Peptides in Trinidad and Tobago: a guide for physicians

Who this guide is for

This guide is for physicians in Trinidad and Tobago who want the facts before they form a view. Peptides are not a fad. They are one of the most productive drug classes in modern medicine, and the glucagon-like peptide-1 (GLP-1) drugs have become the most talked-about medicines of the decade¹². Patients in Port of Spain, San Fernando and Scarborough now ask about semaglutide and tirzepatide, and some ask about research peptides they saw on social media. Below is the evidence, the legal framework of Trinidad and Tobago and the local cases physicians should know.

Peptides are an established drug class

Since insulin was introduced almost a century ago, more than 80 peptide drugs have reached the market¹. The obesity trials set the standard of evidence. In STEP 1, 1,961 adults with overweight or obesity lost 14.9 % of body weight with weekly semaglutide versus 2.4 % with placebo at 68 weeks³. In SURMOUNT-1, 2,539 adults lost 15.0 %, 19.5 % and 20.9 % with tirzepatide 5, 10 and 15 mg versus 3.1 % with placebo at 72 weeks⁴. SELECT went further: in 17,604 adults with cardiovascular disease and overweight or obesity but no diabetes, semaglutide reduced cardiovascular death, non-fatal myocardial infarction or stroke by 20 % (hazard ratio 0.80)². An oral form followed: in OASIS 4, 307 adults taking oral semaglutide 25 mg lost 13.6 % of body weight versus 2.2 % with placebo at 64 weeks⁵.

The evidence map: proven versus promising

• Metabolic and weight (GLP-1, GIP agonists): the strongest evidence in the field, with phase 3 weight trials and a cardiovascular outcomes trial²³⁴⁵.
• Repair and recovery (BPC-157, TB-500): a 2025 systematic review found 36 studies on BPC-157, 35 preclinical and one clinical; the authors warned that adverse effects are possible because of unregulated manufacturing, contamination and unknown clinical safety⁷.
• Longevity and cognition (MOTS-c, epitalon, Semax): interesting biology, little human data. In July 2026 the US Food and Drug Administration's compounding advisory committee voted in favour of six of seven peptides it reviewed, including BPC-157, TB-500, MOTS-c, epitalon and Semax⁶.

Safety: what the trials and the alerts show

Approved peptides have well-described safety profiles. In SELECT, 16.6 % of semaglutide patients and 8.2 % of placebo patients stopped treatment because of adverse events²; in OASIS 4, gastrointestinal events occurred in 74.0 % on oral semaglutide versus 42.2 % on placebo⁵. For research peptides the problem is the absence of human data⁷. The bigger risk in the Caribbean is the product itself: when the Ministry of Health warned about falsified Wegovy tablets in February 2026, it told anyone holding them to stop using them and report to the Chemistry, Food and Drugs Division¹⁶.

The law in Trinidad and Tobago: the Food and Drugs Act

1. What counts as a drug. The Food and Drugs Act, Chapter 30:01 (Act 8 of 1960, in force since 1 January 1965), defines a drug as any substance manufactured, sold or represented for the diagnosis, treatment, mitigation or prevention of disease, or for "restoring, correcting or modifying organic functions in man or animal" (section 2). "Sell" includes offering, exposing, holding for sale and distributing. A peptide sold for any of those purposes is a drug under the Act⁸.

2. Advertising and sale. Section 4 makes it an offence to advertise any food, drug, cosmetic or device to the general public as a treatment, preventative or cure for the conditions in the First Schedule, which include obesity, diabetes, high blood pressure, heart diseases, cancer and sexual impotence. Section 9 bans the sale of a drug that is adulterated or made or stored under unsanitary conditions, and section 10 bans labelling, selling or advertising a drug in a way that is false, misleading or deceptive⁸.

3. Inspections, imports and registration. Inspectors may enter premises, take samples and seize articles (section 21), examine customs entries and stop imported drugs from being admitted if their sale would break the Act (section 22). Section 32(2) bars importing a drug unless it conforms to the law of the country where it was made and carries a certificate to that effect. Section 25 lets the Minister make regulations, including ones providing for a register of approved new drugs and for import licences, and section 26 creates the Drug Advisory Committee on drug standards, schedules and conditions of sale⁸.

4. Penalties. Under section 33, an offence carries, on summary conviction, a fine of TT$1,500 and three months in prison for a first offence and TT$3,000 and six months for a later one; on indictment, TT$15,000 and three years⁸.

Who registers, who prescribes, who dispenses

The Chemistry, Food and Drugs Division (CFDD) of the Ministry of Health administers the Act; its Drug Registration Unit accepts new-drug applications on behalf of the Drug Advisory Committee⁹. A 2022 notice to importers sets a fee of TT$750 per drug and says the CFDD relies on prior approval by reference authorities to speed things up: for biologics and large molecules, certificates from agencies such as the EMA, the US FDA, Health Canada and the MHRA. It also stresses that preparing the dossier is the importer's job, not the regulator's¹⁰. Third Schedule drugs "may be supplied only on the authority of a valid prescription issued by a physician, dentist, or veterinarian", according to the Ministry's portal¹¹. Since March 2026 that portal lets the public search more than 10,000 approved drugs¹², although its notice states that inclusion in the database does not by itself constitute permission to import, sell or dispense a drug¹¹.

Physicians answer to the Medical Board of Trinidad and Tobago, which registers doctors and specialists and can suspend or remove them from the register under the Medical Board Act. Its public notice is plain: "It is an offence to practice medicine in Trinidad and Tobago without proper registration"¹⁷.

What has already happened in Trinidad and Tobago

• May 2024: 24 pharmacies under police probe. The Chief Medical Officer told a parliamentary committee that 24 pharmacies had been referred to police for selling unregistered, fake or expired drugs; 280 pharmacies were inspected between February 2023 and April 2024. Ozempic was reported as not registered, with no application in¹⁵.
• January 2025: Ozempic sold through social media. The Ministry referred online Ozempic sales to the police; its principal pharmacist said "the advertising of the Third Schedule is definitely a breach of the Food and Drug Act", and its legal adviser reported 84 referrals of pharmacy breaches, with no one charged yet¹⁴. Days later the Ministry said there were no bureaucratic delays: no registration application had come from Novo Nordisk's local distributor, although an application for a generic version had been received¹³.
• November 2025: a fake specialist charged. A 39-year-old man who advertised cardiothoracic services from an office in Arima was charged with three offences under the Medical Board Act, including diagnosing human ailments without a licence; he pleaded not guilty¹⁸.
• February 2026: falsified Wegovy tablets. The CFDD issued an alert on a falsified version of the oral semaglutide tablet, which the Ministry said was not authorised in Trinidad and Tobago¹⁶.
• 2026: shortages in the public programme. The Health Minister acknowledged supply and distribution problems in the Chronic Disease Assistance Programme, while pharmacy groups reported months-long gaps in metformin, losartan, amlodipine and rosuvastatin²⁰.

What it means for practice

The Ministry's 2024 STEPS survey of 4,052 adults found 61.2 % overweight or obese, with a mean body mass index of 27.8¹⁹. Patients will keep asking, and some will arrive with pens or vials bought through social media. Two tools help: the Ministry's online drug database, to check whether a product is registered¹¹¹², and the CFDD's reporting channel for suspected falsified products and adverse reactions⁹. The physician who knows the evidence, both for and against, and knows the law becomes the reference; if patients do not find that in the consultation room, they will look for it on Instagram.