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ForumsDosing & ProtocolsHas anyone dealt with compounded sema dosing calculator?

Has anyone dealt with compounded sema dosing calculator?

AttorneyGrant Wed, Sep 10, 2025 at 10:50 AM 26 replies 1,412 viewsPage 1 of 6
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AttorneyGrant
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Sep 10, 2025 at 10:50 AM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

The shortage clause is the answer to the second question and it is a subtraction rather than an addition. Both exemptions forbid compounding something that is essentially a copy of a commercially available approved product. A product FDA has listed as in shortage is not treated as commercially available, so listing removed the objection that otherwise blocked compounding. It never created a permission; it withdrew a prohibition, which is why it evaporated the moment the supply fact changed.

Where I think it is weakest: the subgroup findings are the part I trust least — with enough subgroups something is always significant, and these were not all pre-registered.

What I am after is what actually distinguishes 503A from 503B, in terms of what each may make and from what starting material. Numbers rather than impressions, if you have them.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
7 2Dr.SleepRoch, laura_annarbor, JenMemphis and 4 others
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Dr.SurgeonPGH
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Sep 10, 2025 at 11:14 AM#2
AttorneyGrant said:
The shortage clause is the answer to the second question and it is a subtraction rather than an addition.

No disagreement with AttorneyGrant. One condition attached. They are two different exemptions from the same federal requirements and they buy different things. A 503A pharmacy is regulated primarily by the state board, needs a patient-specific prescription, is exempt from CGMP, and may use a bulk substance that has a USP monograph, is a component of an approved drug, or appears on the 503A bulks list — three independent doorways. A 503B outsourcing facility registers with the FDA, is inspected on a risk basis, must comply with CGMP, may compound for office stock without a patient-specific prescription, and has one doorway to a permitted bulk substance: the 503B bulks list, or the drug shortage list.

Last edited: Sep 10, 2025 at 2:14 PM
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Dr.AddMedPHL
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Sep 10, 2025 at 11:38 AM#3
AttorneyGrant said:
The shortage clause is the answer to the second question and it is a subtraction rather than an addition.

This is where I part company with the consensus forming above. A research-chemical supplier selling lyophilised powder labelled research use only is not compounding and is not claiming to. It is a different legal universe with no pharmacy oversight, no patient relationship and no content guarantee, and conflating the two in these threads helps nobody.

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newstart_MO
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Sep 10, 2025 at 12:02 PM#4

This one has a reasonably settled answer, so here it is. Resolution therefore closed the doors unevenly, and the asymmetry follows from the bulks lists. For 503B the shortage clause was the only route to these molecules, so that route shut completely. A 503A pharmacy can still argue a doorway via "component of an approved drug" — but only for the substance in the form present in the approved product, which is exactly where the base-versus-salt argument lives, and it does nothing about the copy restriction, which came back into force on resolution.

Last edited: Sep 10, 2025 at 6:02 PM
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hannah_MT
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Sep 10, 2025 at 2:14 PM#5
Dr.SurgeonPGH said:
They are two different exemptions from the same federal requirements and they buy different things.

This is my experience too, for whatever a second data point is worth. I had assumed I was the exception until I read this.

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