I decided to add HCG to my regimen but the pharmacy that Defy Medical uses told me Louisiana won't allow pharmacies to ship HCG to addresses within our state. Has anyone else run into this problem?
Louisiana Won't Allow Pharmacy To Ship HCG
- Thread starter Brian963
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Nelson Vergel
Founder, ExcelMale.com
From Shaun Noorian from EmpowerRxPharmacy.com:
Subchapter A of the Louisiana Title 46, Chapter 69 is entitled, Medications used in the Treatment of Obesity.
Section 6095 reads:
A. Absolute Prohibitions. A physician shall not prescribe, dispense, administer, supply, sell, give, or otherwise use to or for any person for the purpose of weight control or weight reduction in the treatment of obesity any amphetamine, dextroamphetamine, methamphetamine, or phenmetrazine drug or compound; any Schedule II controlled substance; human chorionic gonadotropin (HCG); thyroid hormones; diuretic medications; or any drug, medication, compound, or substance which is not indicated for use in the treatment of exogenous obesity by express approval of the U.S. Food and Drug Administration (FDA).
The phrase from their regulations describing the disallowed prescribing of HCG for weight management. I haven't heard of LA going after anyone that uses HCG for TRT as long as they are doing it "properly" i.e. using lab testing to verify hypogonadism therefore warranting its use.
In my experience dispensing HCG to LA as long as the Dx isn't for obesity then HCG can be prescribed for anything outside that scope. I've also run into a lot of pharmacies that are scared of dispensing HCG into LA under the belief that they will lose their licenses as HCG is a "banned" drug in that state. This is obviously not the case for TRT. I believe they are just misinformed.
Subchapter A of the Louisiana Title 46, Chapter 69 is entitled, Medications used in the Treatment of Obesity.
Section 6095 reads:
A. Absolute Prohibitions. A physician shall not prescribe, dispense, administer, supply, sell, give, or otherwise use to or for any person for the purpose of weight control or weight reduction in the treatment of obesity any amphetamine, dextroamphetamine, methamphetamine, or phenmetrazine drug or compound; any Schedule II controlled substance; human chorionic gonadotropin (HCG); thyroid hormones; diuretic medications; or any drug, medication, compound, or substance which is not indicated for use in the treatment of exogenous obesity by express approval of the U.S. Food and Drug Administration (FDA).
The phrase from their regulations describing the disallowed prescribing of HCG for weight management. I haven't heard of LA going after anyone that uses HCG for TRT as long as they are doing it "properly" i.e. using lab testing to verify hypogonadism therefore warranting its use.
In my experience dispensing HCG to LA as long as the Dx isn't for obesity then HCG can be prescribed for anything outside that scope. I've also run into a lot of pharmacies that are scared of dispensing HCG into LA under the belief that they will lose their licenses as HCG is a "banned" drug in that state. This is obviously not the case for TRT. I believe they are just misinformed.
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Jasen Bruce
Member
The information and misinformation is coming from multiple fronts. I have been dealing with this same question for many patients since my time working at the compounding pharmacy until now, spanning 4 years. Some pharmacies are telling doctors that it is illegal to prescribe HCG for off-label indications. Since hypogonadism is an okay indication, one would think that it should be good to go, however there is content within the LA statute that indications that it is illegal to prescribe HCG for the treatment of side effects associated with anabolic steroids. Since testosterone is indeed an anabolic steroid, many pharmacists and attorneys (for both pharmacists and TRT doctors) are interpreting it literally (or misinterpreting). Since most TRT doctors are many times not concurrently endocrinologists nor fertility specialists they tend to overlook the hypogonadism/fertility indication in which HCG is allowed. Remember, its concurrent use with testosterone in TRT is technically not an "approved" treatment for hypogonadism, however it is legally allowed under this indication. This is what I have been trying to tell the opposing forces since day one to no success. To add to all this confusion, the state of LA itself has provided conflicting information. The pharmacy I worked for contacted the state, as did my clinic. The first call we were told that it could not be prescribe by a doctor that is not licensed within the state of LA, therefore could not be shipped in by a pharmacy filling for that unlicensed physician even if that pharmacy is licensed in LA. The second call we were spun in a circle because the state of LA does not apparently know how to interpret their own law. They could not clarify the regulation, nor could they answer our question (is it okay for us to prescribe for our LA patients?), and told us that if we don't know then its best to not prescribe it (not joking). Since Defy is already working in un-chartered territory via applying telemedicine across state lines, Dr Saya feels its best to not to do it at this time. We are trying to figure this out as its a huge issue not just with our patients, but with other clinics and pharmacies as well.
I am awaiting detailed response from an attorney who is presently researching this. I will also follow up with Dr Saya on his recent discussions with a colleague that practices in LA whom I believe contacted the state board reg. HCG Rx for LA patients.
I will update once I get all the info.
