What to ask a clinic before you buy compounded peptides

A compounded-peptide intake call is asymmetric. The clinic has a script for vetting you. You usually do not have a script for vetting them. Most patients never ask a single supply-chain question before paying for their first vial, and most clinics are not used to being asked.

Here's the script that should go the other way. Six questions, in order. The first three you can ask at the intake call. The last three are worth a follow-up email after, and the answers (or non-answers) tell you most of what you need to know about whether the clinic is worth the relationship.

1. Which 503A pharmacy compounds your tirzepatide?

This is the simplest filter and it removes a surprising number of operators. A real telehealth that compounds through a 503A facility will name the pharmacy without hesitation. The names you should expect to hear in the US include Empower Pharmacy, Olympia Pharmaceuticals, Strive Pharmacy, Hallandale Pharmacy, and a small handful of regional 503As. There are legitimate compounders outside that list; there are also a lot of fly-by-night operators, and the test is whether they answer the question concretely.

The wrong answer is "we have a network of partner pharmacies" with no specifics. That phrase is a hedge. Either they don't want to tell you (which is a flag) or they don't actually know (a worse flag).

2. Is your tirzepatide pure tirzepatide, or is it a tirzepatide-containing combination?

This catches an active scam pattern. Some clinics, particularly during periods when compounded GLP-1s were technically restricted, sold "tirzepatide-niacinamide" or "tirzepatide-with-B12" formulations. The B12 or niacinamide additions are arguably therapeutic theater, but they're also a way to keep compounding under the FDA's eye in periods when straight compounded GLP-1s were being scrutinized. Some of these formulations are genuine. Many are not.

The right answer is "pure tirzepatide" or "tirzepatide with bacteriostatic water and a buffer." If they describe a B12 or niacinamide combination, ask why. The honest answers (formulation stability, vial yield) are different from the dishonest ones (regulatory workaround). A clinic that can't articulate why the additions are there is a clinic that's relaying a script they don't understand.

3. What lab does the COA come from, and can you send me one?

A real compounder will have a COA per batch from a third-party analytical lab. In peptide-land the names you'll commonly see are Janoshik, ChemClarity, AnalytiCare, CTL Scientific. None of these are perfect; some have been challenged on methodology. But all of them are real labs that can be looked up.

Ask for the COA for the actual batch you'll be receiving. Most clinics can produce it. Some say "we'll send it with your order." That's acceptable but follow up if it doesn't arrive. The clinics that say "we don't share COAs" or "they're proprietary" are flagging that they either don't have one or don't want you reading it.

4. What's your beyond-use date and how is it set?

Compounded tirzepatide has a beyond-use date (BUD) that's set by the compounder based on the formulation, the storage conditions, and the documented stability data. Federal compounding guidelines give standard BUDs for various formulation types, but specific stability studies can extend them.

The right answer mentions a specific date or duration ("28 days refrigerated" or "30 days from compounding") and references either USP guidelines or stability data. The wrong answer is "indefinite if you keep it cold," which is biochemically nonsense for peptides in solution.

5. What's your protocol if a vial arrives compromised?

Cold-chain failures happen. A vial that warms in transit, a cap that arrives loose, a solution that looks discolored. The question reveals whether the clinic has a real workflow or is making it up at intake.

A serious operator answers in seconds: photograph the vial on receipt, contact us within 24 hours, we'll either reship or refund. They have a return policy because they expect this to happen occasionally. A clinic that hasn't thought about this is a clinic that's too small to have seen the failure modes.

6. Who is the prescribing physician and where are they licensed?

Telehealth GLP-1 prescribing in the US requires a physician licensed in your state. The intake form usually captures your address; the prescribing physician's license should match. Reputable clinics list the physician name on the prescription itself or in your patient portal. Sketchy ones obscure the prescriber identity.

The reason this matters: if there's a complication, you want to know who actually prescribed and where you can lodge a board complaint. If you can't get a name, you have no recourse.

What to do with the answers

A clinic that answers all six clearly is a clinic worth trying. A clinic that answers four of six clearly is a clinic worth trying with a small first order. A clinic that answers fewer than four is one to skip.

The most honest tell isn't any single answer. It's the texture of how they answer. Real operators don't sound rehearsed because they've thought about these things and the words come naturally. Cargo-cult operators either don't understand the questions, or they understand them and don't have good answers.

Most patients won't ask any of this. The cost of asking is a 10-minute conversation. The cost of not asking is finding out at vial three that something is off and having no leverage to do anything about it.