When you compose a Bulk SMS in Aesthetix CRM, the message is checked in real time against a list of medication and product names that mobile carriers do not allow in text messages. If the message contains one of these words, a red banner appears under the message box and the Send SMS button is blocked.
This article explains what is blocked, why, and how to rewrite a message so it sends.
Text messaging in the United States and Canada runs on rules set by the mobile carriers, not by Aesthetix CRM. Under the A2P 10DLC framework, every business texting campaign is registered with the carriers, and message content is filtered at the network level.
Bulk marketing blasts are the most heavily scrutinized type of text traffic. Twilio and the mobile carriers watch promotional mass sends far more closely than one-to-one conversations or transactional messages like appointment reminders, so a prohibited word in a marketing blast is where the risk is highest. That is exactly what the Bulk SMS check is built to catch before a send goes out.
Prescription drugs are one of the carrier-prohibited categories. Promotional messaging for any drug that cannot be purchased over the counter is not permitted, and that restriction applies even when the sending business is a licensed medical provider. Carriers also expect that any consent collected for this kind of messaging uses a real date of birth entry for age verification rather than a checkbox. You can review the published category list in the Twilio forbidden message categories reference.
This is the part that surprises most practices: being licensed to administer a medication does not give you permission to name that medication in a text message. The rule is about the drug name traveling over the carrier network, not about whether your practice is authorized to provide the treatment.
The consequences escalate, and they are rarely limited to the one message:
Silent filtering. The carrier accepts the message, reports it as sent, and never delivers it. You are billed for a message the patient never received.
Number blocking. Repeated violations get the sending number blocked at the carrier level. Every message from that number stops delivering, including appointment reminders and confirmations.
Campaign rejection or revocation. Your registered A2P campaign can be rejected or shut down. Re-registration takes weeks, during which your practice cannot text patients at all.
Account level action. Sustained violations put the entire messaging account at risk, which affects every location on the account.
Because bulk marketing sends draw the most scrutiny from Twilio and the carriers, a prohibited word in a marketing blast is the most likely trigger for filtering or a block. And once a carrier blocks your number, the fallout spreads to every message you send, including the appointment reminders and confirmations that patients rely on. For both reasons the checker blocks the send rather than warning and letting it through.
The check runs as you type in the Bulk SMS window:
Green banner: the message passes all checks.
Amber banner: a word needs a second look, but the send is allowed.
Red banner: a prohibited word was found or the opt-out language is missing. The Send SMS button will not fire, and the banner names the exact word it found.
A few details worth knowing:
Whole words only. The checker matches complete words. "Conversation" and "anniversary" contain the filler brand "Versa" as a fragment, and "lemonade" and "Canada" contain "NAD," but none of those trigger a block. Capitalization, punctuation, hashtags, and plurals are all handled, so "BOTOX!", "#botox", and "botoxes" are each caught.
Links are not scanned. A landing page URL is skipped, so a link ending in /botox-specials will not block the send. Carriers do inspect links, though, so a URL containing a prohibited drug name still carries filtering risk. Point to a clean URL when you can.
Opt-out language is required. Every bulk message must tell recipients how to stop. "Reply STOP to unsubscribe" satisfies the check, as does "Text STOP to opt out."
The checker runs on the Bulk SMS action only. It does not scan workflow and automation messages, saved SMS templates, or one-to-one replies in the conversations view. Carrier rules apply to all outbound messaging regardless of where it originates, so review those messages against the same list manually.
116 terms are blocked. They are grouped here the way they are grouped in the checker.
GLP-1 and weight loss medications ozempic, wegovy, mounjaro, semaglutide, tirzepatide, saxenda, victoza, trulicity, rybelsus, zepbound, phentermine, adipex, qsymia, contrave, xenical, orlistat, lomaira, bontril, didrex, tenuate, plenity
Neurotoxins and botulinum products botox, dysport, xeomin, jeuveau, daxxify, botulinum, onabotulinumtoxin, abobotulinumtoxin, incobotulinumtoxin, prabotulinumtoxin, daxibotulinumtoxin
Dermal fillers juvederm, restylane, radiesse, sculptra, belotero, versa, revanesse, rha collection, kysse, voluma, vollure, volbella, defyne, refyne, lyft, galderma, teoxane, stylage
Fat reduction and body contouring injectables kybella, deoxycholic, aqualyx, lipodissolve
Skin treatments and prescription topicals latisse, bimatoprost, tretinoin, retin-a, retina, hydroquinone, kligman, skinmedica
Hormone therapy and peptides testosterone, estrogen, progesterone, estradiol, sermorelin, ipamorelin, cjc-1295, cjc1295, bpc-157, bpc157, thymosin, pt-141, pt141, melanotan, hgh, human growth hormone, somatropin, kisspeptin, gonadorelin, tesamorelin
Controlled substances and anesthetics ketamine, spravato, esketamine, lidocaine, benzocaine
IV therapy ingredients nad+, nad, glutathione, myers cocktail
Sexual health and ED medications viagra, cialis, sildenafil, tadalafil, vardenafil, levitra, stendra, avanafil, trimix, caverject
Hair loss medications finasteride, propecia, minoxidil, rogaine, dutasteride, avodart, spironolactone
Other prescription products accutane, isotretinoin, metformin, naltrexone, prednisone, cortisone, triamcinolone, kenalog
One term produces an amber banner rather than a red one, because it is both a product name and an ordinary English word:
silk (Restylane Silk, but also "silk touch" and "silk peel")
When you see the amber banner, confirm you are using the word in its everyday sense and send.
