In short
Some of these are approved medicines, and many have never been approved for use in people by any regulator. A status says whether a regulator has licensed something. It is not a verdict on whether it works, and this list gives no doses.
What the labels mean
- Approved medicine Licensed by major regulators for a stated use, which may not be the one people want it for.
- Approved in some countries Licensed somewhere, and not in others. The text says where.
- No longer approved Was licensed, and no longer is.
- Not approved No regulator has approved it for use in people. "Research use only" does not change that.
- Supplement Sold as a food or supplement, so no regulator has judged whether it works.
GLP-1 and incretin medicines
Cagrilintide
Not approved: in trialsA long-acting amylin analogue in phase 3. Novo Nordisk has asked the FDA to approve CagriSema, which is cagrilintide with semaglutide, with a decision expected in 2026. Not approved anywhere on its own, as of 3 November 2026.
Dulaglutide
Approved medicineApproved for type 2 diabetes in the US and EU as Trulicity, and for cardiovascular risk reduction alongside it.
Exenatide
No longer approvedThe first GLP-1 agonist approved anywhere, cleared for type 2 diabetes in 2005 as Byetta and later as weekly Bydureon. All of it is gone now: the brands' US approvals were formally withdrawn in 2025 and 2026, the EU authorisations in January 2026 and Canada's in 2022, and the US generic is no longer sold.
Liraglutide
Approved medicineApproved for type 2 diabetes and for weight management. The daily predecessor to semaglutide.
Lixisenatide
No longer approvedApproved on its own as Lyxumia in the EU and Adlyxin in the US, and no longer sold as either — taken off the US market in 2023, withdrawn in Canada the same year and in the EU in December 2025. Commercial decisions, not safety findings. It is still sold combined with insulin glargine, as Soliqua in the US and Canada and as Suliqua in some European countries.
Mazdutide
Approved in some countriesApproved in China in 2025 for weight management and for type 2 diabetes. Not approved in the US, the EU or the UK.
Oral semaglutide
Approved medicineApproved as a daily tablet for type 2 diabetes, as Rybelsus, in the US, EU, Canada and Mexico, and for weight management as Wegovy tablets in the US since December 2025 and the EU since July 2026. Neither is sold in France. A tablet is absorbed at about 1% of an injection, so Reko draws no level for it.
Pramlintide
No longer approvedApproved in the US as Symlin, for use with mealtime insulin in both type 1 and type 2 diabetes, and never approved in the EU or the UK. Every Symlin presentation was discontinued in October 2025. An amylin analogue rather than a GLP-1.
Retatrutide
Not approved: in trialsPhase 3 trials have reported, and Lilly says it plans to apply to the FDA in early 2027. No regulator has approved it, and everything sold under the name outside a trial is unlicensed, which also means nobody has verified what is in it.
Semaglutide
Approved medicineApproved for type 2 diabetes and for weight management in the US, EU and elsewhere. One of the most thoroughly studied drugs in this list.
Survodutide
Not approved: in trialsA GLP-1 and glucagon dual agonist in phase 3 trials for obesity and liver disease. Not approved in any country.
Tirzepatide
Approved medicineApproved for type 2 diabetes and for weight management in the US, EU and elsewhere.
Healing and recovery peptides
BPC-157
Not approvedNot approved by any regulator, anywhere. The FDA listed it as a compounding safety risk in 2023, and by April 2026 it had come off that list after its nominations were withdrawn. An FDA advisory panel was reported to have narrowly backed it in July 2026. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval. Human data is close to absent; the well-known results are in rats.
KPV
Not approvedNot approved anywhere. A three-amino-acid fragment of a hormone, studied in laboratory models of inflammation. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval.
TB-500
Not approvedNot approved anywhere. A synthetic fragment of thymosin beta-4, studied in animals. Also on the World Anti-Doping Agency’s prohibited list, which matters if you compete. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval.
Thymosin Alpha-1
Approved in some countriesLicensed as Zadaxin in around thirty countries, mostly for hepatitis B and C. Never approved in the US or the EU. The FDA has called its safety information inadequate, and it is not among the peptides reported in the draft 2026 US compounding policy.
Growth hormone secretagogues
CJC-1295
Not approvedNot approved anywhere. Trials of the long-acting version were stopped after a death, though a causal link was not established. Sold in two quite different forms — with and without DAC — that behave nothing alike.
GHRP-2
Approved in some countriesLicensed in Japan under the name pralmorelin, and only as a one-off diagnostic test of growth hormone reserve. Not approved in the US or the EU, and nowhere approved as a treatment.
