If your patient competes under an anti-doping code, a prescription does not protect them. BPC-157 sits in WADA’s S0 category, where no therapeutic use exemption exists, and at least two sanctioned athletes said a doctor or medical provider gave it to them.
Key points
- WADA’s 2026 List names BPC-157 (S0), TB-500 (S2.3), and GHRPs, CJC-1295, ipamorelin and MK-677 (S2.2.4) [1].
- A UFC fighter received BPC-157 “prescribed and provided … by a doctor”; USADA noted no therapeutic use exemption applied [2].
- Another athlete took a BPC-157 supplement “recommended by a medical provider” and was suspended for a year [3].
- A triathlete competing for Panama was banned for 2 years for clostebol from an over-the-counter spray used on medical advice [5].
US status (October 2026): BPC-157 is not FDA-approved and has no lawful compounding pathway; WADA prohibits it at all times. MDside providers do not prescribe it. See the BPC-157 status page.
WADA prohibits these compounds at all times
The World Anti-Doping Agency’s 2026 Prohibited List bans, in and out of competition: BPC-157 under S0 (non-approved substances); “Thymosin-β4 and its derivatives e.g. TB-500” under S2.3; and GHRP-2, GHRP-6, CJC-1295, ipamorelin and ibutamoren (MK-677) under S2.2.4 [1]. The US compounding position for each is on the TB-500, CJC-1295 and ipamorelin status pages.
A doctor’s prescription does not protect the athlete
In 2023 UFC fighter Cortney Casey accepted a four-month sanction. According to USADA, Casey “was prescribed and provided BPC-157 by a doctor to help treat a medical condition”. USADA explained that “A Therapeutic Use Exemption (TUE) was not applicable to this Non-Approved Substance” [2]. In 2024, in a separate case involving a speed skater, an independent arbitrator imposed a one-year suspension over a BPC-157 supplement “recommended by a medical provider” [3].
The point for you as prescriber: there is no therapeutic use exemption for S0 substances, because they are not medicines approved for human use in any country [1][2].
- S0: BPC-157’s category, with no therapeutic exemption possible [1][2]
- 2 years: UFC fighter ban for GHRP-2, GHRP-6 and anastrozole; he blamed “stem cells” in Mexico [4]
- 3 yrs 9 mo: ban for a Panamanian baseball player for stanozolol [6]
Peptides can hide inside other treatments
In 2019 fighter C.B. Dollaway was banned for two years after testing positive for GHRP-2 and GHRP-6, plus anastrozole (and, in another sample, clomiphene). He attributed the result to a stem cell procedure he received in Mexico [4]. Athlete patients do not always know what they were injected with. If they cannot tell you, neither can their test result. Product sourcing matters here as much as the molecule: see supplier diligence.
Cases from Panama show the same pattern
We found no Panamanian sanctions for peptides, but the cases that exist follow the same pattern. A triathlete competing for Panama received a 2-year ban for clostebol from a healing spray that, according to La Estrella, “is available in Panama without a prescription”, used on medical advice [5]. Baseball player Anthony Amaya was banned for 3 years and 9 months for stanozolol [6]. For US clinics with international or traveling athletes, the lesson carries over: medical advice is no defense.
What to do with a competing patient
Ask whether the patient is subject to an anti-doping code before you discuss any peptide. For a competing patient, the first question is whether the compound is on WADA’s list, ahead of whether it works. For BPC-157 and other S0 substances, even a prescription allows no exemption [1][2]. The 2023 and 2024 sanctions both name a doctor or provider [2][3]. Document the conversation. For how a compliant program is built, see peptide programs.
References
- World Anti-Doping Agency. The 2026 Prohibited List. Link
- USADA. Cortney Casey accepts doping sanction. 14 September 2023. Link
- USADA. Independent arbitrator imposes doping sanction for Kamryn Lute. 22 August 2024. Link
- Critchfield T. C.B. Dollaway suspended 2 years after testing positive for multiple banned substances. Sherdog, 26 August 2019 (cites the USADA announcement and the athlete’s statement). Link
- La Estrella de Panamá. Cóctel deportivo (column on the sanction of a Panamanian triathlete for clostebol). Link
- Panamá América. Pelotero panameño Anthony Amaya suspendido por dar positivo a estanozolol. 10 de diciembre de 2018. Link
This is general information, not medical or legal advice. Rules vary by state and change. Confirm your own facts with counsel.