Used to Getting Compounded GLP-1s? Here’s What the FDA’s New Rule Means for You
- Jennifer Hardy
- Mar 29
- 7 min read
Updated: 2 days ago
The access to GLP-1s through compound pharmacies took an abrupt turn in March 2025, leaving potentially millions of people scrambling to find affordable continuations of medications like semaglutide and tirzepatide.
The GLP-1 market has surged in recent years as iterations approved for diabetes, weight loss, and obstructive sleep apnea (OSA) became pricy but practical potential solutions for related health issues. If your insurance covers your GLP-1, nothing will change. For those like me, who it won't, it's time to figure out how to get the next dosage.
The FDA has ruled that most state-licensed compounders can no longer legally produce tirzepatide, effective immediately, while compounded semaglutide remains allowed until at least April 22, 2025—meaning patients who relied on compounded GLP-1s may need to transition to FDA-approved medications soon.
What is a GLP-1?
GLP-1 medications, short for glucagon-like peptide-1 receptor agonists, started as treatments for type 2 diabetes but quickly became game-changers for weight loss.
They work by mimicking a gut hormone that tells your brain you’re full, slows digestion, and helps regulate blood sugar. Think of them as a built-in appetite brake.
Drugs like Ozempic, Wegovy (semaglutide), and Mounjaro, Zepbound (tirzepatide) have skyrocketed in popularity, sometimes outpacing supply. The popularity was also due to high-profile people like Rebel Wilson, Charles Barkley, and Tracy Morgan touting the benefits.
What Is a Compound Pharmacy?
A compounding pharmacy customizes medications by mixing, altering, or combining ingredients to meet individual patient needs.
Unlike standard pharmacies that dispense mass-produced drugs, compounders create tailored formulas—like adjusting dosages, removing allergens, or making liquid versions of pills. They played a big role in producing semaglutide and tirzepatide when demand outpaced supply, which was legally legit.
Compound pharmacies also charged about half the price of the name-brand versions. That's because they bypass patents and high manufacturing costs while also using raw ingredients instead of name-brand formulas.
This is important to note because a one-month supply of GLP-1s can be upwards of $1000. Insurance is more likely to cover the medications for diabetes, but trying to get them to pay for the weight loss versions was hit or miss (and a lot of miss).
Why Compound Pharmacies Can't Make Semaglutide and Tirzepatide Anymore
When GLP-1 medications like semaglutide and tirzepatide were in short supply, compound pharmacies stepped in to create alternative versions. However, under section 503A of the Federal Food, Drug, and Cosmetic Act (FD&C Act), pharmacies can only compound a drug if it is listed on the FDA’s drug shortage list—once the shortage is resolved, compounding becomes illegal.
The FDA removed tirzepatide from its drug shortage list on December 19, 2024, and semaglutide on February 21, 2025, indicating that the supplies of these GLP-1 medications have stabilized. Both were on the shortage list for two to three years.
While compound versions gave patients more affordable access, it also raised concerns about safety, consistency, and legality, particularly from the FDA and drug manufacturers like Novo Nordisk and Eli Lilly.
For a time, enforcement for tirzepatide was put on hold due to legal challenges, including a lawsuit from the Outsourcing Facilities Association (OFA) v. FDA, which sought to delay restrictions on compounded tirzepatide.
However, a recent court ruling denied an injunction request, allowing the FDA to proceed with enforcement.
The FDA Ruling & Enforcement of Compounded GLP-1s
When the FDA released the March 11 update, it specifically mentioned the impacts on tirzepatide and semaglutide, which are on separate timelines.
As of March 5, 2025, state-licensed pharmacies and physicians can no longer legally compound tirzepatide after a court denied an injunction that would have delayed FDA enforcement.
However, outsourcing facilities—larger compounding operations—have until March 19, 2025, before enforcement begins. After that date, most compounded versions of tirzepatide will no longer be legally available.
For semaglutide, the timeline is a bit longer. State-licensed pharmacies and physicians can continue compounding it until at least April 22, 2025, unless a court ruling extends that deadline.
Outsourcing facilities have a little more time, with May 22, 2025, as their current cutoff date—again, unless ongoing litigation changes the enforcement timeline.
What If My Compound Pharmacy Still Offers GLP-1s?
I started my GLP-1 journey with compounding pharmacies and nutritional guidance from Ashley at Legg Day Fitness. I spent two months on the compounded tirzepatide before switching to Eli Lilly Direct.
