HealthRX.com · Printable question sheet
MOTS-c FDA status questions for prescriber or pharmacist
Use this sheet before a visit with a prescriber, pharmacist or insurer if MOTS-c has been offered to you. Fill in the product details, bring the listed papers and write down the answers about FDA approval, compounding lists and safety data.
Product and source details
Write what the label or paperwork says. Leave blank if you do not have it.
Product name on the labelCopy the exact wording, such as MOTS-c acetate or free base
Pharmacy or compounding facility nameName as printed on the label or invoice
Manufacturer or ingredient sourceWrite any name given for the bulk ingredient
Prescriber name
Label wording about compoundingCopy any text such as not for resale
Bring to the visit
Bring copies, not originals, when you can.
- Bring the product label and any packaging you still have.
- Bring any certificate of analysis the source gave you.
- Bring any prescription paperwork that names the product.
- Bring any notice from FDA or HHS you were shown or sent.
- Note which products you have used in the past and when they stopped.
- Check with the pharmacy whether the product is on any FDA list.
- Write down the names of any other medicines or supplements you take.
Questions to ask
- Is MOTS-c FDA approved for any use?
- Is MOTS-c on FDA's list for state-licensed pharmacies?
- Is MOTS-c listed on FDA's list for outsourcing facilities?
- Does the advisory committee vote change whether this product is legal to compound?
- Does the HHS draft policy approve MOTS-c or put it on a list?
- What human safety studies exist for injected MOTS-c?
- Has any adverse event been reported for this product?
- Is MOTS-c prohibited in sport under the WADA list?
- Who is responsible if this product causes a problem?
Symptoms and events to note
Record what you noticed, when, and who you told.
| Date | What happened | Who you told |
|---|---|---|