacist license as well as a home-state license and must work at the pharmacy at least 20 hours a week. Louisiana pharmacy law applies to the Louisiana portion of the business (§2309), and the Board may inspect (§2311). The pharmacy must print a toll-free counseling number on every container (§2315). The Board requires an inspection dated within 24 months before each annual renewal, and NABP inspections are accepted. Pharmacies sending sterile or non-sterile compounded preparations to Louisiana residents must submit an NABP VPP inspection, a state inspection using the NABP blueprint, or an ACHC inspection. Otherwise they must attest that they will stop sending compounds. The Louisiana Board of Pharmacy enforces these rules.

R.S. 37:1232 was last amended by Acts 2020, No. 202, effective 2020-07-01. The nonresident chapter was amended at LR 49:680 (April 2023), and §§2301 and 2307 again at LR 51:1588 (October 2025), a recent change. Louisiana also issues a separate Compounded Sterile Preparations (CSP) permit, and §2535(B) requires Board approval before a permit holder starts sterile compounding. Whether nonresident permit holders need the CSP permit was not confirmed.

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.

LAC 46:LIII §2533 defines compounding as preparation 'for his patient as the result of a practitioner's prescription drug order' or in anticipation of such orders. Under §2535(A)(2)(a)-(b), sterile and non-sterile compounding under a patient-specific prescription must comply with section 503A of the federal Food, Drug, and Cosmetic Act and USP <797>/<795>. The only non-patient-specific authorization is §2535(E), which covers orders from a licensed veterinarian for animal patients. Those products may not be redistributed or resold, and are capped at 5% of the pharmacy's total drug products by dosage units each month; for out-of-state Louisiana-licensed pharmacies, the cap is measured against their Louisiana business. The current text of §2535 contains no equivalent human office-use authorization. The Board states that all compounding must comply with USP chapters, 21 CFR and the federal Act. The Louisiana Board of Pharmacy enforces these rules.

§2535 was last amended at LR 49:66 (January 2023); earlier versions were not reviewed. §2533 still defines 'practitioner administered compounds' (compounds made on a prescriber's medical order for administration by the prescriber), and an older labeling rule for them remains in the nuclear pharmacy chapter. The current §2535 does not authorize them for human use; check with the Louisiana Board of Pharmacy before relying on 503A office stock.

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 Louisiana Drug and Device Distributors Act (La. R.S. 37:3461) says any person engaged in distributing legend drugs 'shall be licensed.' R.S. 37:3462 defines 'manufacturer' to include anyone who prepares legend drugs in dosage form by 'compounding,' and defines 'distribution' as sale or delivery to anyone other than the consumer or patient. The sections reviewed do not mention outsourcing facilities or say how they apply to firms located outside Louisiana. The Louisiana Board of Pharmacy rules (LAC 46:LIII) contain no outsourcing-facility permit. The Board does issue a controlled dangerous substance license class called 'Registered Outsourcing Facility' (CDS-ROF), which covers controlled substances. A 503B that dispenses patient-specific prescriptions to Louisiana residents would fall under the nonresident pharmacy permit (R.S. 37:1232).

The Louisiana Board of Drug and Device Distributors website could not be reached, and the search budget was used up, so its licensing of out-of-state 503B facilities was not confirmed. Check with that board and the Louisiana Board of Pharmacy (https://www.pharmacy.la.gov/, 225-925-6496). The statute suggests a distributor or manufacturer license is likely required, but this is unconfirmed.

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; Louisiana 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.

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.

Board rule LAC 46:LIII.2705 requires every person who procures, possesses, prescribes or dispenses any controlled dangerous substance in Louisiana to obtain a CDS license from the Board of Pharmacy before doing so; practitioners must hold a valid Louisiana professional license or credential. A CDS license is valid for one year and expires annually on the date of initial licensure (LAC 46:LIII.2707); fees are set by R.S. 40:972 and R.S. 40:1013. The Board's FAQ explains that the CDS license is supplied to DEA to show eligibility for a DEA registration and that both are required. For prescribing, one CDS license covers any Louisiana location, but procuring and possessing controlled substances requires a separate CDS license at each location where they are kept.

Sec. 2705 was last amended LR 51:1589 (October 2025). Fee amount not confirmed (set in R.S. 40:972, not opened). Per-location: only where controlled substances are procured/possessed; prescribe-only needs one license statewide.

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.

La. R.S. 40:978(F) requires a prescriber or delegate to access and review the patient's PMP record before initially prescribing any opioid and at least every 90 days if treatment continues beyond 90 days; the Board of Medical Examiners rule LAC 46:XLV.6935 repeats this. Exceptions: hospice or terminally ill patients, cancer-related chronic or intractable pain, patients treated in a hospital, PMP outages (check once restored and chart the delay), and no more than a single 7-day supply. Enforced by the prescriber's licensing board - a first failure draws a notice, a second is treated as a complaint.

