Prescriptions are issued only when a licensed physician determines that treatment is clinically appropriate for the individual patient. A visit does not guarantee a prescription. Compounded medications are not approved by the FDA and have not been reviewed by the FDA for safety, effectiveness, or quality; a physician prescribes a compounded medication only when the physician determines a patient-specific need. Some medications are prescribed for uses other than their FDA-approved indication, at the physician's discretion. Medications are dispensed by independent licensed pharmacies; Beluga is not a pharmacy. Service and medication availability vary by state.