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The patient demand greatly outweighs the federal government's appetite to enforce, so we are in a unique legal environment. But again, Holt says, simply because a peptide is not banned does not make it legal. A pharmacy can compound a bulk substance if it meets one of three criteria: It has a USP monograph (official, written quality standards for a substance that is approved by the FDA), it is a component of an FDA-approved drug, or its on the FDA 503A Positive List

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If you still need to use tramadol, prepare a comprehensive medical file containing all your medical notes in case you need to apply for a Therapeutic Use Exemption (TUE)

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