What compounded GLP-1s are
Compounded medicines are made by a pharmacy rather than the brand manufacturer. During the 2022–2024 shortages of semaglutide and tirzepatide, federal law let compounding pharmacies make copies, and many online clinics sold them for well under brand prices.
Compounded drugs are not FDA-approved. The FDA doesn't review them for safety, effectiveness or quality before they're sold.
What changed
The FDA declared the tirzepatide shortage resolved in October 2024 (reaffirmed December 2024) and the semaglutide shortage resolved on February 21, 2025. Grace periods for making copies ended in early-to-mid 2025.
Since then, compounding pharmacies can generally only prepare versions that are meaningfully different for an individual patient's documented medical need. In 2026 the FDA sent warning letters to dozens of telehealth companies, largely over marketing that implied compounded products were the same as, or made by, the brand manufacturer. In April 2026 it also proposed removing semaglutide, tirzepatide and liraglutide from the list of substances larger outsourcing facilities can compound.
Litigation and FDA proposals were ongoing as of October 2026. Check the FDA's current guidance before relying on a compounded product.
Risks to weigh
- Dosing errors. The FDA has received reports of overdoses from compounded semaglutide, often because of confusion between units and milligrams when drawing up a dose.
- Quality varies. Potency and purity depend on the pharmacy. Some products used salt forms of semaglutide that aren't in approved drugs.
- Price gap is smaller. With brand pills from $149 and Zepbound vials from $299, brand-name medicine is now much closer in price.
If you're considering one
- Ask which pharmacy compounds it and confirm that pharmacy is licensed in your state.
- Be wary of products sold as "research use only" or without a prescription.
- Make sure the dose is written in milligrams and you know exactly how to measure it.
- Compare the total cost with brand-name self-pay prices first. See the cost guide.
We screened compounded programs for named pharmacies, LegitScript certification and FDA warning letters. See the programs that passed.
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