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If the peptide restrictions are reversed through formal FDA rulemaking, compounding pharmacies would be legally allowed to prepare those peptides, but only as traditional, patient-specific compounded drugs, not as mass-market or FDA-approved therapies. If the peptides are formally added to the 503A bulk list, he says, pharmacies would have to follow the traditional 503A compounding rules

Conservative starting doses would be essential: Initial phase : Cagrilintide 0.3 mg + Tirzepatide 2.5 mg weekly Escalation : Increase cagrilintide by 0.3-0.6 mg every 4 weeks Tirzepatide adjustment : Maintain or modestly increase based on tolerance Monitoring : Close observation for cumulative GI effects This remains speculative, as no published trials have examined this specific combination

189, no

Mierau et al