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Compounded Updated May 2026

Compounded Semaglutide / Tirzepatide

503A/503B pharmacies

Compounded versions available during FDA shortage via 503B-certified pharmacies.

Compounded Semaglutide / Tirzepatide medication illustration

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Freshness status: Fresh (28 days since review)

Clinical change log

Substantive medical-content updates are tracked here for transparency. See our methodology and disclosures.

  1. 2026-05-22T00:00:00Z UTC · Reviewed by Anika Reyes, MD

    What changed:Reviewed and updated medication clinical sections (mechanism, evidence, dosing/safety) for medical accuracy and current regulatory context.

    Source impact:Revalidated primary citations and prescribing-label references; no reduction in source rigor.

Clinical guidance, pricing, and eligibility vary by patient profile and prescribing context. We may earn from partner links, but compensation does not change editorial scoring. See our methodology and disclosures.

HIPAA Compliant Protected health data
503B Pharmacy Licensed compounding
Board Reviewed Medical oversight
FDA Registered Regulated facilities
Avg. weight loss Varies
Dose range Custom
Cadence Weekly

How it works

Compounded GLP-1 medications contain the same active ingredients as brand-name drugs but are prepared by licensed compounding pharmacies during FDA-declared shortages. [26] Quality varies by pharmacy — 503B outsourcing facilities are held to higher cGMP standards than 503A pharmacies. The SURMOUNT-1 trial for tirzepatide demonstrated up to 22.5% weight loss, which patients may seek through compounded alternatives when branded drugs are unavailable. [32]

Clinical trial evidence

No independent trials [?]
N/A Efficacy inferred Based on branded drug data (STEP/SURMOUNT programs)
Full trial details
No independent clinical trials for compounded versions exist. Efficacy is inferred from brand-name drug trials (STEP program for semaglutide, SURMOUNT program for tirzepatide). [1] Quality and bioequivalence vary by pharmacy — 503B outsourcing facilities are held to cGMP standards with FDA oversight, while 503A pharmacies operate with less regulatory scrutiny. [27] FDA has issued warning letters to compounders for quality violations, incorrect active ingredients, and unsanitary conditions. [28] Patients should be aware that compounded products are not FDA-approved, even when they contain the same active pharmaceutical ingredient as a branded drug.
Bar chart comparing average weight loss: Semaglutide 15%, Tirzepatide 21%, Retatrutide 24% at 68-72 weeks
Average body weight reduction from pivotal clinical trials. Individual results vary significantly based on adherence, diet, and baseline weight.

FDA approval status

Ongoing Legal under 503A/503B During FDA-declared drug shortages only
2024-25 FDA crackdowns Warning letters for quality violations, unauthorized ingredients
Full approval details
Legal under FDA Section 503A and 503B during declared drug shortages. [27] FDA maintains an official shortage list — compounded versions are permitted while branded drugs remain listed. [23] FDA has cracked down on compounders using unauthorized ingredients (e.g., tirzepatide salt forms instead of the approved free-base form) and those making false advertising claims. [29] Patients should verify their pharmacy's 503B registration on the FDA website and request a Certificate of Analysis (CoA) for each batch. Compounding is intended to fill gaps during genuine shortages — once shortages resolve, compounded versions should no longer be prescribed.

Side effects

Common side effects

Most side effects are mild and temporary, typically occurring during dose escalation. Contact your prescriber if symptoms persist.

BOXED WARNING

Same thyroid C-cell tumor risk as GLP-1 therapies. Additional risk from uncertain product quality.

Common side effects

Same as branded Varies
Quality varies Depends on compounding pharmacy

Serious side effects

FDA reports of adverse events from improperly compounded products: incorrect dosing, contamination, non-pharmaceutical-grade ingredients. Some products found with no detectable active ingredient.

Source

Full side effects details
Same active pharmaceutical ingredient as branded products, so the side effect profile is expected to be comparable. [6] However, quality control varies: there have been FDA reports of adverse events from improperly compounded products including incorrect dosing, contamination, and use of non-pharmaceutical-grade ingredients. [28] Some compounded products have been found to contain no detectable active ingredient at all. [30] A 2024 review of regulatory findings highlighted that quality and safety concerns remain significant for compounded GLP-1 products, emphasizing the importance of sourcing from 503B-certified facilities. [33] Patients should be vigilant about product quality and report any unexpected side effects to both their prescriber and the FDA MedWatch program.

Titration schedule

Follows the same titration protocol as branded equivalents, adjusted by the prescribing clinician. Dose availability and concentration may differ from branded products — some compounders offer custom concentrations not available commercially. Always verify the dose (mg/mL) matches the prescribed titration schedule. Because compounded products may come in different vial sizes and concentrations than branded products, patients should carefully confirm dosing instructions with their prescribing clinician and pharmacist at each fill.

Contraindications and warnings

Same as the branded equivalent (see semaglutide or tirzepatide contraindications above). [7] Additional concerns specific to compounded products: verify pharmacy 503B registration on the FDA website, request a Certificate of Analysis (CoA) for each batch, confirm the active ingredient matches the prescribed drug (not a salt form or unauthorized variant), and check the FDA drug shortage list to confirm legal compounding status. [31] Patients should avoid any compounder that cannot provide batch-level testing documentation.

Providers that offer Compounded Semaglutide / Tirzepatide

The following providers from our comparison carry this medication. Pricing and availability are verified May 2026.