Carriers restrict the drug and brand name, not the treatment category. Describing what the treatment does keeps the message compliant and usually reads better to patients anyway.
Instead of | Write |
|---|---|
Botox, Dysport, Xeomin, Jeuveau, Daxxify | wrinkle relaxer, neuromodulator, smoothing treatment |
Juvederm, Restylane, RHA, Versa | dermal filler, lip filler, volume restoration |
Sculptra | collagen stimulating treatment |
Kybella | injectable fat reduction, double chin treatment |
Ozempic, Wegovy, semaglutide, tirzepatide | medical weight management, weight loss program |
Testosterone, estrogen, peptide names | hormone optimization, hormone therapy consultation |
NAD+, glutathione, Myers cocktail | IV hydration therapy, IV wellness drip |
Latisse | lash enhancement treatment |
Tretinoin, Retin-A, hydroquinone | prescription skincare, medical grade skincare |
Accutane, isotretinoin | acne treatment program |
Finasteride, minoxidil | hair restoration program |
Viagra, Cialis | sexual wellness consultation |
The most reliable pattern is to invite the patient to a consultation or to your website, where the specific product names can appear freely. Carrier restrictions apply to text messages. Your website, your email, and your phone conversations are not subject to the same content rules.
Do not try to work around the checker. Misspellings, spaces between letters, and symbol substitutions such as "B0t0x" are recognized by carrier filters, and deliberate evasion is treated more severely than an honest mistake. If a message needs a prohibited word to make sense, restructure the message.
Passing the checker is not a guarantee of delivery. Carriers filter on more than a word list:
Public link shorteners. Shared shorteners such as bit.ly and tinyurl are a common filtering trigger. Use a branded short domain or your full practice URL.
Consent. Every recipient of a bulk message must have opted in to receive marketing texts from your practice. Purchased lists and numbers imported from an EMR without documented marketing consent are the most frequent cause of complaints and blocks.
Message volume and patterns. Large sends to unengaged lists draw carrier scrutiny even when the content is clean.
We are a licensed medical practice. Why can we not name a medication we legally administer? Carrier rules restrict promotional messaging for drugs that are not available over the counter, and that restriction applies regardless of the sender's licensure. The rule governs what travels across the carrier network, not what your practice is permitted to provide.
A word was blocked that is part of an ordinary English word. What do I do? That should no longer happen. The checker matches whole words, so "conversation," "anniversary," "specialists," and "Canada" all pass. If you hit a case where a normal word is blocked, send the exact message text to support so the rule can be corrected.
Can we add a word to the list? Yes. Contact support with the word and the reason. Practice specific additions are common, particularly for newer products that reach the market before the list is updated.
Can we remove a word from the list? Removals are reviewed case by case. Because bulk marketing sends draw the most carrier scrutiny and a resulting block can spread to all of your messaging, the default answer is to keep the term blocked and rewrite the message instead.
Does this apply to email campaigns? No. Carrier content rules govern SMS and MMS only. Email campaigns can name products and medications freely, subject to your own advertising and medical claims obligations.
Does this apply to messages a patient sends us? No. Inbound messages from patients are never blocked. A patient can ask about any product by name. Be aware that your reply is outbound messaging and is subject to the same carrier rules, even though replies in the conversations view are not scanned by this checker.
What about images in an MMS? Images are not scanned. A graphic containing a prohibited product name carries the same carrier risk as the text would, so apply the same standard to your creative.
Does a message that passes the checker always get delivered? No. The checker prevents the most common and most damaging violations, but carriers apply their own filtering to content, links, sending patterns, and consent history. Treat a green banner as a floor, not a guarantee.
Where else in the platform do these rules apply? Everywhere you send outbound text messages, including workflows, automations, templates, and one-to-one replies. The automated check currently runs on Bulk SMS only, so review other message sources manually.
If a message is being blocked and you are not sure how to rewrite it, contact support with the message text and we will suggest compliant wording. For questions about A2P registration status, carrier filtering on a specific campaign, or adding and removing terms from the blocked list, open a support ticket and include your account name and the sending number involved.
