Who Qualifies for Peptide Therapy? Labs, Conditions, Contraindications

Key takeaways

• Qualification is per drug, set by the FDA label or, for unlabeled compounds, by the clinician's judgment. A program, a quiz or a membership does not qualify you for anything.
• GLP-1 drugs are labeled for adults with obesity, or overweight with a weight-related condition (the trials used a BMI of 30 or more, or 27 or more with a condition), and are ruled out by a personal or family history of medullary thyroid cancer or MEN 2.
• Tesamorelin is labeled for adults with HIV and excess abdominal fat; it and sermorelin raise IGF-1, so active cancer rules them out and IGF-1 and glucose should be checked first.
• Bremelanotide (PT-141) is labeled for premenopausal women with acquired, generalized low sexual desire and is ruled out by uncontrolled hypertension or known heart disease. NAD+ and glutathione have no labeled population and very limited data.
• Pregnancy rules out nearly all of them, and no one 'qualifies' for BPC-157 or TB-500, because no licensed pharmacy may make them.

Who qualifies for peptide therapy is decided drug by drug, not by a program: by the population on the FDA label when one exists, and otherwise by a clinician's judgment from your history and labs. A GLP-1 label sets a weight threshold and a thyroid-cancer exclusion; tesamorelin's sets a diagnosis and a cancer exclusion; bremelanotide's sets a population and a blood-pressure exclusion; sermorelin, NAD+ and glutathione have no current label at all. Which of these can be prescribed by telehealth, and how licensing works in your state, is covered in our hub on getting a peptide prescription online and in can telehealth prescribe peptides. The full evaluation, from labs to stop rules, is in the complete guide to peptide therapy.

Qualification by compound

Sources for the rows: the Wegovy (label), Zepbound (label), Egrifta WR (label) and Vyleesi (label) prescribing information; for sermorelin, the trial in which ten healthy men around 68 years old restored growth hormone and IGF-1 to young-adult levels on 1 mg twice daily for 14 days, while 0.5 mg did not (Corpas 1992); for NAD+, a pilot in which plasma NAD+ did not change for the first two hours of a 6-hour infusion (Grant 2019); for glutathione, a 2026 review that found only modest, inconsistent effects and new safety concerns (Aloraini 2026).

Three notes on the table. First, the BMI numbers come from the trials, not from the indication text: the Zepbound trials enrolled adults with a BMI of 30 or more, or 27 to 30 with at least one weight-related condition such as hypertension, dyslipidemia or sleep apnea (Zepbound label). Second, off-label prescribing is legal; a clinician may prescribe tesamorelin to someone without HIV or bremelanotide to a man, but should be able to say why and what will be measured. Third, the doses in these trials and labels are in our compound profiles as studied doses, not protocols; the peptide calculator converts a prescribed dose into syringe units.

What disqualifies across the board

Some exclusions cut across compounds, and a clinician should screen for all of them before anything else.

• Pregnancy, planned pregnancy and breastfeeding. The GLP-1 labels say to stop when pregnancy is recognized, and Wegovy's says to stop at least two months before a planned pregnancy (Wegovy label). Tesamorelin is contraindicated in pregnancy (Egrifta WR label), and Vyleesi's label says to stop if pregnancy is suspected (Vyleesi label). Compounded sermorelin, NAD+ and glutathione have no pregnancy data.
• Active cancer, for anything that raises growth hormone or IGF-1. Egrifta WR is contraindicated in active malignancy and requires any prior cancer to be inactive with treatment complete (Egrifta WR label). The concern is not theoretical: in a meta-analysis of 21 studies with 3,609 cancer cases, high IGF-1 was associated with prostate cancer (odds ratio 1.49) and premenopausal breast cancer (1.65) (Renehan 2004). Sermorelin works through the same axis.
• Uncontrolled hypertension or heart disease, for melanocortin agonists. Bremelanotide raises blood pressure and lowers heart rate after each dose, usually for up to 12 hours, and its label contraindicates it with uncontrolled hypertension or known cardiovascular disease (Vyleesi label).
• Medullary thyroid cancer or MEN 2, personal or family, for GLP-1 drugs. It is a contraindication on both the semaglutide and tirzepatide labels (Wegovy label; Zepbound label).
• A compound no pharmacy may make. No one qualifies for BPC-157, TB-500, CJC-1295, ipamorelin or MOTS-c in October 2026, because there is no legal product to prescribe; our legal tracker explains why.

What a clinician should ask you

A legitimate evaluation, online or in person, covers at least these questions. If a program approves you without asking them, it has not qualified you; it has sold to you.

1. What is the goal, and how will we measure it?
2. Have you or anyone in your family had medullary thyroid cancer or MEN 2? (GLP-1s)
3. Have you ever had cancer, and is it fully treated? (sermorelin, tesamorelin, and caution for NAD+)
4. What is your blood pressure, and do you have heart disease? (bremelanotide)
5. Do you have diabetes, diabetic retinopathy, pancreatitis, gallbladder disease or slow stomach emptying? (GLP-1s, growth hormone secretagogues)
6. Have you had pituitary surgery, a pituitary tumor, head radiation or a head injury? (tesamorelin, sermorelin)
7. Are you pregnant, breastfeeding or planning a pregnancy, and what contraception do you use? (all; oral contraceptives with tirzepatide)
8. What do you take, including insulin, sulfonylureas, oral naltrexone and supplements?
9. Do you have recent labs, and if not, which ones will we order?
10. When will we recheck, and what result would make us stop?

