Since the GLP-1 shortages between 2022 and 2025, regulations surrounding this medication have tightened. During this period, compounding pharmacies had more room to prepare medications such as compounded tirzepatide and compounded semaglutide. Now that the shortages have ended, federal rules generally prohibit routine compounding of these drugs except for certain patient-specific needs.

Understanding the Purpose of GLP-1 Medications

GLP-1 medications are a class of drugs that function by mimicking certain gut hormones involved in appetite and blood sugar regulation, namely either the GLP-1 hormone receptor or both the GLP-1 and GIP receptors. In doing so, the medications can help people feel full sooner while slowing digestion and reducing cravings.

Originally, GLP-1 medications were developed for the treatment of Type 2 diabetes. With an expansion of the market, they are now also widely used for chronic weight management. These mostly consist of once-weekly injections given under the skin, but oral versions have begun to enter the market. As treatment options shift, the medication is increasingly seen as a part of long-term care and lifestyle support.

Two of the most widely used active ingredients are tirzepatide and semaglutide. Tirzepatide is the active ingredient in Mounjaro® and Zepbound®, made by Eli Lilly. It targets both the GLP-1 and GIP hormone receptors. Semaglutide is the active ingredient in Ozempic® and Wegovy®, made by Novo Nordisk. It targets only the GLP-1 receptor. Typically, doses start low and increase gradually under supervision.

Providing Background on Compounding

Compounding is a separate pharmaceutical practice that may be applied to GLP-1 medication and treatments. It refers to the process by which a licensed pharmacist prepares a medication for an individual patient, based on a prescription from a licensed provider. A state-licensed pharmacy that performs patient-specific compounding is known as a 503A pharmacy.

Compounded tirzepatide and semaglutide are available, but they are not the same products and are not FDA-approved. Individualized doses are not FDA-approved. Compounded medications are not approved or evaluated by the FDA for safety, effectiveness, or quality. Such treatments are intended for patients whose clinical needs can’t be met by an FDA-approved product, such as a patient who needs a dose that the brand-name product doesn’t offer.

“FDA is aware that some patients and health care professionals may look to unapproved versions of GLP-1,” the department website states, “as an option for weight loss… Compounded drugs should only be used in patients whose medical needs cannot be met by an FDA-approved drug.”

Exploring Potential Growth in the GLP-1 Market

Although it may currently be a limiting factor for the compounded medication space, the end of the GLP-1 shortage may contribute to general growth in the market. Data from J.P. Morgan suggests that market penetration remains low on the global stage, with only about seven percent of diabetes patients and two percent of the obese population actively using these medications.

J.P. Morgan’s website identifies factors that could push the market forward. “First is the introduction of oral pills, which, along with being easier to use, also remove the necessity of the cold-chain supply. The other factor is that patents for GLP-1s are set to expire in large markets like China, India, Brazil, Canada, and Turkey.”

Additional refinements to the compounding space could find a niche in this potential market expansion. Individualized treatments may be a necessity in cases where typical GLP-1 doses and oral GLP-1 doses are insufficient for a particular patient. Compounded medication represents a small portion of the GLP-1 market, and only a small portion of the potential GLP-1 market uses these medications at all.

Prioritizing Personalization in Care

Compounded GLP-1 medication has shifted toward personalization within the broader market, but it is not the only way to guide patient outcomes. A medical professional who suggests a compounded alternative may also introduce additional guidelines surrounding lifestyle habits. While GLP-1s might be considered a solution to weight management, one’s food choices are still important.

Regardless of medication, food choice can influence how the stomach tolerates that medication, how much fat is potentially lost, and can have possible impacts on blood sugar, energy, and even gut health. Many preferred foods can be gentler on digestion, high in protein, and rich in nutrients, while remaining easy to eat in small amounts.

Identifying the Best GLP-1 Options

Nothing should inform a medical choice more closely than the advice of a licensed professional. Where one might assume that the brand-name medication is sufficient, a provider might identify a compounded alternative as a better solution. Similarly, an injected or oral form may present a better choice. What matters is that an informed decision is made, and that long-term care and lifestyle support are available.

This article is for informational purposes only and does not substitute for professional medical advice. If you are seeking medical advice, diagnosis or treatment, please consult a medical professional or healthcare provider.