Found 9.3/10
$149/mo starting Free shipping
Visit Found → Read full Found review
Hims 9.1/10
$199/mo all-in Free shipping
Visit Hims → Read full Hims review
Ro 8.8/10
$199/mo starting Free shipping
Visit Ro → Read full Ro review
Calibrate 8.6/10
$199/mo Free shipping
Visit Calibrate → Read full Calibrate review
Alan Meds 8.3/10
$189/mo Free shipping
Visit Alan Meds → Read full Alan Meds review
Lovely Meds 8/10
$99/mo starting Free shipping
Visit Lovely Meds → Read full Lovely Meds review
Gala 8.5/10
$179/mo on yearly plan Free shipping
Visit Gala → Read full Gala review
Henry Meds 8.4/10
$247/mo on 12-month plan Free shipping
Visit Henry Meds → Read full Henry Meds review

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FAQ — Common questions about Compounded Semaglutide / Tirzepatide

What is compounded semaglutide or tirzepatide?

Compounded versions are made by licensed pharmacies during FDA drug shortages. They contain the same active ingredient but are not brand-name products. They must meet USP compounding standards.

Is compounded GLP-1 medication legal?

Yes, compounding is legal during FDA-declared drug shortages when performed by licensed pharmacies (503A or 503B certified). The FDA maintains a shortage list that determines eligibility.

What is the difference between 503A and 503B pharmacies?

503A pharmacies compound on a patient-specific basis and are regulated by state boards. 503B outsourcing facilities can compound without individual prescriptions and are regulated by the FDA under cGMP standards. We generally recommend 503B-certified pharmacies for better quality assurance.

How do I verify my compounded GLP-1 is legitimate?

Request a Certificate of Analysis (CoA) from the dispensing pharmacy. Verify the pharmacy is licensed in your state and, ideally, 503B-certified. Check that the provider conducts clinician intake and contraindication screening before prescribing.

References

  1. [1]Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002. PubMed 33567485
  2. [6]U.S. Food and Drug Administration. Ozempic (semaglutide) Prescribing Information. Novo Nordisk Inc. Revised 2024. FDA Label
  3. [7]U.S. Food and Drug Administration. Wegovy (semaglutide) Prescribing Information — Boxed Warning: Thyroid C-cell Tumors. Novo Nordisk Inc. Revised 2024. FDA Label
  4. [23]U.S. Food and Drug Administration. FDA Drug Shortages Database. Updated 2025. FDA Drug Shortages
  5. [26]U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers. FDA.gov
  6. [27]U.S. Food and Drug Administration. Section 503B Outsourcing Facilities — Drug Quality and Security Act (DQSA) of 2013. FDA.gov
  7. [28]U.S. Food and Drug Administration. FDA Warning Letters to Compounding Pharmacies — GLP-1 Products. 2024-2025. FDA Warning Letters
  8. [29]U.S. Food and Drug Administration. FDA Alert: Compounded Tirzepatide — Salt Forms and Unauthorized Variants. December 2024. FDA Safety Alert
  9. [30]U.S. Food and Drug Administration. FDA MedWatch: Adverse Event Reports for Compounded GLP-1 Products. 2023-2025. FDA MedWatch
  10. [31]National Association of Boards of Pharmacy (NABP). Verification Guide for 503B Outsourcing Facilities. Updated 2025. NABP
  11. [32]Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med. 2022;387(3):205-216. PubMed 35658024
  12. [33]Sujeeth S, Chen X, Kim M, et al. Quality and safety considerations for compounded GLP-1 receptor agonists: A review of regulatory findings. J Pharm Sci. 2024;113(8):2145-2158. PubMed 38641529

Claim-to-Source Traceability

Reviewer attribution: Anika Reyes, MD

  1. [26] Quality varies by pharmacy — 503B outsourcing facilities are held to higher cGMP standards than 503A pharmacies.

    Sources: [26]

  2. [32]

    Sources: [32]

  3. [1] Quality and bioequivalence vary by pharmacy — 503B outsourcing facilities are held to cGMP standards with FDA oversight, while 503A pharmacies operate with less regulatory scrutiny.

    Sources: [1]

  4. [27] FDA has issued warning letters to compounders for quality violations, incorrect active ingredients, and unsanitary conditions.

    Sources: [27]

  5. [28] Patients should be aware that compounded products are not FDA-approved, even when they contain the same active pharmaceutical ingredient as a branded drug.

    Sources: [28]

  6. [27] FDA maintains an official shortage list — compounded versions are permitted while branded drugs remain listed.

    Sources: [27]

  7. [23] FDA has cracked down on compounders using unauthorized ingredients (e.

    Sources: [23]

  8. [29] Patients should verify their pharmacy's 503B registration on the FDA website and request a Certificate of Analysis (CoA) for each batch.

    Sources: [29]

  9. [6] However, quality control varies: there have been FDA reports of adverse events from improperly compounded products including incorrect dosing, contamination, and use of non-pharmaceutical-grade ingredients.

    Sources: [6]

  10. [28] Some compounded products have been found to contain no detectable active ingredient at all.

    Sources: [28]

  11. [30] A 2024 review of regulatory findings highlighted that quality and safety concerns remain significant for compounded GLP-1 products, emphasizing the importance of sourcing from 503B-certified facilities.

    Sources: [30]

  12. [33] Patients should be vigilant about product quality and report any unexpected side effects to both their prescriber and the FDA MedWatch program.

    Sources: [33]

  13. [7] Additional concerns specific to compounded products: verify pharmacy 503B registration on the FDA website, request a Certificate of Analysis (CoA) for each batch, confirm the active ingredient matches the prescribed drug (not a salt form or unauthorized va

    Sources: [7]

  14. [31] Patients should avoid any compounder that cannot provide batch-level testing documentation.

    Sources: [31]

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