Contamination, rashes and injection reactions

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On this page

1. What this page covers
2. The reactions, one at a time
3. Product, technique or molecule?
4. Published cases and outbreaks
5. What regulators have found
6. What visible contamination looks like
7. Insects and other foreign bodies
8. When to get medical care
9. How to report it
10. Frequently asked questions
11. Related on Grey Peptides
12. Sources

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What this page covers

A reaction after an injection can come from three places: what is in the vial (the molecule, its additives, or something that should not be there), how it was injected, or the person's own immune response to the molecule. Telling them apart matters, because the right next step differs: a fatty lump from overusing one spot calls for rotating sites, while a contaminated product calls for stopping it altogether (our reasoning). Most of the clinical evidence below comes from approved and compounded medicines and from outbreak investigations, because those are what clinicians have studied; published reports about grey-market peptides specifically are few, and we say where the evidence comes from in each case.

Our physical risks page covers what laboratory tests have found inside grey-market vials, including endotoxin and sterility results. Our guide to injection-site reactions covers injection technique and site rotation in more depth.

The reactions, one at a time

Expected local reactions: redness, itching, swelling

Approved peptide labels report them. On the label of EGRIFTA WR (tesamorelin), injection-site reactions, including redness, itching, pain, irritation and bruising, occurred in 25% of treated patients and 14% of placebo patients in the first 26 weeks of trials, and the label tells users to rotate sites around the abdomen to reduce them.¹ That placebo figure shows that an injection alone causes some of these reactions (our reading of the label's numbers). Some molecules cause them far more often: with enfuvirtide, an approved HIV peptide injected twice a day, injection-site reactions occur in nearly all patients and range from little or no reaction to cysts, nodules and hardened skin, mostly self-limited.² A 2026 systematic review of semaglutide, liraglutide and tirzepatide found injection-site redness, itching and bleeding reported most often with tirzepatide, in 2% to 7% of patients.³

Urticaria (hives) and allergic reactions

A drug allergy can appear as hives, itching and swelling, and can involve the whole body rather than the injection site (our reasoning from the cases below). The same review lists angioedema, hypersensitivity reactions and drug eruptions among the uncommon skin reactions reported with these drugs.³ In a 2026 case, a woman who had injected tirzepatide for three months without trouble developed generalized hives and episodes of lip swelling after a dose increase; they persisted through steroid treatment and two emergency visits and cleared only when the drug was stopped, and intradermal skin testing confirmed an allergy to tirzepatide itself.⁴ Wegovy's label reports serious hypersensitivity reactions, including anaphylaxis and angioedema, and rules the drug out for anyone who has had a serious hypersensitivity reaction to semaglutide or to any of its excipients.⁵

Granulomas and nodules

A granuloma is a firm, persistent lump formed when the body walls off material it cannot clear (our plain-language summary). FDA's guidance on visible particles in injectables lists "phlebitis, inflammatory reactions, granulomas, and infections at injection sites" among the harms particles can cause.⁷ Nodules can also come from a product's own design: in a reported case, painful nodules that appeared after each weekly injection of extended-release exenatide were shown by biopsy and infrared spectroscopy to be an inflammation of fat around the drug's polymer microspheres, with stains negative for fungi and mycobacteria.⁶ Because a slow mycobacterial infection can also present as a firm lump that will not go away,¹² a persistent nodule needs an examination rather than a guess (our reasoning).

Lipohypertrophy

Lipohypertrophy is a thickened, rubbery build-up of fat at a site injected over and over (our plain-language description). Its rate is best measured in insulin users, where a meta-analysis of 45 studies and 26,865 people found it in 41.8%.⁸ A 2026 meta-analysis found the strongest contributor was incorrect site rotation, followed by needle reuse, and noted that both can be changed by teaching injection technique.⁹ Insulin is a peptide hormone, but these figures describe insulin users, not people injecting grey-market peptides, so they show the mechanism rather than a rate for any other product (our reasoning).

