Clinics in Houston, Texas

FDA regulates the compounded ingredients used in IV therapy and the facilities that prepare them. Patient-specific compounded IVs fall under FDCA Section 503A, while bulk preparations for office use fall under Section 503B (outsourcing facilities). USP Chapter 797 governs sterile compounding standards. FDA has issued warnings about injectable glutathione marketed for skin lightening (2017) and has not approved NAD IV for any specific indication. Vitamin and mineral IV mixtures such as the Myers cocktail are compounded preparations and are not FDA-approved drug products.

• Texas Nursing Practice Act (Tex. Occ. Code Ch. 301)
  Defines RN scope including IV insertion and administration under a valid order from a physician or APRN.
• Texas Medical Board delegation rules (Tex. Occ. Code Ch. 157)
  Governs physician delegation of IV therapy through standing orders and medical director arrangements.

The Texas medical and nursing boards have addressed unlicensed practice in medical spa and IV lounge settings. Common enforcement themes include IV therapy administered without a valid physician order, stale or missing standing orders, absence of a designated medical director, and unlicensed personnel performing venipuncture. Boards have reiterated that a prescribing physician or APRN must establish a bona fide patient relationship before any IV protocol is initiated, and that standing orders must be specific, dated, and periodically reviewed. The Texas Medical Board has disciplined physicians serving as medical directors for IV lounges without establishing bona fide patient relationships, and Texas strictly enforces the corporate practice of medicine doctrine.