Testosterone (C-III) is not caught. Statute last amended by Acts 2024, No. 205 per the history note. A repealed medical-marijuana rule (LAC 46:XLV.7717) had its own PMP review requirement.

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.

The Louisiana State Board of Medical Examiners issues dispensing permits to MDs and DOs holding a Louisiana license, a Louisiana CDS license and DEA registration; the fee is $75 per dispensing location (rules at LAC 46:XLV, Subpart 3, Chapter 65). Physicians with three or more years in practice may dispense at most a 48-hour supply of controlled substances (with a 7-day Lyrica sample exception); those with less than three years may dispense only legend drugs. This effectively rules out dispensing ongoing testosterone.

Board page has no date; access date used.

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.

Telemedicine prescribing is held to the same standards as face-to-face practice, and the exam need not be in person if the technology gives the physician the clinical information needed (LAC 46:XLV.7503-7505). A physician may not prescribe any controlled substance by telemedicine unless the physician has had at least one in-person visit with the patient within the past year and the prescription meets the in-person standard of care; the in-person requirement does not apply to patients treated at a Louisiana-licensed, DEA-registered healthcare facility (LAC 46:XLV.7513). Testosterone prescribing by telemedicine therefore needs an annual in-person visit. IMLC: member.

Rule 7513 promulgated 2009 and last amended February 1, 2017 (LII copy); CCHP (updated 2/16/2026) shows the same text. The board may grant written case-by-case exceptions.

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 Louisiana State Board of Nursing's declaratory statement on cosmetic and aesthetic dermatological procedures (adopted 2011-03-02) says a trained RN may perform Botox (or similar FDA-approved) cosmetic injections and superficial sclerotherapy on the order of a qualified physician or an NP in a Board-approved collaborative practice, but RN scope excludes all dermal fillers. Treatment must be preceded by a history, physical exam and diagnosis by the physician or NP, informed consent and a medical record; the RN may then follow standing orders and protocols. Procedures must be done in a medical facility or office with the physician or NP physically present on the premises and immediately available, and the setting needs written policies and competency validation. Qualified NPs may perform cosmetic procedures as a subspecialty within their collaborative agreement.

Adopted 2011 — possibly stale, but still posted as current on the Board's scope-of-practice page on 2026-09-23. Biostimulators and skin boosters are not addressed; as injectable fillers they are likely within the filler exclusion — confirm with LSBN.

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 Louisiana State Board of Nursing's scope-of-practice documents and practice-petition list (checked 2026-09-23) include IV-related opinions for clinical settings but no statement on IV hydration clinics, prior exams or mobile IV services.

Check with LSBN and the Louisiana State Board of Medical Examiners.

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 Louisiana as 'Unclear', citing the Louisiana State Board of Medical Examiners' Statement of Position (1992-09-24, reviewed 2001-03-21); MedPath Compliance (reviewed 2026-06-20) calls it 'Nuanced'.

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?

The LSBN declaratory statement (2011) lists non-ablative laser skin resurfacing and laser hair removal among procedures a trained RN may perform, subject to the same conditions as injectables: a prior history, exam and diagnosis by a qualified physician or collaborating NP, a medical facility or office setting, and the physician or NP physically present and immediately available. Ablative lasers are not within RN scope. The Board also lists a practice opinion on RNs performing Class IV laser procedures under the direct supervision of a qualified physician. The statement cites a Louisiana State Board of Medical Examiners Statement of Position on medical lasers (rev. 2001), which was not fetched; whether estheticians or unlicensed technicians may use lasers was not confirmed.

Possibly stale (2011). A vendor compilation lists Louisiana as 'physicians only' for laser hair removal, which conflicts with the LSBN statement for RNs; check with LSBME.

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). Louisiana was not among them, but this research did not confirm its statutes. Louisiana's CLIA state agency is Louisiana Dept. of Health, Health Standards Section CLIA Program (225-342-9324); 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. ASCLS lists Louisiana among the states that license clinical laboratory personnel, which applies to labs located in the state.

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 Louisiana's rule. Louisiana's lab regulator (CLIA state agency) is Louisiana Dept. of Health, Health Standards Section CLIA Program (225-342-9324). The question matters for take-home and consumer test kits, not for panels a clinician orders.

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. Louisiana 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.

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?

A 2023 compilation lists Louisiana among the ten states with cosmetic animal-testing sales bans. Louisiana does not appear on 2026 lists of states with PFAS-in-cosmetics laws.

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.