Compounded semaglutide and compounded tirzepatide are GLP-1 medicines that a licensed US pharmacy prepares for one patient, based on a clinician's prescription. Both are usually injected once a week, and a licensed clinician decides which one, if either, fits your health history. Here are plain answers to the questions people ask most before they start.
What is compounded semaglutide?
Semaglutide is a GLP-1 receptor agonist. It acts like GLP-1, a hormone your gut releases after you eat. The brand-name semaglutide products are Ozempic and Wegovy, which are FDA-approved drugs owned by their maker.
Compounded semaglutide is made by a state-licensed pharmacy for an individual patient who has a valid prescription. It is not a brand-name product, and it is not a generic version of one.
What is compounded tirzepatide?
Tirzepatide acts on two hormone receptors instead of one: GLP-1 and GIP (glucose-dependent insulinotropic polypeptide). The brand-name tirzepatide products are Mounjaro and Zepbound, which are FDA-approved drugs owned by their maker.
Compounded tirzepatide follows the same path as compounded semaglutide: a licensed pharmacy prepares it for one patient after a clinician writes a prescription. If you are weighing the two, our guide on whether you can choose semaglutide or tirzepatide explains how that decision gets made.
How do GLP-1 medicines act in the body?
GLP-1 medicines act on signals your body already uses around meals. In general, they:
- Send fullness signals to the brain, which can lower appetite.
- Slow how quickly the stomach empties, so food stays with you longer.
- Help the body manage blood sugar after eating.
Tirzepatide adds the GIP signal on top of GLP-1. For a longer walk through the biology, read how GLP-1 medicines act in the body.
Are compounded GLP-1s FDA-approved, and are they legal?
The FDA does not approve compounded drugs, and it does not review them for safety, quality or how well they perform before they are sold. That is a real difference from Ozempic, Wegovy, Mounjaro and Zepbound, and you should know it going in.
Compounding itself is legal. Under section 503A of the federal Food, Drug, and Cosmetic Act, a state-licensed pharmacy may compound a medication for an individual patient who has a valid prescription. The FDA has warned consumers about GLP-1 products sold by unlicensed online sources and by sellers that label them "for research use." Those are not the same path at all. Read our compounded medication disclosure for the details.
What side effects should I know about?
The FDA labeling for brand-name semaglutide and tirzepatide lists these common side effects:
- Nausea, vomiting, diarrhea or constipation
- Stomach pain
- Decreased appetite
- Reactions at the injection site
The same labeling lists serious risks, including pancreatitis, gallbladder problems, low blood sugar (mainly in people also taking insulin or a sulfonylurea), kidney problems from dehydration and serious allergic reactions. It also carries a boxed warning about thyroid C-cell tumors seen in rodents. If something feels wrong, message your clinician, and call 911 in an emergency. Our guide on what to do if you have GLP-1 side effects goes deeper.
How do I take and store it?
Both medicines are usually injected once a week under the skin of the belly, thigh or upper arm. Rotate your injection sites. Compounded vials come in different concentrations, so the number of units you draw depends on your pharmacy label. Never convert milligrams to units yourself; ask your clinician if anything is unclear.
Follow the storage directions on the pharmacy label. Typically that means keeping it in the refrigerator, never freezing it, keeping it away from light and using it before the beyond-use date. Put used needles in a sharps container.
Who can get it, and what does it cost?
Under Beluga Health rules, adults 18 to 80 can be considered. First-time GLP-1 patients need a BMI of 25 or higher, and people already on a GLP-1 can continue with a BMI above 20. You do not need diabetes. It is not a fit if you are pregnant, breastfeeding or trying to conceive, or if you or a family member has had medullary thyroid carcinoma or MEN 2. The clinician makes the final call on your health history.
Plans start from $199/mo, and the price is the same in every state. It is cash-pay, and VevaMD does not bill insurance. Whether an HSA or FSA can be used depends on your plan, so check with your plan administrator. See current pricing for plan details.
Next step
VevaMD is a technology company, not a medical provider or a pharmacy. If you want a licensed clinician to review whether compounded semaglutide or tirzepatide is right for you, start with the free online assessment. It takes a few minutes. Questions first? Call +1 (888) 275-1703 or email info@vevamd.com.
VevaMD is a technology platform, not a medical provider. Educational content only, not medical advice. All prescriptions are written by independent licensed clinicians. Individual results vary.