Peptide profile
TB-500 and Thymosin Beta-4: FDA Status, Research and Uses
Key takeaway
TB-500 is a lab-made 7 amino acid piece of thymosin beta-4, a natural 43 amino acid peptide. TB-500 is not FDA approved, and FDA found no human studies of it. Full-length thymosin beta-4 was tested in small human trials of eye drops, a topical skin treatment and IV doses. WADA bans both in sport [1, 7, 6].
At a glance
Where it stands
Checked
- FDA approvedNoNo approved product
- Pharmacy compounding (503A)HHS interim policyOn HHS's interim enforcement policy (Appendix A), released Oct 28, 2026. HHS does not intend to take action against a state-licensed pharmacy, federal facility or licensed physician compounding TB-500 acetate for subcutaneous or intramuscular injection, with a patient-specific prescription and the policy's other conditions (FDA-registered source with a certificate of analysis, single ingredient, adverse event reporting). It is not FDA approval and not a place on the 503A bulks list; HHS may revisit it if a safety or quality problem arises. The July 2026 advisory committee voted in favor of listing it, and FDA's final rule is still pending.
- Outsourcing facilities (503B)Not nominatedNeither TB-500 nor thymosin beta-4 appears in any 503B category on FDA's 503B list updated March 21, 2025.
- WADA (sport)ProhibitedS2.3 Growth factors and growth factor modulators (thymosin-β4 and its derivatives, e.g. TB-500)
Same data as the Status Tracker. Checked against 11 sources
- HHS: Enforcement Discretion Policy Regarding 503A Compounding Using Certain Peptide Bulk Drug Substances (Appendix A and B)
- Federal Register: HHS notice of availability, FR Doc. 2026-22192 (filed Oct 28, 2026; publishes Oct 30, 2026)
- FDA: Bulk drug substances nominated for use in compounding under section 503A (updated May 14, 2026)
- FDA: Certain bulk drug substances for use in compounding that may present significant safety risks
- FDA: Evaluation of TB-500-related bulk drug substances, PCAC briefing, July 2026
- FDA: PCAC briefing document introduction, July 23-24, 2026
- FDA: Bulk drug substances nominated for use in compounding under section 503B (updated March 21, 2025)
- WADA: 2026 Prohibited List
- openFDA Drugs@FDA query: thymosin (no matches)
- openFDA drug shortages query: thymosin
- DEA Diversion: Controlled Substances - Alphabetical Order
Key facts
- Class
- TB-500: synthetic fragment of thymosin beta-4. Thymosin beta-4: natural actin-binding peptide [1, 7]
- Half-life
- Not established in humans for TB-500. For IV thymosin beta-4, half-life rose as the dose rose in a phase 1 study [1, 10]
- Route in studies
- TB-500: under the skin in horses and intraperitoneal in rats. Thymosin beta-4: eye drops, topical on skin ulcers and IV in human trials [1, 10, 11, 12]
How it works
Thymosin beta-4 is a 43 amino acid peptide first isolated from calf thymus and sequenced in 1981 [7]. It is found in many cell types and in body fluids such as blood, saliva, tears and wound fluid [1]. One of its known roles is to bind G-actin, a building block of the cell's internal skeleton. This helps control cell shape and movement [1].
TB-500 is not the same molecule. It is a synthetic 7 amino acid copy of amino acids 17 to 23 of thymosin beta-4, with an acetyl group added at one end [1]. This short stretch, LKKTETQ, holds the actin-binding site [8]. FDA notes that adding the acetyl group can change how a peptide behaves, so results for the natural fragment cannot simply be applied to TB-500 [1].
In mice, both thymosin beta-4 and the unmodified LKKTETQ fragment were linked to faster skin wound repair [9]. Thymosin beta-4 was also linked to heart cell survival after induced heart attacks in mice [14]. In contrast, a 2024 lab study found TB-500 itself did not speed closure of scratched fibroblast cultures, while one of its breakdown products had a small effect [1, 18]. In horses and rats, TB-500 is broken down into shorter pieces that show up in blood and urine [1, 8].
What the research shows
4 human trials3 animal studies1 lab study
2022Human trial RGN-259 eye drops for neurotrophic keratopathy (Sosne et al.)
