Q&A: Pharmacists Must Steer Patients from Risky, Gray-Market Peptides

While gray-market peptide vendors flood the internet with unregulated, variable-potency products—as well as stakeholders in the federal government pushing to deregulate them—pharmacists are emerging as a critical line of defense. Experts believe pharmacists will need to begin guiding patients away from risky online sources and toward compounding pharmacies that test for purity and safety.

“Pharmacists steering to known sources—as long as the pharmacies are getting these in, doing testing on them for purity, and doing testing on them for contaminants—that’s where you want to be,” Christopher Shade, PhD, CEO and founder of Quicksilver Scientific, told Drug Topics®. “They have to make sure they go above and beyond on the testing of these to ensure they have the safety. Most of them should know that, but they just have to be super diligent and not get too crazed out with every new number that comes out.”

In part 3 of our interview with Shade, he delved into the risks and challenges pharmacists have been—or will be in the future—faced with regarding the current developments around peptide molecules for improving health outcomes.

READ MORE: Q&A: Understanding the Pharmaceutical Community’s Attention on Peptides

Drug Topics: Many patients are bypassing traditional pharmacies to buy peptides from online “gray market” vendors. What are the risks associated with peptide popularity rising and what role can pharmacists play in steering patients to reputable medication sources as this “craze” continues to ramp up?

Christopher Shade: There was a place called Peptide Sciences that really led the charge in this online stuff and online availability. They were making boat loads of money. Then, a whole bunch of places grew up around it, selling them cheaper. As far as I’ve seen, Peptide Sciences; I know a little bit about them. They were from pharmacy families in China, and they had pretty good product. They shut down recently because of federal pressure. A lot of these others, they call them ‘for-research-only.’ So you’re basically saying, ‘I’m doing animal research’ or research on something. A lot of those weren’t very good. They were low-potency [or] variable potency. There were contaminants in them, sometimes endotoxins, like little parts of bacteria that wind up inflammation when you’re trying to bring it down. There were things that people would have allergic reactions to. People got really into the craze of growth hormone promoters because of changes to body composition. You’ll have more lean muscle mass; you’ll burn fat, build muscle. Some of these things were used in HIV patients for a long time. People just jumped into those. But I saw a woman have an anaphylactic reaction to that, had to go to the hospital. I heard about 2 others that did, [and] doubtlessly, there were more.

So, those things really shouldn’t be free to the public with no oversight. If you do have a cancer, a growth hormone promoter can really amplify that. The least of the risk [is] you get low-potency stuff; at the highest, you get contaminants in there. BPC-157, that’s never going to hurt anyone, if it’s clean. But some of these other things were a little heavy-handed to be going in for the general public. I think over time, we do make an oral liposomal version of a number of these that are very common, already exist in the body, and we sell them as dietary supplements because they can be obtained from extracting glands of animals. The use of glandulars has been established for a long time. Some things are lower risk, some things are higher risk, but those online ones, those are a real crapshoot and they could be a problem. Pharmacists steering to known sources—as long as the pharmacies are getting these in, doing testing on them for purity, and doing testing on them for contaminants—that’s where you want to be.

Drug Topics: What other issues or challenges may pharmacies encounter in the near future as peptide information continues to circulate?

Christopher Shade: You see Bobby Kennedy’s crew. They’re big fans of peptides, and they’re trying to get the good, safe ones back on the market through the compounding pharmacies. There was a whole bunch that went on the do-not-compound list. I believe 12 are coming back, things like BPC and some mitochondrial stimulators like SS-31, Mod-C. But there’s also this growing list of peptides coming out of research. I’ve seen lists from some of these suppliers where there’s 100-150 different peptides. Just going after every new peptide, we don’t have a lot of track record with them. BPC, they found that in 1993. They’ve been doing tons with that.

[It’s] staying with stuff that has the research, the pharmacist staying on top of regulations—when things are taken off, when things are put back on the list—and ensuring they have quality compounding pharmacists. They’re not CGMP like the supplement companies, so they don’t always have regulations to pretest what’s coming in. They have to make sure they go above and beyond on the testing of these to ensure they have the safety. Most of them should know that, but they just have to be super diligent and not get too crazed out with every new number that comes out.

READ MORE: FDA Set to Review Peptide Access for Compounding Pharmacies

Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.