Abscesses and cellulitis

Cellulitis is a bacterial infection of the skin. Its signs include redness or inflammation that grows as the infection spreads, warm skin, pain or tenderness, a tight, glossy appearance, and fever with chills.¹⁰ A skin abscess is a pocket of pus: a raised area or sore with redness, tenderness, warmth, hardened skin and fluid or pus draining, sometimes with fever or chills. MedlinePlus advises not to push and squeeze on an abscess.¹¹

Atypical (nontuberculous) mycobacterial infections

Nontuberculous mycobacteria are environmental organisms that can enter the body through an injection or procedure. Outbreaks have been traced to contaminated injected solutions or medications and to poorly disinfected equipment, and a high index of suspicion is needed because they present as subacute or chronic infections.¹² Published outbreaks after injections include:

• China, 2006. 35 of 604 people injected at a rural clinic developed buttock abscesses; every case had received drugs mixed with saline from 100 mL multiple-dose bottles, a 16-gauge needle was left in the bottles' stoppers and reused, and Mycobacterium abscessus grew from abscesses and from the clinic's water supply.¹³
• France. Severe infections with M. chelonae after mesotherapy (injections of mixtures into the skin) were linked to a multiple-injection device cleaned with tap water.¹⁴
• Spain, 2009. 17 of 77 patients at an aesthetic clinic developed M. abscessus abscesses after injections from multi-dose vials; the clinic's equipment and procedures were judged correct, a different bacterium was grown from unused vials, the product was withdrawn and the factory's line suspended, and investigators judged contamination at the factory the most likely cause, without laboratory confirmation.¹⁵
• Canada, 2026 report. Four people injected by the same esthetician within one month had M. abscessus isolates that were nearly identical by whole-genome sequencing.¹⁷

A systematic review of 423 patients with mycobacterial infections after mesotherapy found that nearly all had several well-localized lesions without fever or other whole-body symptoms; infections often took weeks to resolve, many needed more than one course or agent of antibiotics, and scarring was common.¹⁶ One case involved a hormone peptide: a woman developed a tender abdominal lesion at the site of a previous human chorionic gonadotropin (hCG) injection, which the authors described as an unregulated weight-loss product; culture grew M. fortuitum, and treatment chosen by susceptibility testing ran for six months.¹⁸

Fever and chills: a sign of endotoxin

Endotoxin is a residue of gram-negative bacteria; fever is its best-known effect, and sterilizing filters do not remove it, so a product can be sterile and still contain it.¹⁹ Outbreaks show what it does when injected. In Brazil in 2002, 28 of 355 surgical patients fell ill a mean of 2.5 hours after receiving intravenous solutions from implicated lots, and 5 of them died; unopened bottles held a mean of 88.3 endotoxin units per mL against a permitted limit below 0.5, and the outbreak stopped after a national recall.²⁰ In California in 1998, 20 patients developed severe shaking chills, often with fever, a fast heart rate or a drop in blood pressure, within 3 hours of an intravenous antibiotic; the investigation found that the drug's endotoxin was within the pharmacopeia's standard but that once-daily dosing may deliver enough of it to cross the threshold for these reactions.²¹ Both were intravenous drugs; we found no published measurement of how endotoxin injected under the skin in a peptide behaves, so the timing here is an observation from these outbreaks, not a rule (our reasoning). Fever and chills that start within hours of an injection, without a red, painful site, fit an endotoxin reaction better than an infection, which takes longer to build (our reasoning from the cases above).

