How unapproved drugs get prescribed in Canada

Compounding, and what it is actually for

Compounding is a pharmacy preparing a medication for one named patient against a prescription, rather than manufacturing a product for sale. It exists for genuinely good reasons: a patient allergic to a dye in the commercial tablet, a dose no manufacturer makes, a child who needs a liquid, a drug in shortage, a product discontinued while people still depend on it.

Crucially, it is regulated by provincial pharmacy colleges, not by Health Canada's drug-approval system. That is the gap. Health Canada decides what is an approved drug; the colleges decide how pharmacies may practise. A compounded preparation can therefore exist without anyone federally having assessed it — which is fine when it is an approved drug in a different strength, and is the whole issue when it is a substance that was never approved at all.

What the rules actually say

Health Canada's policy is POL-0051, Manufacturing and Compounding Drug Products in Canada. Two of its expectations matter here:

• The active ingredient should be one used in an authorised product, or listed in a recognised pharmacopoeia.
• Compounding should fill a gap— a shortage, a discontinued product, a dose nobody manufactures — rather than produce a drug that was never approved. Imported ingredients are supposed to be ones "not commercially available" in Canada, which Health Canada reads as discontinued, suspended, back-ordered or approved-but-unmarketed.

Read against those two, most of what this site covers does not clear the bar. BPC-157, TB-500, CJC-1295 and ipamorelin are in no authorised Canadian product. There is no shortage of them to relieve, because there was never an approved version to be short of.

The colleges have started saying so

This is the part that tells you which way things are moving. Alberta's College of Pharmacy stated flatly that unauthorised compounding of semaglutide-containing products is not permitted. Ontario's has said that compounding with ingredients Health Canada has not authorised could be investigated as a breach of professional conduct.

The semaglutide ruling is worth understanding because the reasoning generalises. Compounded semaglutide was justified by a shortage of the real thing. That shortage is over and there is now an approved generic — so the gap the practice claimed to fill has been filled, and the justification went with it.

In July 2026 CBC News ran a hidden-camera investigation into clinics in Ontario and BC prescribing BPC-157, reporting that Health Canada will not authorise it as an injectable or as a licensed natural health product while accepting that it can be compounded as an oral preparation. Those findings prompted new Health Canada investigations.

How the injection in the clinic actually happens

The abstract version above does not explain the thing people actually want explained: how a naturopath ends up putting an unapproved substance into your arm, in their office, lawfully. There are two separate authorities being stacked, and neither of them is "this substance is approved".

1. The authority to inject at all

This part is real and more rigorous than people assume. In Ontario, a naturopath administering IV therapy must have passed both the Prescribing and Therapeutics exam and the Intravenous Infusion Therapy (IVIT) exam, and must practise on premises inspected by the College of Naturopaths of Ontario. They are then authorised to administer a defined list of intravenous substances. Ontario's ND IV authority is the broadest in the country. In BC, the equivalent runs through the College of Complementary Health Professionals, with separate certifications for IV therapy, IV and chelation, and advanced injection therapies.

So the person injecting you is licensed, examined and inspected for that act. That is a genuine credential and it is worth knowing they hold it. It is a credential about the procedure, not about the contents of the syringe. Those are assessed by different bodies, and only one of them has looked.

2. How the substance gets into the room

This is where the visibility disappears, and it is the part almost nobody is told. There are several routes, and they differ a lot:

• A patient-specific compounded prescription. Written for you by name, filled by a licensed pharmacy, labelled with your name. This is the route the rules are actually built around, and the one that leaves a paper trail.
• "Office use" stock. A pharmacy supplying the clinic in bulk, with no prescription for any named patient — the clinic draws your dose from its own supply. This is the loophole worth knowing about, and it is being closed: NAPRA's revised compounding standards contain no provision for practitioners procuring stock this way, and where those standards are adopted office use ends. Compounding is meant to follow a prescription, not stock a shelf.
• Compounded in the clinic itself. The IVIT training explicitly covers preparing sterile products for IV administration, so the mixing may not involve a pharmacy at all.
• A supplier selling direct to clinics. The furthest from oversight, and indistinguishable from the others once the vial is on the counter.

The practical consequence: if the clinic administers it, you may never see a pharmacy label. No dispensing record with your name, no pharmacist involved in your care, and nothing on the vial you get to read. The injection being administered by a licensed professional on inspected premises can make the whole chain feel verified when only the last step of it was.

Which is why the question worth asking is narrower than "is this safe". It is: where did this vial come from, and is there a prescription in my name behind it? A clinic on the first route answers immediately. The answers get vaguer as you go down the list.

Supplements and injectables are different systems

This trips up almost everyone, and NAD is the clearest example. Oral NAD is licensed in Canada as a Natural Health Product — an NPN number, and permitted claims limited to things like "provides antioxidants". That is a much lower bar than drug approval and involves no finding that it treats anything.

An injectable cannot be a Natural Health Product. Injection is a drug route, so an injectable version needs to be a drug with a DIN, which requires clinical evidence review. So the oral licence does not extend upward to the needle — they are different applications under different regulations, and there is no ladder between them. "The oral one is licensed" says nothing about the injectable.

Where your material came from still matters

None of the above makes every source equivalent. Unapproved covers a wide range, and the practical risk differs enormously:

1. A licensed Canadian pharmacy, on a prescription, with a practitioner following you. The material was prepared under real standards for sterility, identity and content. That is worth something concrete. It still does not mean the substance was evaluated, and — per the rules above — it may not mean the practice is sanctioned either.
2. A clinic dispensing from a source it has not named. Worth simply asking. A clinic using a licensed compounder will name it without hesitation, and hesitation is itself an answer.
3. An online vendor, usually labelled "research use only". This is what Health Canada's warnings actually target — it has named BPC-157, TB-500, CJC-1295, ipamorelin and retatrutide among unauthorised products sold online. Research-use-only is not a legal category for human use; it is a disclaimer protecting the seller. Nothing verifies the contents, and mislabelled concentration is the normal failure, not the exceptional one.

What to actually do with this

Three questions get you most of the way, and all are reasonable to ask a practitioner directly:

1. Is this approved in Canada for what I am taking it for?
2. Where does the vial come from — which pharmacy, and is there a prescription in my name?
3. What would make you stop, and what are we measuring?

A good practitioner answers all three plainly, including "no" to the first, and explains why they think it is worth it anyway. That is an informed-consent conversation and it is the one you are owed. The third question is the one that separates a considered decision from an open-ended subscription — if there is no measure and no stopping condition, nobody is evaluating anything, including you.

What should not reassure you is the prescription itself. Most practitioners offering these believe they help — that is not the question. The question is whether anyone has checked, and a prescription is not evidence that anyone has.