Dr.SportsMedIN said:

Steady state is the thing most people miss.

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

raj_cambridge said:

Worth adding the genuine exception, because it is real and narrow: a change made for an identified patient where the prescriber determines it produces…

That reframing is the part I needed.

Dr.SportsMedIN said:

Steady state is the thing most people miss.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

PharmHunterJen said:

My pharmacy stopped supplying with three weeks notice and a letter that explained nothing, so I went and read the statute.

FDA inspection results for compounding pharmacies selling compounded supply: you can look up any 503B facility's FDA inspection history on the FDA website.

Check for: Form 483 observations (violations), warning letters, and recall history. A clean inspection record is a strong indicator of quality. My pharmacy has had 0 Form 483 observations in their last 4 inspections.

This is public information. Use it. Link: fda.gov/inspections-compliance-enforcement-and-criminal-investigations

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.