Anaphylaxis

Anaphylaxis is a severe, whole-body allergic reaction. Its symptoms develop quickly, often within seconds or minutes, and include swelling of the face, eyes or tongue, difficulty breathing or wheezing, and hives; a very hoarse or whispered voice is a warning sign of dangerous throat swelling. MedlinePlus says to call 911 or the local emergency number immediately and to use an epinephrine injector at once if one is available.²² Approved peptide labels report it: Wegovy's label lists anaphylaxis and angioedema among serious hypersensitivity reactions and advises stopping the drug and treating promptly.⁵

Reactions from the molecule that are not reactions at the site

Some skin changes come from what the molecule does, not from contamination or technique. Melanotan, an unapproved tanning peptide, stimulates pigment cells: clinicians in Dublin reported a woman who developed multiple new atypical moles within a week of two injections.²³ Clinicians in Glasgow reported ulcers at a melanotan user's injection sites, diagnosed as pyoderma gangrenosum, an inflammatory skin disease, which took months of steroid treatment to heal.²⁴

Product, technique or molecule?

The literature allows a rough sorting. It is a guide to which questions to ask, not a diagnosis: several causes can produce the same lump or rash, and only an examination, and sometimes a culture or biopsy, can tell them apart (our reasoning).

Technique is a real risk on its own. When researchers in Connecticut gave 20 adults semaglutide vials, diluent and supplies and asked them to prepare and inject a dose using only information they found online, participants completed 15 of 34 steps correctly on average, with errors that could cause wrong doses, needle sticks or infections.²⁵ A grey-market product adds the product's own uncertainty to that, because no release test that a buyer can check has confirmed its sterility or endotoxin before sale (our reasoning; see physical risks).

Published cases and outbreaks

Published reports of infection from grey-market peptides themselves are rare; we found the hCG case above¹⁸ and the melanotan cases²³²⁴ on PubMed, and no published case of infection traced to a specific product sold as a research peptide (our search, October 28, 2026). That is an absence of published reports, not evidence that infections do not happen: an infection is only linked to a product when a clinician suspects it, asks and reports it (our reasoning).

Compounded injectables, made by pharmacies rather than drug manufacturers, have a longer record. A CDC-led review identified 19 US outbreaks from 2001 to 2013 linked to contaminated pharmacy-compounded sterile preparations, with at least 1,000 cases, and deaths in almost half of the outbreaks. Gram-negative bacteria were the most common cause; the infections were most often bloodstream infections, eye infections and meningitis, and also included skin and soft tissue infections and flu-like symptoms. Two thirds of the outbreaks with known methods came from making a sterile product out of non-sterile ingredients, and the investigators repeatedly found breaches in aseptic technique, faulty sterilization, and inadequate sterility and endotoxin testing.²⁶ The largest, in 2012, involved nearly 14,000 people exposed to a contaminated injectable steroid and at least 751 cases of fungal meningitis and other infections, with at least 64 deaths.²⁶ The review also warned that outbreaks are likely undercounted, partly because many compounders were not required to report adverse events to FDA.²⁶

A grey-market vial comes with no sterilization method that a buyer can check (our reasoning; see Chinese peptides explained). Making a sterile injectable from non-sterile material is the step the review found behind most of the compounding outbreaks.²⁶

What regulators have found

FDA's recent records on compounded peptide injectables describe the kinds of failure the outbreak review found (our reading of the records below). We link each record so it can be checked, and describe it without naming the company.

• A black particle in a semaglutide vial (FDA alert, November 1, 2024). FDA told patients and clinicians not to use semaglutide and tirzepatide injections from a California compounder, because it had made them from non-sterile ingredients without sterilizing them, and a patient complaint reported "a black particulate in a vial of semaglutide." FDA said it was not aware of adverse reactions, and noted that compounders not registered as outsourcing facilities are not required to report them.²⁷
• Mould spores and particle defects at an outsourcing facility (FDA warning letter, April 7, 2026). At a registered outsourcing facility making tirzepatide and semaglutide, inspectors recorded a Trichoderma mould recovered from an air sample during a tirzepatide production run, microbial growth on workers' fingertip samples after aseptic work, products released despite microbial recoveries in the cleanest zone, and a visual-inspection classification of particle defects that FDA found inadequate. The firm had recalled tirzepatide and semaglutide multidose vials for lack of sterility assurance, and FDA wrote that "a passing sterility test result does not indicate the absence of contamination within a batch."²⁸
• Sterility failures released to patients (FDA warning letter, January 16, 2026). At a state-licensed compounding pharmacy, FDA found a compounded tirzepatide injection that failed sterility testing among nine lots with sterility failures, products released and distributed despite failing sterility and potency specifications, and production areas with "visibly dirty equipment or surfaces."²⁹

