What a compounded GLP-1 is
A compounded GLP-1 is semaglutide or tirzepatide prepared by a state-licensed compounding pharmacy for an individual patient’s prescription. It is not Wegovy or Zepbound, and not a generic of either. A compounding pharmacy prepares it, and compounded drugs are not FDA-approved: the FDA does not review them for safety, effectiveness or quality before they are sold.
What changed in 2025 and 2026
During the GLP-1 shortages, the FDA allowed pharmacies to make copies of the brand drugs. That ended once the shortages were declared over.
| Date | What happened |
|---|---|
| Dec 19, 2024 | FDA confirms the tirzepatide shortage is resolved. |
| Feb 21, 2025 | FDA declares the semaglutide shortage resolved. |
| Apr–May 2025 | Grace periods for pharmacies end; courts decline to block the FDA. |
| Sep 2025 | FDA sends more than 50 warning letters, largely over claims that compounded drugs are the same as approved ones. |
| Mar 3, 2026 | FDA warns 30 more telehealth companies; over 70 warned in six months. |
| Apr 30, 2026 | FDA proposes excluding semaglutide, tirzepatide and liraglutide from the 503B bulk list. |
Today, a 503A pharmacy can still compound for an individual patient with a prescription, but it may not regularly make what are essentially copies of a commercially available drug. A prescriber can document a significant clinical difference for a specific patient, such as a dose the brand does not offer.
How to choose a compounded program carefully
- Ask which pharmacy fills your prescription, and check that it is state-licensed. Some programs name the pharmacy before you pay.
- Be wary of “same as Wegovy” claims. The FDA has warned companies for saying compounded drugs are generic or equivalent to approved drugs.
- Look for a real clinical review and a clinician who adjusts your dose over time.
- Check LegitScript certification and read the refund terms before you prepay.
For what it costs, read How much does compounded tirzepatide cost per month?. For the steps, read How to get the Wegovy pill online.
Common side effects
Stomach-related side effects are the most common, especially while the dose is going up. Compounded versions have no trials of their own; these are the brand labels’ rates, people on the medication vs placebo.
Scroll sideways to see the full table
| Side effect | Wegovy 2.4 mg | Zepbound 5–15 mg | Foundayo |
|---|---|---|---|
| Nausea | 44% vs 16% | 25–29% vs 8% | 26–35% vs 10% |
| Diarrhea | 30% vs 16% | 19–23% vs 8% | 21–25% vs 11% |
| Vomiting | 24% vs 6% | 8–13% vs 2% | 13–24% vs 4% |
| Constipation | 24% vs 11% | 11–17% vs 5% | 20–27% vs 9% |
| Abdominal pain | 20% vs 10% | 9–10% vs 5% | 13–14% vs 7% |
| Fatigue | 11% vs 5% | 5–7% vs 3% | 6–9% vs 4% |
| Hair loss | 3% vs 1% | 4–5% vs 1% | 4–5% vs 2% |
Source: Wegovy (rev. 06/2026), Zepbound (rev. 08/2026) and Foundayo (rev. 07/2026) prescribing information.
Safety: GLP-1 medications carry a boxed warning for thyroid C-cell tumors and are not for people with a personal or family history of medullary thyroid carcinoma or MEN 2. Labels also warn about pancreatitis, gallbladder problems, low blood sugar with some diabetes drugs, kidney problems from dehydration and severe stomach problems. Talk to a licensed clinician about your history.
Legal status: Prescription only; compounded and not FDA-approved.