18 adults with neurotrophic keratopathy Phase 3, randomized, double-masked, placebo-controlled
Full closure of the corneal defect at 4 weeks in 6 of 10 on drops vs 1 of 8 on placebo. This difference was not statistically significant (p = 0.0656) [13].
Read the study2015Human trial RGN-259 eye drops for dry eye (Sosne and Ousler)
72 adults with moderate to severe dry eye Phase 2, randomized, double-masked, placebo-controlled, 28 days
0.1% thymosin beta-4 eye drops missed both primary endpoints. Some secondary measures improved, and no adverse events were seen [11].
Read the study2010Human trial IV thymosin beta-4 phase 1 (Ruff et al.)
40 healthy adults (4 cohorts of 10) Randomized, placebo-controlled, single dose then 14 daily IV doses
Full-length thymosin beta-4, not TB-500, was tested for safety. Adverse events were infrequent and mild or moderate, with no dose-limiting toxicity [10].
Read the study2010Human trial Topical thymosin beta-4 for venous ulcers (Guarnera et al.)
Studied for venous ulcers
73 adults with venous leg ulcers Phase 2, double-blind, placebo-controlled, dose escalation, 8 European sites
Safety was similar to placebo. Authors suggested a 0.03% dose may speed wound closure [12].
Read the study2012Animal study TB-500 detection in horses (Ho et al.)
Horses Doping-control method study after a single 10 mg dose of TB-500
TB-500 and its breakdown products were found in horse plasma and urine [8].
Read the study2004Animal study Heart repair in mice (Bock-Marquette et al.)
Mice and cultured heart cells Coronary artery tie model plus cell culture
Thymosin beta-4 was linked to better early heart cell survival and heart function after injury [14].
Read the study2003Animal study Skin wounds in diabetic and aged mice (Philp et al.)
Mice and rats Full-thickness skin wound models, topical thymosin beta-4 or LKKTETQ fragment
Thymosin beta-4 and the unmodified 7 amino acid fragment were linked to faster wound repair in aged mice [9].
Read the study2024Lab study TB-500 metabolism and fibroblast scratch test (Rahaman et al.)
Cell culture, human serum and rats Lab metabolism study plus fibroblast wound-closure assay
TB-500 at 50 micrograms per mL did not speed scratch closure vs control. One metabolite caused a small closure [1, 18].
Read the study
Doses used in studies
No human dose of TB-500 has been established, because FDA found no human studies or human exposure data for it by any route [1]. Animal doses include a single 10 mg dose under the skin in horses and 50 mg per kg into the abdomen in rats [1]. The lab study used 50 micrograms per mL in cell culture [1].
Full-length thymosin beta-4 is a different molecule with its own trial doses. A phase 1 study gave 42, 140, 420 or 1260 mg IV daily for 14 days to healthy adults [10]. Eye drop trials used a 0.1% solution [11, 13], and a venous ulcer trial suggested 0.03% as a topical dose [12].
Dosing is set by a licensed provider.
Side effects and safety
FDA says TB-500 may cause immune reactions, especially as an injection, because peptides can clump and may carry impurities [1, 2]. FDA found no clinical studies or human exposure data for TB-500, so its risks in people are unknown [1]. FDA also found no animal toxicity studies of TB-500 [1].
FDA's drug adverse event database (FAERS) had no reports for TB-500. FDA's food and supplement complaint system had two reports about blended TB-500 and BPC-157 products, but they had no safety assessments [1]. There is no FDA label or boxed warning because no TB-500 product is approved [1].
In trials of full-length thymosin beta-4, IV doses up to 1260 mg daily for 14 days had infrequent mild or moderate adverse events [10]. Topical and eye drop trials reported safety similar to placebo or no adverse events [11, 12, 13]. These results apply to thymosin beta-4 under trial conditions, not to TB-500.