Both letters use the law's wording that the drugs were "prepared, packed, or held under insanitary conditions, whereby they may have become contaminated with filth."²⁸²⁹ These are compounding pharmacies operating under FDA and state oversight; a grey-market seller is inspected by no one before it ships (our reasoning; see legal risks). Health Canada lists the contamination it is concerned about in unauthorized injectable peptides: solvents, heavy metals, particles such as fibres, glass or plastic, and microbes including bacteria, fungi and endotoxins.³⁶

What visible contamination looks like

Every approved injectable carries an instruction to look before injecting. The bacteriostatic water label states the general rule: "Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration," and reconstituted drugs should be inspected "for clarity (if soluble) and freedom from unexpected precipitation or discoloration."³³ Peptide labels say what that means in practice:

• Cloudiness or colour. Wegovy: "Only use if the solution is clear, colorless, and contains no particles."⁵ EGRIFTA WR: "Do not use if solid particles appear or if the solution is cloudy or colored."¹
• Particles, flakes or fibres. Zepbound: "Do not use ZEPBOUND if particulate matter or discoloration is seen."³⁵ FDA's guidance names the kinds of particles found in injectables: metal, glass, dust, fibre, rubber, polymer, mould and precipitate.⁷ A September 2026 manufacturer's recall of epinephrine vials identified its particles as nylon, cellulose, acrylic, polyethylene and glass.³⁰
• A cake that will not dissolve. Gattex, a freeze-dried peptide mixed before each injection: "Inspect the vial for any undissolved powder ... If the product remains undissolved after the second attempt, do not use."³⁴

Why such a vial must not be used: visible particles "can jeopardize patient safety," and FDA lists the harms, from phlebitis, inflammatory reactions, granulomas and infections at injection sites to emboli and abscesses in organs.⁷ A cloudy solution or growth in the vial can also mean microbes: in a published case, a fungus-like body seen in a counterfeit bevacizumab vial grew a mould on culture, and the vial held no protein at all.³¹ For a grey-market vial there is no label stating what the solution should look like, so anything other than a clear, colourless solution after gentle mixing is a reason to stop (our reasoning, from the approved labels above).

Looking is necessary but not sufficient. Some contamination cannot be seen (our reasoning): endotoxin, for example, was found in unopened bottles in the Brazilian outbreak.²⁰ And needles can cut tiny rubber fragments from a vial's stopper ("coring"): in a test of 800 punctures, no fragment was visible to the naked eye, but a microscope found them in 10% to 33% of samples, depending on the needle; a filter needle removed them.³² A clear vial is not proof of a clean one (our reasoning).

Insects and other foreign bodies

Some buyers ask whether insects have been found in peptide vials. We searched PubMed and FDA's recall records on October 28, 2026 and found no published report of an insect in a peptide vial, grey-market or otherwise. That does not mean it has not happened; it means no one has documented it where we could check (our reasoning).

What has been documented is foreign matter in injectables generally: a black particle reported in a compounded semaglutide vial,²⁷ fibres, plastics and glass in a recalled drug,³⁰ a fungal growth inside a counterfeit vial,³¹ and the categories FDA lists in its guidance, including dust, fibre and mould.⁷ FDA's warning letters describe compounding rooms where drugs "may have become contaminated with filth."²⁸²⁹ Any visible object in a vial, whatever it looks like, is a reason not to use it and to keep it for a clinician or a report (our reasoning from the labels and guidance above).

