Which peptides can be compounded now? What the 2026 rules mean for you
Since October 2026, HHS has said it won't take federal action when licensed pharmacies or physicians compound six peptides (BPC-157, TB-500, epitalon, Semax, KPV and MOTS-c) for a specific patient under ten conditions. That isn't FDA approval, it's an interim policy, and states can set their own rules.
Reviewed by Darshan Patel, MD, Obesity medicine physician, on 2026-11-12. Next review 2026-12-12.
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The short version
In October 2026, the Department of Health and Human Services published an interim policy for six peptides. Federal regulators won't take action against state-licensed pharmacies, federal facilities or licensed physicians who compound them for a specific patient, as long as all ten conditions below are met.
For anyone curious about peptides, that means a clearer, safer path than buying online: a prescription, a licensed pharmacy, and an ingredient that has been tested.
The six peptides, and how each can be used
| Peptide | How the policy allows it to be used |
|---|---|
| BPC-157 | Injection under the skin or into muscle, by mouth, on the skin |
| TB-500 | Injection under the skin or into muscle |
| Epitalon | Injection under the skin or into muscle, given in courses with breaks between them |
| Semax | Nasal spray |
| KPV | By mouth or on the skin |
| MOTS-c | Injection under the skin or into muscle |
What a careful pharmacy does: the ten conditions
Use this as a checklist when you talk to any clinic or pharmacy.
- The peptide is one of the six on the policy's list.
- The peptide matches the policy's description and is used only in the ways above.
- The ingredient comes from an FDA-registered facility, with a certificate showing identity, purity, strength and tests for contaminants such as endotoxins and heavy metals.
- The original manufacturer is registered with FDA, follows good manufacturing practice, and the location of its plant is listed on the certificate.
- It reports what it compounds, serious side effects and quality problems to FDA's MedWatch program and to the states involved, and the label tells you how to report a problem.
- The label says "This is a compounded drug product. Not for resale."
- Each product contains one peptide, not a blend.
- For a product you take by mouth, the pharmacy keeps records showing that your body absorbs enough of it.
- The only device in the box is an FDA-cleared syringe.
- Every other federal pharmacy rule is followed, including clean conditions and a prescription written for you.
What the policy doesn't change
It isn't an approval, so it doesn't show that any peptide is safe or effective. States can still set their own rules. Blends, peptides outside the six, and ingredients sold as lab chemicals aren't covered. HHS can revise the policy at any time.
How we got here
FDA listed all six peptides as substances with significant safety risks (Category 2) in September 2023 and removed them on April 22, 2026. FDA's drug center recommended against allowing them; FDA's Pharmacy Compounding Advisory Committee voted in favor. HHS then issued this interim policy while FDA works through formal rulemaking, with public comments open through November 13, 2026.
What's next
More peptides may come up for review as FDA works through its list. We check this page every month and update it whenever the rules change.
Thinking about a peptide? Start with the goal
Most people looking into peptides want something specific: to recover faster, keep muscle, sleep better, have more energy or age well. Those goals deserve a plan with strong evidence behind it.
At Aayu Well, an obesity medicine physician and a registered dietitian work with you on weight, metabolic health, sleep and mood, with medicine when it's right for you. We don't prescribe these peptides right now, but you're welcome to bring every question you have to your visit. Book my consultation
Questions people ask
Does Aayu Well prescribe these peptides?
Not right now. We're reviewing the evidence and the pharmacy requirements, and we'll update this page if that changes. You're welcome to bring your peptide questions to a visit: your physician will walk you through the evidence and build a plan around your goal.
Is BPC-157 legal now?
Federal regulators have said they won't take action when a licensed pharmacy or physician compounds BPC-157 for a specific patient under all ten HHS conditions. It still isn't an FDA-approved drug, and some states set their own rules.
Does this cover peptides sold online as research chemicals?
No. The policy covers only ingredients from FDA-registered manufacturers, certified for compounding medicines. Products sold as lab chemicals aren't made or tested for people.
Are sermorelin and NAD+ covered by this policy?
No, neither is one of the six. Sermorelin was the ingredient of an approved drug that's no longer sold, so pharmacies compound it under a separate rule. NAD+ isn't a peptide. For regular pharmacies, FDA lists NAD+ as an ingredient it is still evaluating, and in January 2026 FDA told an outsourcing facility that NAD+ isn't eligible under the rules for outsourcing facilities.
Can a pharmacy combine two of these peptides in one product?
Not under this policy. Each compounded product may contain only one of the six peptides.
Curious about peptides? Start with a conversation
Bring what you've read to a video visit with an obesity medicine physician. We'll talk through the evidence, look at everything you take, and build a plan around your goal, whether that's weight, energy, recovery or sleep.
Sources
- HHS: Enforcement Discretion Policy Regarding 503A Compounding Using Certain Peptide Bulk Drug Substances, Appendices A and B (October 2026)
- Federal Register notice FR Doc. 2026-22192, 91 FR 68526 (October 30, 2026)
- Holland & Knight: HHS Issues Interim Enforcement Discretion Policy for Compounding of 6 Peptides (Nov 4, 2026)
- FDA: Bulk drug substances used in compounding under section 503A
- FDA warning letter to GenoGenix LLC, WL 718739 (January 20, 2026)
- FDA: Bulk drug substances nominated for use in compounding under section 503A, categories 1 to 3 (updated May 14, 2026)
