Reference

Every peptide on a telehealth menu, and where the FDA actually put it

Of the 18 peptides on a typical telehealth menu, 3 have an FDA-approved product behind them. 15 appear by name on the FDA's list of compounding substances that raise safety concerns. 6 have one randomized trial or none. Here is the whole table, with the source for every cell.

Evidence read September 2026. Nobody here holds a medical license and none of this is medical advice. Every source below is listed so you can check it yourself.

What this comes down to

Only 3 of them — tesamorelin, sermorelin and PT-141 — have ever been the active ingredient of an approved American drug, and sermorelin's approvals are discontinued.
The FDA's compounding page carries two tables — fourteen substances currently in category 2, and seventeen whose nominations were later withdrawn. Most of the second table is peptides sold on these menus.
Trial counts range from 0 to 42. The counts do not track the marketing: the peptides sold hardest are not the peptides studied most.
A withdrawn nomination is not a clearance. The FDA's safety text stays published beside the name.

Peptides with an approved product

3 of 18

Named on the FDA safety-risk page

15 of 18

With one randomized trial or none

6 of 18

Range of trial counts

0 to 42

The table

Peptide	FDA compounding placement	Approved product	Randomized trials
Tesamorelin	Not listed	Egrifta, approved 2010	26
Sermorelin	Not listed	Geref, approved 1990 and 1997, both discontinued	19
PT-141 (bremelanotide)	Not listed	Vyleesi, approved 2019	14
Thymosin alpha-1	Nomination withdrawn	None	35
GHRP-2	Category 2 (503B)	None	42
GHRP-6	Category 2 (503B)	None	19
TB-500 (thymosin beta-4 fragment)	Nomination withdrawn	None	7
Kisspeptin-10	Category 2 (503A)	None	4
MOTS-c	Nomination withdrawn	None	4
Selank	Nomination withdrawn	None	3
Ipamorelin	Category 2 (503B), nomination withdrawn	None	2
GHK-Cu (injectable)	Nomination withdrawn	None	2
CJC-1295	Nomination withdrawn	None	1
Semax	Nomination withdrawn	None	1
Melanotan II	Nomination withdrawn	None	1
BPC-157	Nomination withdrawn	None	0
Epitalon	Nomination withdrawn	None	0
AOD-9604	Nomination withdrawn	None	0
Semaglutide (for scale)	Not a compounding nomination	Ozempic, Wegovy, Rybelsus	312

Compounding placement read from the FDA page dated April 22, 2026. Approvals queried in Drugs@FDA. Trial counts are PubMed records tagged as randomized controlled trials with human indexing, read September 2026. Sorted by trial count.

The last row is a control, not a recommendation

Semaglutide is in the table so the other numbers have a scale to sit against, and so a reader can tell that the filter finds things. A count of 312 is what a molecule with a full development program looks like in this column. It is not an argument for taking one.

What each column means, and what it doesn't

FDA compounding placement

A pharmacy compounding under section 503A may only use a bulk substance that meets a USP or National Formulary monograph, is a component of an approved drug product, or sits on the FDA's 503A bulks list^[1]. While the agency works through the nominations, an interim policy sorts them into three categories. Category 1 substances get an enforcement grace period. Category 2 does not — that is the bucket for substances where the FDA has identified significant safety risks, and the agency says explicitly it would consider action against a compounder using one^[2].

“Nomination withdrawn” means the substance was in category 2 and whoever nominated it pulled the nomination. The safety text the agency wrote stays on the page. Withdrawal removes the substance from the queue for the bulks list; it does not remove the finding.

Approved product

Queried in Drugs@FDA by active ingredient^[3]. A fabricated ingredient name was run in the same session and returned nothing, which is the only way an empty result means anything. Three rows came back with something: tesamorelin as Egrifta, bremelanotide as Vyleesi, and sermorelin as Geref, whose two approvals are both discontinued with a Federal Register determination that neither was pulled for safety or effectiveness reasons.

Randomized trials

One PubMed query per row, all identical in shape: the peptide's name, the randomized-controlled-trial publication type, and the human indexing tag^[4].