When to get medical care

Call 911 or your local emergency number for swelling of the face, lips, tongue or throat, a hoarse or whispered voice, trouble breathing or wheezing, or hives with any of these after an injection.²²

See a clinician promptly for:

• redness that spreads or keeps growing instead of fading, or skin that becomes tight and glossy;¹⁰
• warmth, swelling and increasing pain at the site;¹⁰¹¹
• pus or any drainage, or a lump that feels like it holds fluid;¹¹
• red streaks spreading from the site;¹⁰
• fever, chills or sweating;¹⁰¹¹ and shaking chills within hours of an injection, which fit an endotoxin reaction;²¹
• a lump or sore that lasts for weeks, keeps coming back or will not heal, which can be a slow mycobacterial infection.¹²¹⁶

Do not squeeze or try to drain a lump yourself.¹¹

Take the vial and its packaging with you, including the water or diluent you mixed it with, and write down the product name, lot number, where it was bought, and the dates of your injections (our advice). A clinician can culture a sample: a culture of the lesion is how the hCG case was identified as M. fortuitum,¹⁸ and outbreak investigators have cultured unused vials¹⁵ and tested unopened containers for endotoxin²⁰ to find the source. Mycobacterial infections are easy to miss unless a clinician suspects them, so say that you injected an unapproved product.¹² Tell the clinician that it was not a prescribed medicine (our advice).

How to report it

In the United States, FDA's MedWatch program takes reports from patients and consumers as well as clinicians, covering "serious reactions, product quality problems, therapeutic inequivalence/failure, and product use errors." You can file the online reporting form yourself, or use Form 3500B, a consumer-friendly version of the reporting form; the page also gives a phone line, 1-888-INFO-FDA (1-888-463-6332).³⁷ A report about a contaminated or reacting vial is more useful with the product name, lot number and where it was bought (our reasoning). Compounders that are not registered outsourcing facilities do not have to report adverse events to FDA,²⁷ so a patient's report may be the only one FDA receives (our reasoning).

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Frequently asked questions

Is a red, itchy spot after a peptide injection normal?

A small red, itchy or sore patch that fades is common: on tesamorelin's label, injection-site reactions occurred in 25% of treated patients and 14% on placebo. Redness that spreads, warmth, pus, red streaks or fever are signs of infection and need a clinician.¹¹⁰¹¹

Can a contaminated peptide cause a fever?

Yes. Endotoxin, a bacterial residue that sterilizing filters do not remove, causes fever, and outbreaks of endotoxin-contaminated drugs caused shaking chills and fever within about three hours.¹⁹²⁰²¹

What does a contaminated vial look like?

It may be cloudy or coloured, contain particles, flakes or fibres, or hold powder that will not dissolve; approved peptide labels say not to use any of these. Some contamination, such as endotoxin, cannot be seen.¹⁵²⁰³⁴

Have insects been found in peptide vials?

We found no published report of one, as of October 28, 2026. Documented foreign matter in injectables includes a black particle in a compounded semaglutide vial, fibres, glass and plastics, and fungal growth.²⁷³⁰³¹

Should I bring the vial to the doctor?

Yes, with its packaging and the water you mixed it with. A clinician can culture the infection, and investigators have found outbreak sources by testing the product.¹⁵¹⁸²⁰

How do I report a bad reaction or a contaminated vial?

In the US, report it to FDA's MedWatch program online or with Form 3500B; patients can report directly.³⁷

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Related on Grey Peptides

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Sources

Papers were read at PubMed, in full text where PubMed Central holds it; labels are the DailyMed versions current on October 28, 2026; FDA and MedlinePlus pages are cited with the dates they show. All read October 28, 2026.

