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In real-world practice, the “stacking” conversation often blurs three very different categories: FDA-approved peptide drugs (e.g., tesamorelin for HIV-associated lipodystrophy—more on this below) (FDA Access Data) Non-approved peptides sometimes discussed in compounding/wellness circles (e.g., AOD-9604, BPC-157, CJC-1295, ipamorelin) Unregulated “research use only” products sold online (which often have the worst quality and highest risk) That distinction matters because safety isn’t just about pharmacology—it’s also about purity, stability, sterility, and labeling accuracy