GHRP-6
Not approvedNo regulator has approved it for anything. Older than most compounds on this list and still research-only everywhere.
Hexarelin
Not approvedStudied in humans in the 1990s and never approved anywhere. What is sold is research material.
Ipamorelin
Not approvedNot approved anywhere. Developed and abandoned as a drug candidate — it was studied and did not go on to be licensed, which is a different history from never having been examined.
Sermorelin
No longer approvedWas an approved medicine and no longer is: withdrawn from the US market in 2008, for commercial reasons rather than a safety finding. What is sold now is compounded, not licensed.
Tesamorelin
Approved in some countriesThe only growth hormone secretagogue here any regulator has approved: licensed in the US, and registered in Mexico, for the fat redistribution seen in HIV lipodystrophy. Canada approved it in 2014 and it left the market there in 2022; the European application was withdrawn in 2012, the regulator having found the benefit-risk balance unproven. Use outside that indication is off-licence.
Metabolic and mitochondrial
AOD-9604
Not approvedNot approved as a medicine. Trialled for obesity and did not beat placebo on weight loss, which is the finding most often left out of what is written about it.
Epitalon
Not approvedA Russian research peptide with almost no evidence published in English. Not approved in the US, the EU or the UK. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval.
HGH Fragment 176-191
Not approvedA fragment of growth hormone that reached early human trials for obesity and was not taken further. Approved nowhere.
IGF-1 LR3
Not approvedA laboratory-modified IGF-1 made for cell culture, not for people. Plain IGF-1 is an approved medicine; this version is not, and they are not interchangeable.
Metformin
Approved medicineApproved for type 2 diabetes in the US, EU, Canada and Mexico, where most of it is sold as a generic. No regulator in these countries has licensed it for PCOS, so prescribing it for PCOS is off-label, though common.
MOTS-c
Not approvedNot approved anywhere. A peptide encoded in mitochondrial DNA, studied in cells and in mice. Human data is scarce. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval.
Myo-inositol
SupplementNot a licensed medicine in the US, EU, Canada or Mexico. It is sold as a dietary or food supplement, and in Canada as a natural health product, so no regulator has judged whether it works for PCOS. Purity and dose are the maker's responsibility.
NAD+
Not approvedNot approved as an injection. Sold as a supplement and through compounding pharmacies; the infusion clinics offering it are not doing so under a licence.
SS-31
Approved in some countriesAlso called elamipretide. The FDA approved it in September 2025 as Forzinity, under accelerated approval with a further trial required, for Barth syndrome in patients weighing at least 30 kg — an ultra-rare genetic disease affecting around 150 people in the US — and for nothing else. Not approved in the EU. Its larger mitochondrial trials missed their endpoints, and every other use is off-label.
Skin and hair
GHK-Cu
Not approvedApproved as a cosmetic ingredient in creams, which is not the same as being approved to inject. No regulator has licensed an injectable form.
Melanotan II
Not approvedNever approved anywhere. Several health agencies, including the UK’s and Australia’s, have issued warnings about it by name.
Cognitive
DSIP
Not approvedIsolated in the 1970s and studied for sleep and pain. No regulator has approved it, and the human work is thin and old. An FDA advisory panel was reported to have voted against allowing it in compounding in July 2026.
Selank
Approved in some countriesA licensed medicine in Russia. Not approved in the US, the EU or the UK, and the same language barrier applies to its evidence.
Semax
Approved in some countriesA licensed medicine in Russia. Not approved in the US, the EU or the UK, and almost none of the supporting literature is in English. In October 2026, HHS published a draft, non-binding policy saying it does not intend to act against licensed pharmacies compounding certain peptides, reported to include this one. That is not an approval.
Hormone therapy
Gonadorelin
Approved in some countriesLicensed in several European countries — France, Germany, Austria and the Netherlands among them — as a pump giving it in pulses for hypothalamic amenorrhoea, and as a one-off diagnostic test. Not licensed in Spain or Romania, and no longer sold in the US or Canada, where Factrel and Lutrepulse were discontinued. What clinics use alongside testosterone is compounded, and that use was always off-label.
Kisspeptin
Not approvedStudied in humans at Imperial College and elsewhere, and approved as a medicine nowhere.
Medroxyprogesterone
Approved in some countriesApproved as tablets for absent periods (secondary amenorrhoea) and abnormal uterine bleeding in the US, Canada, Spain and Mexico, as Provera, Progevera in Spain, and generics. Neither France nor Romania licenses it as a tablet on its own.
Oestradiol cypionate
Approved in some countriesApproved as an injectable oestrogen in the US, where it is sold as Depo-Estradiol. Not available in Europe. Longer-acting than the valerate.