1. Theratechnologies. EGRIFTA WR (tesamorelin) US prescribing information, sections 2 and 5.6 (injection site reactions; do not use if solid particles appear or the solution is cloudy or colored). DailyMed set 839334d3, version 2, effective July 29, 2026; read October 28, 2026. Source
2. Mirza RA, Turiansky GW. Enfuvirtide and cutaneous injection-site reactions. J Drugs Dermatol. 2012;11(10):e35-8. PMID 23134996. Source
3. Gupta AK, et al. Cutaneous Adverse Events Associated with Semaglutide, Liraglutide and Tirzepatide: A Systematic Review. Med Sci (Basel). 2026;14(6):652. PMID 42930571. Source
4. Nejat C, et al. Hypersensitivity Reaction to Tirzepatide With Demonstrated Tolerance to Semaglutide: A Case Report. Clin Case Rep. 2026;14(7):e73183. PMID 42487660. Source
5. Novo Nordisk. WEGOVY (semaglutide) US prescribing information, section 2 (visually inspect; only use if clear, colorless, no particles) and section 5.7 (hypersensitivity reactions). DailyMed set ee06186f, version 19, effective June 18, 2026; read October 28, 2026. Source
6. Zhu CS, et al. Exenatide-induced granulomatous panniculitis associated with poly(d,l-lactide-co-glycolide). J Cutan Pathol. 2022;49(5):496-499. PMID 34954842. Source
7. U.S. Food and Drug Administration. Inspection of Injectable Products for Visible Particulates: draft guidance for industry, December 2021 (content current as of December 17, 2021; draft, not for implementation). Read October 28, 2026. Source
8. Wang K, et al. A meta-analysis and meta-regression on the prevalence of lipohypertrophy in diabetic patients on insulin therapy. Therapie. 2021;76(6):617-628. PMID 33958198. Source
9. Mader JK, et al. Risk factors for Lipohypertrophy in People With Insulin-Treated Diabetes: A Systematic Meta-Analysis. J Diabetes Sci Technol. 2026;20(4):1342-1352. PMID 40109173. Several authors report ties to a needle maker. Source
10. MedlinePlus (US National Library of Medicine). Cellulitis. Medical Encyclopedia, review date April 1, 2025; read October 28, 2026. Source
11. MedlinePlus (US National Library of Medicine). Skin abscess. Medical Encyclopedia, review date October 13, 2024; read October 28, 2026. Source
12. Kasperbauer S, Huitt G. Management of extrapulmonary nontuberculous mycobacterial infections. Semin Respir Crit Care Med. 2013;34(1):143-50. PMID 23460014. Source
13. Yuan J, et al. Mycobacterium abscessus post-injection abscesses from extrinsic contamination of multiple-dose bottles of normal saline in a rural clinic. Int J Infect Dis. 2009;13(5):537-42. PMID 19269204. Source
14. Carbonne A, et al. Outbreak of nontuberculous mycobacterial subcutaneous infections related to multiple mesotherapy injections. J Clin Microbiol. 2009;47(6):1961-4. PMID 19386853. Source
15. Galmés-Truyols A, et al. An outbreak of cutaneous infection due to Mycobacterium abscessus associated to mesotherapy. Enferm Infecc Microbiol Clin. 2011;29(7):510-4. PMID 21684045. Source
16. Singsing ME, et al. Clinical features of mesotherapy-associated non-tuberculous mycobacterial infections: A systematic review. Int J Womens Dermatol. 2022;8(4):e059. PMID 39916988. Source
17. Quan-Nguyen X, et al. Mycobacterium abscessus soft tissue infections associated with subcutaneous injection of lipolytic agents: An outbreak report and novel molecular epidemiology analysis approach. Can Commun Dis Rep. 2026;52(6):256-263. PMID 42603027. Source
18. Neill BC, Bahr NC, Bryan Z, Aires DJ. Cutaneous infection with Mycobacterium fortuitum after subcutaneous injection of human chorionic gonadotropin. Dermatol Online J. 2017;23(8). PMID 29469752 (case details from the full text). Source
19. U.S. Food and Drug Administration. Inspection Technical Guide: Bacterial Endotoxins/Pyrogens. Content current as of November 17, 2014; read October 28, 2026. Source
20. Daufenbach LZ, et al. Pyrogenic reactions and hemorrhage associated with intrinsic exposure to endotoxin-contaminated intravenous solutions. Infect Control Hosp Epidemiol. 2006;27(7):735-41. PMID 16807850. Source
