503A/503B compounding integration, vial-level inventory, dose ladder tracking, AI patient instructions. Documentation that holds up to scrutiny.
Why peptide clinics need a purpose-built EHR
Peptide therapy lives in a regulatory grey area. The molecules are real, the patient outcomes are real, and the prescribing is almost entirely off-label. That combination sets a documentation bar most generic EHRs were never designed to meet. Every off-label prescription needs a captured clinical rationale, a documented risk discussion, and a timestamped patient consent — not reconstructed later when a board inquiry shows up, but at the moment of prescribing.
Then there's the supply chain. Peptides come from 503A and 503B compounding pharmacies, and the difference matters: 503A is patient-specific compounding, 503B is outsourcing-facility manufacturing, and the FDA treats them differently. Your EHR needs to know which pharmacy filled which prescription, what lot number it came from, and what the pharmacy's classification was on the date of the dispense. Most platforms treat the pharmacy as a free-text vendor name. That's not enough when the FDA or your state board asks who sourced what.
Inventory is the next failure mode. Peptides ship in vials of varying potency, often reconstituted on-site, and dispensed in fractional doses. A "one-vial = one-medication" model collapses immediately. You need vial-level inventory: each vial has a lot number, an expiry, a pharmacy of origin, and a remaining quantity in milligrams or micrograms that decrements per dispense. When a 503B issues a recall, you should be able to pull every patient who received that lot in seconds — not export a spreadsheet and call patients from memory.
And then there's the actual clinical workflow. A typical peptide patient isn't on "one drug at one dose." They're on a multi-protocol regimen — one substance titrating up over a defined ladder, another in a cycle-on/cycle-off cadence with planned washout periods, others queued for future cycles. The chart needs to know what week of what protocol they're on, what's titrating up, what's cycling off, and what's coming next. A flat "medication list" cannot model this. The patient knows their protocol is more sophisticated than what their EHR can describe — and they notice.
Capabilities
Eight things your peptide practice needs that generic EHRs can't do.
Each vial has a lot number, expiry, pharmacy of origin, and remaining mg/mcg. Dispenses decrement the vial, not a generic SKU. Append-only audit trail at the database level — UPDATE and DELETE are blocked. Recall traceability in seconds.
Each compounding pharmacy is a structured vendor with its 503A/503B status captured. Prescriptions, dispenses, and lots tie back to the specific pharmacy. Lab/pharmacy result import where the pharmacy supports it.
Configurable week-by-week dosing schedules. Clinicians define the substance, titration ladder, and cycle cadence per protocol. Patients sit on a structured protocol, not a free-text instruction blob — but the protocol itself is always clinician-authored and clinician-owned.
Mandatory rationale field on every off-label Rx. The audit row captures the clinician's justification, risk-discussion completion flag, and patient-consent timestamp — captured at the moment of prescribing, not reconstructed later.
From the chart note, the AI generates a structured patient handout: peptide, dose, reconstitution steps, injection schedule, expected effects, side-effect watchlist. Clinician reviews and approves. Ships to the portal as PDF.
Automated message cadence keyed to the patient's week of protocol. Pre-injection reminders, mid-cycle check-ins, end-of-cycle survey, taper guidance, restart prompts. The system knows where the patient is in the protocol because the protocol is a first-class object.
Built-in interpretation for the peptide-relevant panels: IGF-1 for growth-hormone-axis peptides, glucose and HbA1c for GLP-1 protocols, lipids and inflammatory markers for healing peptides. Trends per patient with reference ranges.
"Who's between cycles and overdue to restart?" "Which patients on protocol X haven't refilled in 60+ days?" "Show me every patient currently in a washout phase." Plain-English queries against the whole panel, with clickable patient lists.
What you'll see in the demo
"We dispense peptides at our own clinic. Every EHR we evaluated treated peptides like a checkbox — a single 'medication' record with no awareness of compounding source, lot number, dose ladder, or cycle position. We built Moonshot to track what's actually happening: which vial from which 503A, on what week of what protocol."
— Tom Kashul, founder of Moonshot Medical & Moonshot Clinic
Related Features
Vial-level peptide tracking, lot capture, append-only audit, recall traceability.
Learn morePanel-wide queries in plain English: cycle position, refill cadence, protocol audits.
Learn moreScriptSure-powered e-prescribing for the prescription-strength side of your formulary.
Learn moreBook a 20-minute demo. We'll show vial tracking, cycle management, and patient instructions live.
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