Online peptide orders and Cayman's 1979 Pharmacy Law: who may import

Retatrutide and other unapproved peptides are advertised and sold online, often with influencers acting as sales affiliates and showing themselves injecting the drug⁹. The law that decides who may bring such products into the Cayman Islands is not a modern medicines act. It is the Pharmacy Law, 1979 (Law 23 of 1979), assented to by the Governor on 2 October 1979 and printed on eight pages with a cover price of 80 cents¹. Its replacement, the Pharmacy Act, 2024, is still listed as not in force³. Here is what the 1979 text actually says.

A short law built around a Pharmacy Board

The 1979 law was enacted "to control dealings in poisonous substances and in pharmaceutical products having potential danger to health if misapplied"¹. It created a Pharmacy Board chaired by the Chief Medical Officer, with three other members appointed by the Governor (sections 3 and 4)¹. Its key definitions are brief: a "pharmaceutical" is "a prescribed pharmaceutical product or class of pharmaceutical products", and a "restricted pharmaceutical" is one prescribed as such "which may not be dispensed or administered except under prescription and all drugs scheduled in the Misuse of Drugs Law, 1973"¹. Which products are restricted depends on regulations made under section 19¹.

Who may import, dispense and store

• Import and dealing (section 11): anyone who is not the Chief Medical Officer, a medical practitioner, the Chief Agricultural Officer or a pharmacist and who "imports, dispenses or otherwise deals in restricted pharmaceuticals is guilty of an offence"¹.
• Dispensing (section 12): a pharmacist who dispenses a restricted pharmaceutical "otherwise than upon the authority of a prescription" commits an offence¹.
• Records (section 15): everyone lawfully dispensing restricted pharmaceuticals must record all acquired and all dispensed, with the prescription or particulars of the person they were given to¹.
• Customs (section 16): the Board must keep the Collector of Customs informed of everyone authorized to import poisons or restricted pharmaceuticals¹.
• Inspection and labelling (sections 17 and 18): storage places are open to inspection by the Chief Medical Officer, and restricted pharmaceuticals must be labelled with their contents and intended use and their names or synonyms in the Pharmacopoeia¹.
• Penalty (section 20): a fine not exceeding $1,000, imprisonment up to six months, or both¹.

At the border, Customs and Border Control administers "the legislated import requirements on behalf of other government departments", and goods may require permits, certificates or inspection⁵. In April 2026 the Ministry appointed Dr. Mark Paramlall as the first deputy Chief Medical Officer, with statutory duties that include the Pharmacy Act⁶.

Why officials call the law outdated

When the draft replacement went to consultation in September 2023, the then Chief Medical Officer, Dr. Nick Gent, said: "The Pharmacy Bill, 2023 will close gaps due to the existing Pharmacy Act being so outdated", and that it would help stop imports by those "without the appropriate licence or authority"⁴. The 1979 law has no concept of an approved or non-approved medicine and no rule on online sellers¹. The Pharmacy Bill, 2024 adds both: an offence of importing, prescribing or administering a non-approved medicine (clause 15) and a ban on dispensing from internet or mail-order pharmacies (clause 22), each punishable by a fine of twenty thousand dollars, five years in prison, or both². The Act is listed as not in force³.

What US and UK regulators say about online peptides

The products in question are mostly unapproved anywhere. The US FDA's page on bulk drug substances that may present significant safety risks in compounding lists, among substances whose nominations were withdrawn, BPC-157 (immunogenicity and impurity concerns; the FDA "has identified no, or only limited, safety-related information for the proposed routes of administration"), CJC-1295 ("FDA has identified serious adverse events associated with CJC-1295 including increased heart rate"), TB-500, AOD-9604, Melanotan II, epitalon and others⁷. In February 2026 the FDA announced its intent to restrict GLP-1 active ingredients used in non-approved compounded drugs, saying the actions aim "to safeguard consumers from drugs for which the FDA cannot verify quality, safety, or efficacy"⁸.

Enforcement has had limited reach. Public Citizen reported in June 2026 that the FDA had issued 14 warning letters since 2024 to companies selling retatrutide, that 11 of the 14 still advertised unapproved peptides, and that a testing company had rated 71 of 179 vendors (39.6%) as "poor," "bad," or "fraud"⁹. In the UK, the Medicines and Healthcare products Regulatory Agency seized over 12,000 fake retatrutide and tirzepatide pens in a raid on an industrial unit in Birmingham on 14 October 2026¹⁰. The Pan American Health Organization warned in March 2026 that products sold online "may contain incorrect doses, different active ingredients, or undeclared substances"¹¹. A 2025 systematic review of BPC-157 in orthopaedic sports medicine included 36 studies, of which 35 were preclinical and one clinical, and warned that "Adverse effects are possible due to unregulated manufacturing, contamination, or unknown clinical safety"¹².