MDside prescribes compounded GLP-1s in 56-day cycles and testosterone in ten-week cycles. The two numbers have different reasons. A compounded GLP-1 can’t be dispensed for longer than its beyond-use date allows, and the 503A preparations we use don’t reach 84 or 90 days. For testosterone, MDside uses only commercially manufactured, FDA-approved product, never 503A or 503B compounded testosterone, and a single 10 mL vial covers ten weeks at a typical weekly dose.
The two cycles side by side
| Compounded GLP-1 (semaglutide, tirzepatide) | Testosterone cypionate | |
|---|---|---|
| Product type | Compounded by a 503A pharmacy for a named patient | FDA-approved, commercially manufactured only. Never 503A or 503B |
| What limits the supply | The beyond-use date the pharmacy assigns | Vial size and controlled-substance refill rules |
| Cycle | 56 days (eight weekly doses) | Ten weeks (one 10 mL vial of 200 mg/mL) |
| Controlled substance | No | Schedule III |
| Why not longer | The preparation would expire before the last dose | Longer fills mean larger or extra vials and more product on hand |
A compounded GLP-1 is limited by its beyond-use date
A 503A pharmacy compounds for a specific patient on a prescription, and federal law requires it to follow the USP chapter on pharmacy compounding [21 U.S.C. 353a(b)(1)]. For sterile injectables, that chapter caps the beyond-use date: the date after which the preparation should not be used. The pharmacy prints that date on the label.
A manufactured drug is different. It carries an expiration date “determined by appropriate stability testing” [21 CFR 211.137], usually measured in months or years. A compounded preparation doesn’t have that kind of stability program behind it, so its window is much shorter.
That is why a 90-day GLP-1 supply doesn’t work here. If the beyond-use date is shorter than the supply, the last doses expire in the patient’s refrigerator. An 84-day fill fails for the same reason. A 56-day cycle, eight weekly doses, fits inside the dates our pharmacies assign. Every dose is used in date, and the next fill arrives on time.
Opened vials add a second limit. CDC’s guidance for clinicians is that an opened multi-dose vial “should be dated and discarded within 28 days unless the manufacturer states another date” [CDC]. A 56-day supply lets the pharmacy package the fill so each vial is used up within that window. The rules after the shortage, including FDA’s position on essentially-copy compounding, are at compounded GLP-1s after the shortage [FDA]. How 503A and 503B pharmacies differ is at 503A vs 503B sourcing.
MDside uses only manufactured testosterone, never compounded
This is a deliberate choice. MDside prescribes testosterone only as a commercially manufactured, FDA-approved product. We don’t use 503A or 503B compounded testosterone. The manufactured product has an FDA-reviewed label, a stability-tested expiration date and a consistent concentration from vial to vial. The label lists 200 mg/mL in 1 mL and 10 mL multiple-dose vials, stored at controlled room temperature and protected from light [DailyMed]. Because it is manufactured, compounding beyond-use dates don’t apply. The manufacturer’s expiration date does [21 CFR 211.137].
At 200 mg per week, a 10 mL vial of 200 mg/mL lasts exactly ten weeks. Patients on a lower dose use less of the vial per week, and the physician adjusts the cycle. Sending one 10 mL vial instead of several 1 mL vials means:
- Fewer shipments. One cold-chain-free package every ten weeks.
- Fewer fills. Fewer chances for a refill to stall on a missed message, a card decline or a pharmacy delay.
- Fewer gaps in care. Testosterone works best at steady levels, and a missed shipment shows up as symptoms.
The label notes that crystals may form in storage and that “warming and shaking the vial should redissolve” them [DailyMed]. Include that in patient instructions.
The controlled-substance rules cap the cycle too
Testosterone is a Schedule III controlled substance [21 CFR 1308.13]. A Schedule III prescription can’t be filled or refilled more than six months after it was issued, or refilled more than five times [21 CFR 1306.22]. A ten-week cycle sits comfortably inside both limits: a new prescription and two refills cover about thirty weeks.
Telehealth prescribing of controlled substances currently relies on the DEA and HHS temporary flexibilities, which run from January 1, 2026 through December 31, 2026 [DEA/HHS, fourth temporary extension]. What happens after that date is covered at three DEA telehealth scenarios for January 2027, and state rules at telehealth testosterone by state.
The monitoring schedule around the cycle
The prescription cycle is one layer. MDside runs the follow-up on its own schedule, so a patient is never seen only when a refill is due.
| Touchpoint | When | What it covers |
|---|---|---|
| Automated check-in | Every month | Side effects, response, adherence and red-flag screening, with escalation to a clinician when an answer needs it |
| Asynchronous visit | Before every refill | A clinician reviews the check-ins, dose and any changes before the next prescription is sent |
| Synchronous video visit | Once a year | A live visit with the prescribing clinician |
| Full labs (testosterone only) | Day zero, week 6 to 7, then every six months | Baseline before the first prescription, an early check after starting, then ongoing monitoring. GLP-1 patients are not put on a lab schedule |
No prescription renews on autopilot. Every refill follows a clinician review, and the monthly check-ins mean a problem surfaces between fills, not at the next one.
What this means for you
Match prescription length to the product. For compounded GLP-1s, ask your pharmacy for the beyond-use date it assigns and set the cycle inside it. Don’t promise patients a 90-day supply the preparation can’t support. For testosterone, use manufactured, FDA-approved product, size the fill to the vial and the patient’s dose, and keep the cycle inside the Schedule III limits. Build monitoring around the cycle: automated monthly check-ins, a clinician review before every refill, a yearly video visit, and for testosterone, labs at baseline, week 6 to 7 and every six months. For a program built this way, see how to start a GLP-1 telehealth business and weight management services.
Related reading
Frequently asked questions
Why can’t a compounded semaglutide prescription be filled for 90 days?
Because the preparation would expire before the last dose. A 503A pharmacy must assign a beyond-use date under the USP compounding chapter, and for sterile injectables that date is far shorter than a manufactured drug’s expiration. If the supply outlasts the date, the final doses are out of date. MDside uses 56-day cycles to stay inside it.
How long does a 10 mL vial of testosterone cypionate last?
At 200 mg per week, a 10 mL vial of 200 mg/mL lasts ten weeks. Lower weekly doses last longer, and the prescribing physician sets the cycle to match. MDside uses only FDA-approved manufactured testosterone, never 503A or 503B compounded product, so the manufacturer’s expiration date applies.
How many refills can a testosterone prescription have?
Testosterone is Schedule III. Federal rules allow no more than five refills, and no fill or refill more than six months after the prescription was issued. State law can be stricter. A ten-week cycle fits within those limits, with each new prescription sent only after an asynchronous clinician review.
Can a telehealth provider prescribe testosterone without an in-person visit?
For now, under federal rules, yes. DEA and HHS extended the telemedicine flexibilities for controlled substances through December 31, 2026. State rules still apply, and some states require more. Programs should plan now for what happens after that date, including in-person or special registration paths if the flexibilities lapse.
How often should a telehealth GLP-1 or testosterone patient check in?
In MDside’s model, every month through an automated check-in, with an asynchronous clinician visit before every refill and a synchronous video visit once a year. Testosterone patients also get full labs at day zero, week 6 to 7, and every six months. GLP-1 patients don’t have routine labs. Any concerning check-in answer goes to a clinician sooner.
This is general information, not legal advice. Rules vary by state and change. Confirm your own facts with counsel.