What is the green list of drugs? Understanding the Context

October 8, 2025 •

3 min read

Did you know the term 'green list' for drugs can refer to at least three different and unrelated classifications by international and national regulatory bodies? The answer to What is the green list of drugs? depends entirely on the context, from controlling illegal imports in the US to managing prescribing responsibilities in the UK and regulating international psychotropic substances.

Quick Summary

The "green list" of drugs is a term with multiple meanings, depending on the regulatory context. It can refer to an FDA import alert for GLP-1 drug ingredients, an INCB list of psychotropic substances, or a category within the UK's NHS prescribing system.

Key Points

Multiple Meanings: The term "green list" has different definitions depending on the context and governing body.
FDA Green List: Refers to a U.S. import alert for GLP-1 drug APIs, allowing entry only from FDA-compliant foreign facilities.
INCB Green List: An international reference for psychotropic substances controlled under the 1971 Convention.
NHS Green Category: A component of the UK's "Traffic Light" system for guiding prescribing responsibility, designating drugs suitable for general practitioners.
Context is Key: Misinterpreting the specific 'green list' being referenced can lead to serious confusion, as the lists regulate different substances for different purposes.
Not a Safety Rating: The lists are not a universal safety rating; they are regulatory tools for specific purposes like import control or prescribing authority.

The phrase "green list of drugs" is not tied to a single, universal meaning. Instead, it can refer to several distinct classifications maintained by different national and international organizations. Understanding which body or system is being referenced is critical to interpreting the information correctly. The primary definitions relate to the U.S. Food and Drug Administration (FDA), the International Narcotics Control Board (INCB), and the UK's National Health Service (NHS).

The FDA's Green List for GLP-1 Ingredients

The U.S. FDA established a "green list" as part of an import alert (66-80) to regulate the import of glucagon-like peptide-1 (GLP-1) active pharmaceutical ingredients (APIs). This was done to address safety concerns with illegally imported and compounded versions of GLP-1 drugs.

Key Aspects of the FDA Green List:

Purpose: To protect consumers from potentially dangerous, unverified GLP-1 ingredients.
Criteria: It lists foreign facilities that the FDA has found compliant with its manufacturing standards.
Effect: Only GLP-1 APIs from listed facilities can enter the U.S..
Context: This alert targets APIs for compounding pharmacies and does not apply to finished, FDA-approved drugs.

The INCB's Green List of Psychotropic Substances

The International Narcotics Control Board (INCB) publishes a "Green List" of psychotropic substances regulated under the 1971 Convention on Psychotropic Substances.

Key Aspects of the INCB Green List:

Purpose: To facilitate international control of these substances.
Content: It details four schedules of controlled substances, including synonyms, trade names, and import/export restrictions.
Scope: This is a global regulatory tool for managing legal international trade.
Maintenance: The INCB updates the list regularly.

The NHS "Traffic Light" System for Prescribing

In the UK, many local NHS bodies use a "Traffic Light" system to define prescribing responsibilities. Medicines are categorized as Red, Amber, or Green.

Key Aspects of the NHS Green Category:

Purpose: To define medicines that primary care providers (GPs) can prescribe based on a local formulary.
Inclusion Criteria: Includes common, well-understood medicines appropriate for prescribing within a GP's competency.
Responsibility: The prescriber, usually a GP, takes full responsibility.
Contrast with Other Categories: This differs from Amber drugs (shared care) and Red drugs (specialist use only).

Comparison of Different "Green Lists"


Feature	FDA Green List (GLP-1 APIs)	INCB Green List (Psychotropics)	NHS Green Category (Traffic Light System)
Organization	U.S. Food and Drug Administration (FDA)	International Narcotics Control Board (INCB)	UK National Health Service (NHS)
Jurisdiction	United States	International (member states)	United Kingdom (local ICBs/Trusts)
Purpose	Controls import of GLP-1 drug ingredients for safety.	Manages international control of psychotropic substances.	Guides prescribing responsibilities for healthcare providers.
What is listed?	Foreign facilities authorized to export GLP-1 APIs to the US.	Psychotropic substances regulated by international convention.	Medicines appropriate for prescribing by general practitioners.

Why Context is Crucial

Multiple definitions for "green list" emphasize the need for context. The meaning changes significantly based on whether the discussion involves U.S. importers, international regulators, or UK healthcare professionals. Failing to specify the governing body can cause confusion.

Conclusion

The term "green list of drugs" has no single meaning. It refers to different regulatory categories depending on the context and governing body. Key examples include the FDA's import alert for GLP-1 APIs, the INCB's list of psychotropic substances, and the NHS's prescribing framework. Identifying the specific organization is vital for accurate understanding. Always seek clarification to interpret medical or regulatory information correctly.

For more information on the FDA's recent import alert regarding GLP-1 drugs, you can visit the official FDA press release.

How to Interpret the Green List

To understand which "green list" is being discussed:

Consider the region: Is it the U.S., UK, or international?.
Identify the body: Look for the FDA, INCB, or NHS.
Note the drugs: Are GLP-1s or psychotropics mentioned?.
Determine the purpose: Is it for import control, international regulation, or prescribing guidelines?.

Frequently Asked Questions

The FDA's green list is an import alert to control the entry of GLP-1 active pharmaceutical ingredients (APIs), like those used in semaglutide and tirzepatide, into the U.S. It lists foreign facilities that have been inspected by the FDA and found to be in compliance with U.S. standards.

By detaining APIs from unverified foreign sources, the FDA prevents potentially substandard or unsafe ingredients from entering the U.S. supply chain, thus protecting consumers who might otherwise receive compounded GLP-1 drugs with quality concerns.

The INCB's Green List contains a catalog of psychotropic substances under international control, regulated by the 1971 Convention. It details the four schedules of these substances, along with their synonyms and trade names.

The NHS green category is a domestic UK system that designates which common, well-understood medicines can be prescribed by general practitioners. In contrast, the FDA green list is a U.S. import control measure for specific foreign-sourced GLP-1 drug ingredients.

The other categories are Amber and Red. Amber drugs are suitable for shared care, meaning prescribing can be transferred from a specialist to a GP under a shared-care protocol. Red drugs are for specialist use only.

No. The term 'green list' does not imply a universal safety rating. Its meaning is specific to the regulatory context. For example, the INCB list controls potentially harmful psychotropic substances internationally, while the NHS green category simply defines prescribing responsibility for standard medicines.

Since there isn't one universal 'green list', you must identify which one you need information on. For the FDA list, check the official FDA website. For the INCB list, refer to the INCB's official publications. For NHS prescribing categories, consult the local formulary or website for the relevant Integrated Care System.