Oestradiol valerate
Approved in some countriesApproved as an injectable oestrogen in the US, as Delestrogen and generics. In Europe a stand-alone injection is licensed only in the Czech Republic and Slovakia, and none is sold in Canada; in Mexico it is registered as part of a monthly contraceptive injection. Widely used in gender-affirming hormone therapy, which is an established use though not always the wording on the licence.
Progesterone
Approved medicineApproved as an intramuscular injection in oil in the US, Canada and Mexico, most of it prescribed for luteal support in IVF. In Spain, France and Romania the licensed injection is a different product — a water-based solution given under the skin — and the oil is not sold there. The oldest injectable on this list.
PT-141
Approved in some countriesApproved in the US as Vyleesi, for low sexual desire in premenopausal women. Never submitted to the European regulator, so it is unapproved in the EU. Use by anyone else is off-label.
Spironolactone
Approved medicineApproved as a diuretic for heart failure, high blood pressure, fluid retention and excess aldosterone in the US, EU, Canada and Mexico. Mexico's label also lists excess hair growth (hirsutism). Elsewhere, using it for hirsutism, acne or PCOS is off-label.
Testosterone cypionate
Approved medicineApproved for testosterone replacement in men with diagnosed deficiency in the US and Canada, and in Spain, the one EU country that licenses it. Elsewhere in Europe, France and Romania included, the licensed injections are other esters. A controlled substance in most countries.
Testosterone enanthate
Approved medicineApproved for testosterone replacement in men with diagnosed deficiency — in the US, Canada, Mexico and France among others. Not licensed in Spain or Romania, where the licensed injections are other esters. A controlled substance in most countries.
Testosterone propionate
Approved in some countriesAn approved testosterone ester, largely superseded by the longer ones: discontinued in the US, and still licensed elsewhere, often combined with a longer ester. A controlled substance.
Testosterone undecanoate
Approved medicineApproved as a long-acting injection for testosterone replacement in the US, in Europe and in Mexico; in Canada only the oral capsule is licensed. The injection carries a specific warning about oil entering the lung, which is why many countries require it to be given in a clinic with observation afterwards.
Vitamins and wellness
Cyanocobalamin (B12)
Approved medicineApproved as a prescription injection for B12 deficiency in the US and EU. The oldest and best-established of the three B12 forms.
Glutathione
Approved in some countriesLicensed as an injection in Italy only, to protect nerves during chemotherapy with cisplatin or related platinum drugs. No other regulator checked has approved it, including those of the US, Canada, Mexico, Spain, France and Romania. Elsewhere it reaches people through compounding pharmacies, which is a different thing from an approved medicine.
Hydroxocobalamin (B12)
Approved medicineApproved as a prescription injection for B12 deficiency in the US, Spain and Mexico among others, and separately, at far higher doses, as a cyanide antidote. In France, Romania and Canada none is sold for B12 deficiency, which is treated with cyanocobalamin instead. Stays in the body longer than cyanocobalamin.
L-carnitine
Approved medicineApproved as a prescription injection for carnitine deficiency, a rare metabolic condition, in the US, Canada, Mexico and most of Europe; in Romania only the oral form is licensed. Its use for fat loss or performance is not an approved one.
Lipo-C / MIC
Not approvedA compounded blend, not an approved medicine. There is no standard formula — what is in the vial depends on the pharmacy that made it, so two people’s “lipo-C” may not be the same drug.
Methylcobalamin (B12)
Approved in some countriesApproved as an injection in Japan and some other markets, but not by the FDA and not in the EU. In the US it is compounded rather than licensed.
Before you use anything on this list
Talk to a prescriber or pharmacist. Products sold online as research chemicals have not been checked by a regulator, so nobody has verified what is in them. Reko recommends nothing, sells nothing and suggests no doses.
Useful pages
We re-checked the entries most likely to change on 3 November 2026. Status changes, so confirm with a current source. "Not approved anywhere" means we found no approval; nobody can prove a negative. This page is general information and not medical advice. Names belong to their owners.
- U.S. Food and Drug Administration: bulk substances that may present safety risks, and 503A category list.
- HHS draft enforcement policy, Federal Register 2026-22192, 30 October 2026, and a law firm summary for the peptides listed.
- July 2026 advisory panel, as reported by AJMC.
- Lilly on retatrutide: 5 August 2026 release. Novo Nordisk on CagriSema: December 2025 release. Innovent on mazdutide: September 2025 release. FDA on elamipretide: September 2025 announcement.
- Each entry links a PubMed search, not a chosen paper, so results include studies that found nothing.