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This is why our GI physicians and advanced practice providers follow guidelines set by the American Society of Anesthesiologists (ASA)
Step 2: Draw the bacteriostatic water A fresh insulin syringe is used to draw the chosen volume of BAC water
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How to Verify: Ask pharmacy for license number Visit your state board of pharmacy website Search pharmacy name and license number Verify license is current and in good standing Check for disciplinary actions What to Look For: Valid license number displayed on website Expiration date is current No disciplinary history Authorized to compound sterile preparations (if applicable) FDA Registration (For Compounding Pharmacies) 503A Compounding Pharmacies: State-regulated with state licenses Compound based on individual prescriptions Subject to state board inspections Can ship to states where licensed 503B Outsourcing Facilities: Registered directly with FDA Subject to FDA inspections Must meet cGMP standards Listed on FDAs public database How to Verify 503B Registration: Visit FDA website Search registered outsourcing facilities Confirm pharmacy is listed Check registration is current VIPPS Certification (Optional but Valuable) Verified Internet Pharmacy Practice Sites (VIPPS): Accreditation from National Association of Boards of Pharmacy Demonstrates commitment to quality and compliance Requires rigorous inspection and ongoing review Look for VIPPS seal on pharmacy website How to Verify: Visit NABP website (nabp.pharmacy) Search VIPPS-accredited pharmacies Confirm seal matches legitimate VIPPS design Physical US Address Legitimate pharmacies have: Actual physical location in United States Not just a PO Box or mail drop Phone number with US area code Staff who answer questions Red Flags: Only overseas addresses No phone number or overseas numbers Email-only contact Mailbox services rather than actual pharmacy location Transparency Indicators: Clear Information Provided: Legitimate providers display: Names and credentials of medical team Provider license numbers and states Pharmacy name, address, and license numbers Clear pricing (no hidden fees) Detailed medication information Privacy policy and terms of service Contact methods (phone, email, chat) Professional Website: Trust indicators: Professional design and function Secure connection ( No spelling/grammar errors Medical information is accurate Clear description of process Working contact forms and phone numbers Red Flags in Website: Poor English or obvious translation issues Promises that sound too good to be true Pressure tactics or urgent language No clear provider information Missing privacy policy or terms Requests for unusual payment methods Pricing Reasonableness: Legitimate Price Ranges: Compounded semaglutide: $199-$599/month Brand-name Wegovy: $900-$1,350/month (before insurance) Consultation fees: $0-$129 (often included) Red Flag Pricing: Significantly cheaper than market rates (likely fake) No clear pricing information Hidden fees discovered at checkout Prices in foreign currency Too good to be true discounts Prescription Requirements: Legitimate Sites Always: Require valid prescription Conduct medical evaluation before prescribing Have licensed providers review cases Refuse to sell without appropriate assessment Illegal Sites: Offer semaglutide without prescription Auto-approve everyone Sell for research purposes without medical use restrictions Dont ask medical history questions Customer Service Quality: Good Signs: Knowledgeable staff who answer questions Licensed pharmacist available for consultation Clear process for addressing concerns Responsive to messages/calls Professional communication Warning Signs: Cant reach anyone by phone Generic email responses Pressure to purchase quickly Unwilling to answer safety questions Defensive when asked about credentials Third-Party Verification: Check Multiple Sources: Better Business Bureau: Look up company name Review complaint history Check accreditation status Read customer feedback Trustpilot and Review Sites: Read recent reviews (not just highlighted positive ones) Look for patterns in complaints Be skeptical of all 5-star reviews (may be fake) Pay attention to detailed negative reviews State Board of Pharmacy: Search for complaints or disciplinary actions Verify license information matches what company claims Check for any violations or warnings Medical Board: Verify individual provider licenses Check for disciplinary history Confirm provider specialties and qualifications Questions to Ask Before Purchasing: Essential Questions: Which pharmacy will fill my prescription and what is their license number? Is your compounding pharmacy FDA-registered as 503A or 503B? What are the credentials of the provider who will prescribe my medication? What follow-up care is included in the program? Where is your pharmacy physically located? Can I speak with a licensed pharmacist about my medication? What happens if I experience side effects? What is your refund policy if medication is damaged or I need to discontinue? If a provider cant or wont answer these questions clearly, thats a major red flag
