In the United States a compounding pharmacy can only make a drug from a substance that is on the FDA's approved bulk substances list, has a USP monograph, or is a component of an FDA-approved drug. Sermorelin was an FDA-approved drug (Geref) until it was withdrawn for commercial reasons, so pharmacies continue to compound it. Tesamorelin is an approved drug (Egrifta) and can be prescribed off-label. Semaglutide and tirzepatide are approved drugs and are the peptides behind medical weight loss. By contrast, the FDA reviewed BPC-157, CJC-1295, TB-500, GHK-Cu, MOTS-c, AOD-9604, epitalon and thymosin alpha-1 for the compounding lists and flagged each with an immunogenicity risk and limited human safety data; none is on the approved list, and ipamorelin sits on the restricted category for outsourcing facilities. A clinic offering those is sourcing them from somewhere that is not a compliant pharmacy. In Canada, Health Canada's April 2026 advisory says injectable peptides such as BPC-157 sold this way are unauthorized drugs.