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States with restrictions: Arkansas, Louisiana: Require in-person visit before prescribing controlled substances or weight-management medications (tirzepatide is not controlled, but some providers interpret regulations conservatively) Texas: Requires Texas-licensed provider for prescriptions filled at Texas pharmacies California: Allows telehealth prescribing but requires ongoing relationship (not one-time consultation) Compounding pharmacy restrictions: Some states restrict out-of-state compounding pharmacies from shipping into the state

Reliable regional suppliers typically accept secure local payment methods, including Mada, Apple Pay, STC Pay, and occasionally secure installment services like Tabby, Tamara, or Cash on Delivery (COD)

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