21. Centers for Disease Control and Prevention. Endotoxin-like reactions associated with intravenous gentamicin, California, 1998. MMWR Morb Mortal Wkly Rep. 1998;47(41):877-80. PMID 9810010. Source
22. MedlinePlus (US National Library of Medicine). Anaphylaxis. Medical Encyclopedia, review date January 20, 2026; read October 28, 2026. Source
23. Reid C, Fitzgerald T, Fabre A, Kirby B. Atypical melanocytic naevi following melanotan injection. Ir Med J. 2013;106(5):148-9. PMID 23914578. Source
24. Dickson D, Hlaing Htwe S. Pyoderma Gangrenosum Secondary to Melanotan. Cureus. 2025;17(12):e98297. PMID 41487785. Source
25. Sedensky A, et al. Ability of Adults to Correctly Use Grey Market Peptide Semaglutide GLP-1 Receptor Agonists Acquired Without a Prescription. Public Health Rep. 2026 (online ahead of print). PMID 42541373. Source
26. Shehab N, Brown MN, Kallen AJ, Perz JF. U.S. Compounding Pharmacy-Related Outbreaks, 2001-2013: Public Health and Patient Safety Lessons Learned. J Patient Saf. 2018;14(3):164-173. PMID 26001553 (figures from the full text, PMC4668233). Source
27. U.S. Food and Drug Administration. Drug alert: FDA warns patients and health care professionals not to use a California compounder's injectable drugs, including semaglutide and tirzepatide. November 1, 2024 (content current as of November 1, 2024); read October 28, 2026. Source
28. U.S. Food and Drug Administration. Warning letter to a 503B outsourcing facility, April 7, 2026 (inspection September 9-19, 2025). Read October 28, 2026. Source
29. U.S. Food and Drug Administration. Warning letter to a 503A compounding pharmacy, January 16, 2026 (inspection May 12 to June 9, 2025; Form FDA 483 issued June 9, 2025). Read October 28, 2026. Source
30. U.S. Food and Drug Administration (company announcement). Voluntary nationwide recall of three lots of epinephrine injection vials due to particulate matter and lack of assurance of sterility, September 3, 2026. Read October 28, 2026. Source
31. Garcia-Aguirre G, Vanzinni-Zago V, Quiroz-Mercado H. Growth of Scytalidium sp. in a counterfeit bevacizumab bottle. Indian J Ophthalmol. 2013;61(9):523-5. PMID 24104716. Source
32. Hecker A, Di Maro A, Liechti EF, Klenke FM. Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration. Osteoarthr Cartil Open. 2021;3(2):100164. PMID 36474986. Source
33. Hospira, Inc. Bacteriostatic Water for Injection, USP, prescribing information (inspect visually for particulate matter and discoloration; inspect reconstituted drugs for clarity and freedom from unexpected precipitation or discoloration). DailyMed set 87d6e9dc, version 20, effective May 22, 2026; read October 28, 2026. Source
34. Takeda. GATTEX (teduglutide) US prescribing information and instructions (inspect the vial for undissolved powder; if it remains undissolved after the second attempt, do not use). DailyMed set 66b69c1e, version 20, effective September 5, 2025; read October 28, 2026. Source
35. Eli Lilly. ZEPBOUND (tirzepatide) US prescribing information (inspect visually before use; do not use if particulate matter or discoloration is seen). DailyMed set 487cd7e7, version 40, effective August 28, 2026; read October 28, 2026. Source
36. Health Canada. Think twice before injecting peptides bought online: unauthorized products can seriously harm your health. Public advisory, April 9, 2026; read October 28, 2026. Source
37. U.S. Food and Drug Administration. Reporting Serious Problems to FDA (MedWatch). Content current as of September 26, 2025; read October 28, 2026. Source

This page describes how the grey market works; it is not legal or medical advice, and it is not a guide to buying. Grey Peptides sells nothing, links to no seller and rates none. If you have taken a product and feel unwell, contact a clinician or Poison Help (1-800-222-1222 in the US).