In brief
  • Shortages ended and warning letters followed for compounded GLP-1 sellers
  • Salt forms, added vitamins and dosing slips change what sits in the vial
  • NextMed faces a $150,000 order while buyers learn what to check

More than 15-fold growth in calls tied to injected weight-loss drugs since 2019 set the scene for regulatory action through 2025 and 2026. Generic semaglutide stays blocked by patents until at least 2032 and tirzepatide until 2036, shortages from 2022 have ended after FDA allowed compounding, and Stanford Medicine reports FDA warning letters to some pharmacies plus an FTC TruHeight matter dated July 15, 2026.

GLP-1 means glucagon-like peptide-1, a gut hormone that supports control of blood sugar and hunger. Worn through the morning like a light layer on skin, GLP-1 receptor agonists copy its action in the body with a steadier signal. Semaglutide brands cover Ozempic, Wegovy and Rybelsus, and tirzepatide brands cover Mounjaro and Zepbound for daily routines.

Versions made by compounders lack the FDA approval carried by brand name drugs on the pharmacy shelf. At the high point in 2024, almost 1 in 3 Americans using a GLP-1 drug reported supply from a compounding pharmacy rather than the brand channel. List prices for patented GLP-1s can run above $1,000 per month, and clinicians say the cost and access pressures pushing people toward compounded versions are genuine and heavy for households to carry.

The mixtures often vary in small tactile ways that still matter for finish and feel. Some compounders work with salt forms like semaglutide sodium, which have not been shown safe and effective in humans or approved by FDA. Many mix in vitamin B12 plus other additions such as B6, niacinamide, glycine or carnitine that have no proven benefit for weight loss or diabetes management. A 2026 study found that tirzepatide compounded with B12 can chemically join, creating a new molecule absent from the FDA-approved drug, a result replicated by Eli Lilly in its own laboratory work.

Measurement carries a separate risk around vials, droppers and small printed labels. The FDA has noted cases in which patients using multidose vials took 10 to 20 times the prescribed amount in error during a home routine. Some compounding pharmacies offer sublingual drops or dissolving tablets of semaglutide or tirzepatide that never underwent study in clinical trials. Poison control centers around the US have logged a more than 15 fold rise in calls tied to injected weight loss drugs since 2019.

The FTC gave final clearance to an order against telehealth provider NextMed and principals Robert Epstein and Frank Leonardo over GLP 1 weight loss programs. In its July 2025 complaint the FTC said NextMed sold weight loss programs with hidden costs, unsupported weight loss claims, fake testimonials and skewed reviews. The final order calls for payment of $150,000, expected to fund consumer refunds, and calls for solid and reliable proof behind claims about average or typical results.

Marina Basina, MD, clinical professor in endocrinology, gerontology and metabolism, said compounded drugs for people using GLP1s without medical supervision pose significant risk and can lead to significant consequences

Written by

Jocelyn Hardy

Jocelyn looks after the brands Second Skin works with and makes sure every sponsored page says so. She spent five years in packaging development for a Brooklyn beauty studio, which is how she knows what a heavy glass jar costs to ship.

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