Houston Pharmacy Recalls Compounded Glutathione Across 14 States, the Second Texas Endotoxin Recall in Two Weeks

A compounded injectable widely marketed through wellness, longevity and IV-therapy channels is the subject of a second safety recall in about two weeks. On August 19, 2026, Optimal Balance Pharmacy of Houston, Texas announced a voluntary nationwide recall, to the patient level, of one lot of its Compounded Glutathione 200 mg/mL 30 mL multi-dose vials after the pharmacy's own testing identified elevated bacterial endotoxin levels. The FDA published the recall notice on August 20, 2026. Because compounded glutathione is frequently prescribed and shipped to patients through telehealth and med-spa channels, the recall is relevant to anyone who obtained an injectable glutathione product from the affected lot.

What was recalled

The recall covers Optimal Balance Pharmacy's Compounded Glutathione 200 mg/mL supplied in 30 mL multi-dose vials. According to the recall notice, the affected lot is LG342009076, with an expiration date of October 4, 2026. The recall is described as voluntary and nationwide, conducted to the patient level, which means the pharmacy is seeking return of product already dispensed to individual patients rather than only pulling stock from distributors.

The notice states the product was distributed to consumers in 14 states: Arizona, Colorado, Florida, Illinois, Louisiana, Michigan, New York, Nevada, Oklahoma, Pennsylvania, Texas, Utah, Vermont and Washington. Patients who have a vial from the affected lot are directed to stop using it immediately, set it aside, and arrange return or disposal through the pharmacy.

Why it was recalled

The stated reason is that pharmacy testing identified elevated bacterial endotoxin levels in the affected product. Endotoxins are components of certain bacteria that can trigger a strong inflammatory response when introduced into the bloodstream, even when no live organisms are present. Per the recall notice, there is a reasonable probability that injectable products with elevated endotoxin levels could cause significant medical events including fevers, hypotension, inflammatory reactions, anaphylactic shock and death. That is the stated risk profile for elevated-endotoxin injectables generally, as described in the recall notice, not a claim that every exposed patient will experience harm.

Reported adverse events

The pharmacy says that, to date, it has received reports of adverse events associated with the product. The reported effects listed in the notice include fever, chills, severe headache, nausea, vomiting, pain and symptoms consistent with an allergic reaction. These are reports received by the pharmacy rather than confirmed, adjudicated case counts, and the notice does not state how many patients were affected or the severity of individual cases.

The second Texas recall in two weeks

This recall follows a closely similar one earlier in the month. On August 5, 2026, Victory Medical Center Pharmacy of Austin, Texas recalled three lots of the same 200 mg/mL compounded glutathione formulation, also to the patient level, and also citing elevated bacterial endotoxin found in the pharmacy's own testing. Our earlier report on the Victory Medical Center recall covers that action, which the notice said reached patients in Texas, Florida and New York.

The two recalls are separate, pharmacy-initiated actions by different companies rather than a single FDA enforcement step. Neither notice reviewed here states a final FDA recall classification, which the agency typically assigns after a recall is announced. What the two share is the same product category, the same stated defect (elevated endotoxin), and the same distribution model: an injectable compounded in Texas and shipped to patients across multiple states.

A recurring concern with compounded glutathione injectables

Federal regulators have flagged injectable glutathione before. In a June 2019 communication, the FDA raised concerns about using the dietary ingredient glutathione to compound sterile injectable drugs, after testing found glutathione samples containing excessive bacterial endotoxin and after the agency received reports of patients who experienced reactions following glutathione injections. The FDA's broader point was that an ingredient marketed for use in orally taken dietary supplements may not be suitable for sterile injectable compounding, because ingredients not intended for that use can carry impurities and contaminants, including endotoxins. Injectable glutathione is not an FDA-approved drug and is commonly marketed as an antioxidant, immune-support or skin-brightening product.

Why this matters for telehealth patients

Injectable glutathione is frequently prescribed through telehealth wellness clinics, longevity practices and IV-therapy providers, then shipped directly to patients. That distribution model means an affected patient may not have a local pharmacist to consult and may be several steps removed from the compounding pharmacy that prepared the product. A patient-level recall for a mailed injectable therefore depends on the pharmacy reaching each recipient across the states where the product was shipped. Optimal Balance Pharmacy says it is notifying patients and arranging for return and disposal of the recalled lot.

What affected patients can do

This is general information, not medical advice. If you have an injectable glutathione product, these steps follow the guidance in the recall notice and standard FDA reporting channels:

• Check whether your vial is Optimal Balance Pharmacy Compounded Glutathione 200 mg/mL (30 mL multi-dose) from lot LG342009076, expiration October 4, 2026, and stop using it if so.
• Set aside (quarantine) any affected product and contact Optimal Balance Pharmacy about the recall and return of product. The recall notice lists a pharmacy contact line of (218) 919-2964, 9 a.m. to 5 p.m. Central time, Monday through Friday.
• If you have used product from the affected lot and feel unwell, contact your prescribing clinician or seek medical care; the notice describes potential reactions ranging from fever and chills to more serious events.
• Report any adverse event to the FDA's MedWatch program online or by calling 1-800-332-1088.
• Ask any telehealth, wellness or compounding provider how they source and test injectable products, including whether each batch is tested for bacterial endotoxin.