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Explainer 03

GLP-1s and the compounding question.

GLP-1 medications — like semaglutide and tirzepatide — exist both as FDA-approved brand products and as compounded copies made by pharmacies.

Why compounded versions exist

Shortages and cost. That's the honest answer. But compounded versions are not FDA-approved, and quality varies by the pharmacy making them — which is why it's fair to ask whether that pharmacy is a 503A or 503B facility before you agree to anything.

The rules move

Regulations around compounded copies change as brand supply changes. What a clinic could legally sell last year may not be permitted now. A clinic that can explain where things currently stand is telling you something about how closely it is paying attention.

Questions to ask

Ask these before you pay

  • Brand or compounded — and which pharmacy?
  • What exact form of the drug? The FDA has flagged some salt forms.
  • What screening do you do before prescribing?
  • What is the monitoring plan for side effects — GI issues, gallbladder, muscle loss?
  • What is the maintenance plan if I stop?
Red flags

Signals to take seriously

  • No health screening and no conversation about BMI.
  • No discussion of side effects.
  • 'No prescription needed.'
  • A clinic that will not name its pharmacy.

Educational only — not medical advice. Always consult a licensed clinician.