The filter, and the proof that it works

PubMed, via the E-utilities API

<peptide> AND "randomized controlled trial"[pt] AND "humans"[mh]

Returned 0. Positive control — semaglutide through the identical filter — returned 312 through the identical filter in the same session. Read September 2026.

The count shown here is the count for a deliberately fabricated peptide name, run in the same session — a filter that returns 0 for everything is the failure mode this whole table would otherwise be vulnerable to. An invalid PubMed filter returns zero silently for every term, aspirin included, and a published census on a sibling property once rested on exactly that.

Two rows where the number flatters the peptide

Thymosin alpha-1's 35 trials are largely hepatitis B and sepsis studies of a licensed product used outside the United States, not studies of a compounded wellness injection. Melanotan II's single trial is the only one that names melanotan II specifically; a looser search that also catches afamelanotide, an approved drug, returns seven. Read a count with its query attached or don't read it.

How to use this before you buy

Find your peptide in the table. If the approval column says None, you are buying a compounded preparation, which is legal but sits outside the FDA's review for safety, effectiveness and quality.
Check the placement column. Category 2 means the agency has published a specific concern about it.
Read the trial count as a measure of how much is known, not how well anything worked. Zero is still the most informative number in that column.
Then ask the seller the compounding questions: which pharmacy, 503A or outsourcing facility, and what the vial's beyond-use date is.

None of this is a grade. We grade the company, not the molecule — what it publishes, what it withholds, and what it charges in month two. That method is on how we grade, and every price behind it is sourced under how we verify prices. Four of these peptides have their own write-up: BPC-157, sermorelin, NAD+ infusions and IV glutathione.

Questions people actually ask

Are any peptides FDA-approved?

Yes, a few. Tesamorelin is approved as Egrifta and bremelanotide as Vyleesi. Sermorelin was approved as Geref and both products are discontinued. Everything else in this table has no approved product behind it in the United States.

What does category 2 mean on the FDA's compounding list?

It means the FDA reviewed a nomination to add the substance to the compounding bulks list, identified significant safety risks, and declined to extend the enforcement grace period it gives category 1 substances. The agency says it would consider taking action against a compounder using one.

Does a withdrawn nomination mean the FDA cleared the peptide?

No. Withdrawal was done by whoever filed the nomination, not by the agency, and the FDA's published safety text stays on the page beside the substance name. It means the substance is no longer in the queue for the bulks list.

Why do some peptides with almost no research get sold the hardest?

Because a compounded preparation does not need a trial behind it to be dispensed on a prescription, and because the peptides with the loudest claims are usually the ones nobody has tested against a placebo. The trial column in this table does not track the marketing at all.

Sources

Every source here was fetched and read for this article, with the identifier taken off the record that came back and the claim it supports written down beside it.

Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act. U.S. Food and Drug Administration, 2026. Source · Read September 2026
A 503A compounder may use a bulk substance only if it meets a USP or NF monograph, is a component of an FDA-approved drug product, or appears on the 503A bulks list; an interim policy sorts nominations into three categories while the agency works through them.
Substances in Compounding that May Present Significant Safety Risks. U.S. Food and Drug Administration, 2026. Source · Document dated April 2026; read September 2026
The page carries two tables: fourteen substances currently in category 2 of the interim policies, and seventeen whose nominations were later withdrawn by the nominators. Category 2 covers substances where the FDA identified significant safety risks and declined to apply its category 1 enforcement policy.
Drugs@FDA: FDA-Approved Drugs, queried through the openFDA API. U.S. Food and Drug Administration, 2026. Source · Read September 2026
Tesamorelin (Egrifta, approved 2010), bremelanotide (Vyleesi, approved 2019) and sermorelin (Geref, approved 1990 and 1997, both discontinued) are the only peptides in this table with an approved product; a fabricated ingredient name returned the same empty result as the rest in the same session.
PubMed, queried through the E-utilities API. National Library of Medicine, 2026. Source · Read September 2026
Every trial count in the table, one query per row, all through the identical randomized-controlled-trial and human-indexing filter, with semaglutide (312) as a positive control and a fabricated peptide name (0) as a negative control in the same session.