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However, because federal law does not require state-licensed pharmacies that are not outsourcing facilities to submit adverse events to FDA, many cases are likely going undocumented.FDA has also warned companies that have illegally sold unapproved drugs containing semaglutide, tirzepatide or retatrutide that are falsely labeled for research purposes or not for human consumption. These products have been sold directly to consumers for human use with dosing instructions

Meanwhile, researchers and doctors are concerned that some of these online companies aren't properly screening or monitoring patients

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