Legal and regulatory history
HHS issued an interim enforcement policy for certain peptides used in 503A compounding. Until a final rule decides whether TB-500 goes on the 503A bulks list, HHS does not intend to take action against state-licensed pharmacies, federal facilities or licensed physicians who compound it under the policy's conditions [19]. For TB-500 acetate, the policy covers subcutaneous or intramuscular injectable forms [19]. Conditions include a single active ingredient, bulk substance from an FDA-registered facility with a certificate of analysis, reporting of serious adverse events to FDA and a patient-specific prescription [19]. The policy is not FDA approval and does not place TB-500 on the 503A bulks list [19]. HHS may revisit it if a safety signal or product quality issue arises [19]. A Federal Register notice of availability, which calls the policy a draft, publishes October 30, 2026 [20]. Source
FDA's Pharmacy Compounding Advisory Committee discussed TB-500 for the 503A bulks list, with wound repair as the use reviewed. FDA staff proposed that TB-500 and TB-500 acetate NOT be added. FDA's final decision comes after the committee process [4, 5]. HHS's October 28, 2026 policy states the committee voted in favor of both forms [19]. Source
FDA's 503A categories list, updated May 14, 2026, does not place TB-500 in category 1, 2 or 3. FDA lists it with substances previously in category 2 whose nominations were withdrawn [3, 2]. Source
A Federal Register notice (91 FR 20465) announced the July 2026 advisory committee meeting covering TB-500 [15]. Source
The WADA 2026 Prohibited List took effect. It lists thymosin beta-4 and its derivatives, such as TB-500, under S2.3 growth factors, banned at all times [6]. Source
Common questions
Is TB-500 the same as thymosin beta-4?
Is TB-500 FDA approved?
No. FDA says TB-500 is not part of any FDA-approved drug and has no USP monograph [1].
Can a US pharmacy compound TB-500?
TB-500 is still not on the 503A bulks list and is not FDA approved, and FDA's final rule is pending [1, 3, 19]. FDA staff proposed against adding it in July 2026 [5]. Since October 28, 2026, an HHS interim policy says HHS does not intend to take action against state-licensed pharmacies, federal facilities or licensed physicians who compound TB-500 acetate under set conditions [19]. It covers subcutaneous or intramuscular injectable forms [19]. The policy is not FDA approval, and HHS may revisit it [19].
Has TB-500 been tested in humans?
Is TB-500 banned in sports?
Yes. WADA's 2026 list names thymosin beta-4 and derivatives such as TB-500 under S2.3, banned in and out of competition [6].
What is TB-500 promoted for online?
FDA found sites promoting it for tendon, muscle and wound repair, endurance and more, with no human studies behind those uses [1].
Where did TB-500 come from?
FDA says it appears to have first been made from thymosin beta-4 in 2003. A veterinary version appeared in 2011 for horse and greyhound racing [1].
Sources
- FDA: Evaluation of TB-500-related bulk drug substances, PCAC briefing, July 2026
- FDA: Certain bulk drug substances for use in compounding that may present significant safety risks
- FDA: Bulk drug substances nominated for use in compounding under section 503A (updated May 14, 2026)
- FDA: July 23-24, 2026 meeting of the Pharmacy Compounding Advisory Committee
- FDA: PCAC briefing document introduction, July 23-24, 2026
- WADA: 2026 Prohibited List
- Low et al. 1981, PNAS (PubMed)
- Ho et al. 2012, J Chromatogr A (PubMed)
- Philp et al. 2003, Wound Repair Regen (PubMed)
- Ruff et al. 2010, Ann N Y Acad Sci (PubMed)
- Sosne and Ousler 2015, Clin Ophthalmol (PubMed)
- Guarnera et al. 2010, Ann N Y Acad Sci (PubMed)
- Sosne et al. 2022, Int J Mol Sci (PubMed)
- Bock-Marquette et al. 2004, Nature (PubMed)
- Federal Register: PCAC notice of meeting, April 16, 2026 (91 FR 20465)
- FDA: Bulk drug substances nominated for use in compounding under section 503B (updated March 21, 2025)
- Treadwell et al. 2012, Ann N Y Acad Sci, review (PubMed)
- Rahaman et al. 2024, J Chromatogr B (PubMed)
- HHS: Enforcement Discretion Policy Regarding 503A Compounding Using Certain Peptide Bulk Drug Substances (Oct 28, 2026)
- Federal Register: HHS notice of availability, FR Doc. 2026-22192 (publishes Oct 30, 2026)
