HealthRX.com · Printable question sheet
Epitalon questions for prescriber or pharmacist
Use this sheet before any visit about epitalon, a peptide with no FDA or EMA approval. Fill in the product details, bring the label and seller information, and write down the answers you receive about status, compounding, safety and dose.
Product I am asking about
Copy exactly what the label or seller page says.
Product name as labeledWrite the name exactly as printed
Form on the labelFor example vial, capsule, oral spray or injection
Where it was obtainedPharmacy, clinic, online seller or other
Seller or pharmacy nameName and location as shown
Label wordingCopy any words such as research use only or not for resale
Prescriber or pharmacist I am speaking withName and role
Bring or gather before the visit
Bring copies if the original is needed elsewhere.
- Bring the product packaging and any printed label
- Bring the seller page or receipt showing where it was bought
- Write down any paperwork that mentions a certificate of analysis
- Note whether a pharmacy has prepared the product for you
- List every other medicine, supplement or peptide you take now
- Write down any changes you have noticed since you started
- Check with your pharmacist whether any listing applies to your medicine
- Bring a note of any sport you play that has drug testing rules
Questions to ask
- Is this product approved by the FDA or the EMA for any use?
- Is this product listed as a component of any approved drug?
- Can a pharmacy legally prepare this product for me in my state?
- Does the product I have match the ingredient named on its label?
- What safety information exists for this product in people?
- Has anyone reported side effects from this product to a database?
- What dose would you use, and how would it be confirmed?
- Would this product affect any medicine I already take?
- Is this product on the WADA prohibited list for my sport?
- What would you need to see before deciding whether it is appropriate?
Answers received at the visit
Write answers as given. Ask for written notes if unsure.
| Question | Answer given | Written source |
|---|---|---|
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.