I am awaiting detailed response from an attorney who is presently researching this. I will also follow up with Dr Saya on his recent discussions with a colleague that practices in LA whom I believe contacted the state board reg. HCG Rx for LA patients.
I will update once I get all the info.
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Jasen Bruce
Member
I don't think the issue is with the pharmacy, I believe were the law is causing the confusion is regarding out of state doctors not licensed in LA prescribing a C-2 controlled substance to a patient across state lines. The real problem is that HCG is a schedule-2 substance in LA (and NY and a few other states)...that dosnt even make sense.
Thank you all for your responses. It's encouraging to know and see that someone from Defy is on here as well. I discovered in 2005, while evacuated to Atlanta, that I suffered from low T. It took me 9 years to find someone to treat me for it. I couldn't find anyone in the New Orleans Metro that treats patients for low T. It's nice to know we have resources like Excelmale and Defy out there for us.
Nelson Vergel
Founder, ExcelMale.com
I have known Jasen for 12 years. He jokes that he read my first book while he was in high school. He knows his stuff and trains his staff great. He has become one of my best friends and I know he really wants to help people.
We are lucky to have him on this site.
We are lucky to have him on this site.
trthcg05
New Member
Hey Jasen,
I want to use Defy, but I am having the exact same problem with the law here and with horrible docs in the state. My testicles are shrinking fast on pellet TRT and I live in Louisiana. Did you find out how to get HCG to Louisiana somehow? If it matters, I am concerned about fertility! I am willing to drive to Houston to get the HCG, if I must. THANKS!
I want to use Defy, but I am having the exact same problem with the law here and with horrible docs in the state. My testicles are shrinking fast on pellet TRT and I live in Louisiana. Did you find out how to get HCG to Louisiana somehow? If it matters, I am concerned about fertility! I am willing to drive to Houston to get the HCG, if I must. THANKS!
Nelson Vergel
Founder, ExcelMale.com
EmpowerRxpharmacy.com ships HCG to Louisiana
EmpowerPharmacy
Member
As long as the HCG isn't for weight loss it can be dispensed inside Louisiana. Hypogonadal hypogonadism is an approved use for HCG.
Dr. John Crisler
Physician
Here here!
Dr Justin Saya MD
Moderator
Some pharmacies will ship to Louisiana, some will not. However, for physicians the real question/risk is not whether a given pharmacy will ship into Louisiana, but rather the risk involved. Pharmacies are governed by a different body than physicians and, consequently, may view risks differently (as risks may in fact be much different to the pharmacy compared to the physician).
Physicians are governed by the board of medicine and it turns out the Louisiana Board of Medicine is very hostile towards HCG use (yes, even as ancillary for TRT). In fact, from my discussions with several LA providers, the Louisiana board of medicine seems more hostile to many aspects of contemporary hormone replacement than many other states. I have three separate Louisiana physicians as my patients all independently verify same and one even had his medical license formally threatened with discipline for prescribing HCG in the exact circumstances we typically use it. Further, a colleague from my medical school class now licensed and practicing in Louisiana submitted a formal inquiry to the LA Board of Medicine and the response confirmed our caution..."prescribe at your own risk" was the gist of their response. I would LOVE to prescribe HCG to my Louisiana TRT patients whom need it for the RIGHT reasons...unfortunately, the risk to my (and my colleagues) license/livelihood is simply too great at this time. Until, if or when, the Louisiana Board of Medicine adopts a more accepting stance on the use of HCG as ancillary support for TRT.
Physicians are governed by the board of medicine and it turns out the Louisiana Board of Medicine is very hostile towards HCG use (yes, even as ancillary for TRT). In fact, from my discussions with several LA providers, the Louisiana board of medicine seems more hostile to many aspects of contemporary hormone replacement than many other states. I have three separate Louisiana physicians as my patients all independently verify same and one even had his medical license formally threatened with discipline for prescribing HCG in the exact circumstances we typically use it. Further, a colleague from my medical school class now licensed and practicing in Louisiana submitted a formal inquiry to the LA Board of Medicine and the response confirmed our caution..."prescribe at your own risk" was the gist of their response. I would LOVE to prescribe HCG to my Louisiana TRT patients whom need it for the RIGHT reasons...unfortunately, the risk to my (and my colleagues) license/livelihood is simply too great at this time. Until, if or when, the Louisiana Board of Medicine adopts a more accepting stance on the use of HCG as ancillary support for TRT.
Dr. John Crisler
Physician
It's as if the Powers-That-Be in LA are bound determined to keep them in the last millenium.
Louisiana fought, tooth and nail, to prevent Osteopathic physicians from being licensed there. They clearly do not have the best interests of the People in mind. It's embarrassing, really, as their wrongheaded policies purposely hurt their citizens.
Louisiana fought, tooth and nail, to prevent Osteopathic physicians from being licensed there. They clearly do not have the best interests of the People in mind. It's embarrassing, really, as their wrongheaded policies purposely hurt their citizens.
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