The labs follow the goal. An A1c and kidney function matter before a GLP-1 because these drugs lower glucose and can cause dehydration; an IGF-1 is the only objective reason to prescribe sermorelin and a high one is a reason not to; glucose matters before tesamorelin because the label warns of glucose intolerance (Egrifta WR label). For NAD+ and glutathione no lab predicts a response, which is why a clinician should check the basics for a treatable cause of fatigue first. The complete guide has the full labs-by-goal table and the monitoring schedule.

Bottom line

You qualify for a peptide, not for peptide therapy. The GLP-1 drugs, tesamorelin and bremelanotide come with labeled populations and hard exclusions: thyroid cancer history and MEN 2, active cancer, uncontrolled blood pressure and pregnancy. Sermorelin, NAD+ and glutathione have no label, so the qualification is only as good as the clinician's history and labs. And no one qualifies for a compound no pharmacy may legally make. A provider that asks about cancer, thyroid cancer in the family, blood pressure, pregnancy and your medicines before prescribing is evaluating you; one that does not is processing an order.

Frequently asked questions

+−Who qualifies for peptide therapy?

There is no single qualification; each drug has its own. GLP-1 drugs are labeled for adults with obesity, or overweight with at least one weight-related condition, and are contraindicated with a personal or family history of medullary thyroid cancer or MEN 2. Tesamorelin is labeled for adults with HIV and excess abdominal fat and is contraindicated in active cancer and pregnancy. Bremelanotide is labeled for premenopausal women with acquired, generalized low sexual desire and is contraindicated with uncontrolled high blood pressure. Sermorelin, NAD+ and glutathione have no current label, so qualification is the clinician's judgment.

+−Who is a good candidate for peptide therapy?

Someone with a specific goal that a legally prescribable peptide has evidence for, no contraindication to it, baseline labs that support it where labs exist, and a plan to measure whether it worked. A person with a weight-related condition and a BMI in the labeled range is a good candidate for a GLP-1; a person who wants to feel younger and has normal labs is a candidate for a conversation, not a vial.

+−Who should not take tesamorelin?

The Egrifta WR label contraindicates it in people with a disrupted hypothalamic-pituitary axis (after pituitary surgery or tumor, hypopituitarism, head irradiation or head trauma), active malignancy, pregnancy and known hypersensitivity. It also warns about higher IGF-1, fluid retention, carpal tunnel symptoms and glucose intolerance, so people with diabetes need glucose checked before and during treatment.

+−Who should not take Mounjaro?

Mounjaro is tirzepatide, the same molecule as Zepbound. Its label contraindicates it in anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2, and in anyone with a known serious hypersensitivity to tirzepatide. Mounjaro is labeled for type 2 diabetes; people with a history of pancreatitis, gallbladder disease, severe gastrointestinal disease or who are pregnant or planning pregnancy need a careful conversation first.

+−Who shouldn't take TB-500?

In practical terms, no one can take it legitimately: TB-500 is not FDA-approved and no licensed pharmacy may compound it in October 2026, so there is no labeled population, no studied dose and no tested product. FDA's reviewers told its advisory committee in July 2026 that there were no human studies of TB-500 itself and that products vary by vendor.

+−What are the risks of taking peptides?

They depend on the drug. GLP-1s cause nausea, vomiting and constipation and carry pancreatitis and gallbladder warnings. Tesamorelin and sermorelin raise IGF-1, which brings fluid retention, joint pain and higher glucose, and higher IGF-1 is associated with some cancers. Bremelanotide raises blood pressure briefly after each dose. Glutathione injections have reports of hypersensitivity and liver toxicity. Research vials add an unknown: what is actually in them.

+−How do I get peptide therapy?

See a clinician licensed in your state, in person or by telehealth, with a specific goal. Expect a history, a medication list, labs where the compound calls for them and a prescription to a named, licensed pharmacy. Our hub on getting a peptide prescription online explains licensure and the state rules on live visits.

Sources

1. LabelNovo Nordisk. Wegovy (semaglutide) injection and tablets: prescribing information, revised June 2026 (DailyMed setid ee06186f-2aa3-4990-a760-757579d8f77b). (2026)
2. LabelEli Lilly. Zepbound (tirzepatide) injection: prescribing information (DailyMed, revised August 2026). (2026)
3. LabelTheratechnologies. EGRIFTA WR (tesamorelin) for injection: full prescribing information, revised March 2025. DailyMed. (2025)
4. LabelCosette Pharmaceuticals. VYLEESI (bremelanotide injection) prescribing information, revised March 2024. DailyMed. (2024)
5. StudyCorpas E et al. Growth hormone (GH)-releasing hormone-(1-29) twice daily reverses the decreased GH and IGF-I levels in old men. J Clin Endocrinol Metab 1992;75:530-5. (1992)
6. ReviewRenehan AG et al. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet 2004;363:1346-53. (2004)
7. StudyGrant R et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Front Aging Neurosci 2019;11:257. (2019)
8. ReviewAloraini K et al. Glutathione for skin lightening via intravenous, oral, and topical routes: a critical narrative review of current evidence, safety, and the evidence-practice gap. J Med Life 2026;19:511-23. (2026)