Each compound pharmacy has its own take on what the letter of the law says. For example, the hook for compounding name-brand drugs rests on avoiding making "essentially a copy."
Using that wording, some places believe that creating different doses than the FDA-approved versions is "not a copy." Instead of starting with a maintenance dose of 2.5mg and a dose up to 5mg, a compound pharmacy might start at 3.3mg and dose up to 6.6mg.
Another tactic some compounding pharmacies use is labeling GLP-1 medications as "not fit for human consumption." They believe this sidesteps FDA regulations on safety, efficacy, and marketing. This disclaimer allows them to sell peptides and research chemicals without meeting strict pharmaceutical standards, often exploiting legal loopholes in compounded, off-label, or research-use-only classifications to avoid regulatory scrutiny.
Certain compounders have also modified the chemical form of semaglutide, using variations like semaglutide sodium or acetate salts. The FDA has not evaluated these altered compounds for safety or efficacy.
I found it's important to ask—not just the person who answers the phone at your pharmacy—but the actual pharmacist or pharmacy owner. They are all likely getting legal guidance from attorneys and will choose their own path. My pharmacy owner was very clear about why they believed they were within legal guidelines before the recent ruling.
What the Ruling Means for Consumers Using Compounded GLP-1s
The FDA's enforcement isn't targeted at consumers. If a compounding pharmacy continues to sell tirzepatide or semaglutide after enforcement deadlines, the pharmacy—not the patient—faces legal and regulatory consequences, which could include fines or losing their license.
At the same time, those used to compounded versions will either have to stop taking the medication or get it through the maker-approved options.
I switched to Eli Lilly Direct for Zepbound which I take for OSA. The price has dropped to a point where it ended up being almost $100 cheaper than my compound pharmacy in the Midwest. Plus, I saved $40 on shipping.
Where to Find Affordable GLP-1s Now?
When it comes to semaglutide or tirzepatide, "affordale" isn't always the same as "cheap." The price has decreased substantially in some areas; you just need to know where to look.
Novo Nordisk makes Ozempic (semaglutide for diabetes), Wegovy (semaglutide for weight loss), and Rybelsus (oral semaglutide).
Eli Lilly manufactures Mounjaro (tirzepatide for diabetes) and Zepbound (tirzepatide for weight loss).
Getting the auto-injector pens for Zepbound (without insurance covering it) would cost me $1,119 a month for the auto-injector pens. Using Eli Lilly Direct, I paid $504 for the vials and the supplies to give myself injections.
To find the lowest GLP-1 price near you, here's my list of tips, assuming you can't get insurance to cover it:
Apply through insurance, then appeal if denied. While I didn't have success with this particular appeal, I've won most of my insurance appeals over the past decade. Plus, a mountain of paperwork sends a message of how many people want affordable access to this potentially life-saving medication.
Look for savings with discount cards like GoodRx. While the price was still painful for me, it was about 10-30% cheaper out of pocket if I had gone that route.
See what options the manufacturer offers. Eli Lilly offers saving options on the Zepbound website, but Eli Lilly Direct lowered prices in early 2025. Wegovy's manufacturer also offers a discount (but still about $650 a month), but opened NovoCare Pharmacy, cutting the cash price to $499 a month.
Maximize the Benefits of GLP-1s
As a journalist, I was able to find a lot of great information by digging. I want to share that with you to help on your journey. After all, if we're paying that much for medication, we might as well make real lifestyle and personal adjustments to maximize the benefits.
Take Collagen
Have you heard of Ozempic face? Rapid weight loss from GLP-1 medications can lead to a loss of collagen, making skin appear looser or more aged. Supplementing with collagen may help maintain skin elasticity, support muscle retention, and promote gut health.
Foods rich in collagen include bone broth, chicken skin, fish skin, beef with connective tissue, and gelatin, while egg whites, citrus fruits, berries, bell peppers, leafy greens, and tomatoes support collagen production by providing essential amino acids and vitamin C. We recommend that you try Ancient Nutrition Collagen Peptides.
Add Vitamin B6 to Your Routine
Vitamin B6 plays a key role in metabolism by helping the body convert food into energy more efficiently. This can be useful when appetite suppression leads to lower calorie intake. It also supports digestion to regulate stomach acid and overall gut function.
Foods rich in B6 include chicken, fish, bananas, potatoes, and fortified cereals. You can also get a bottle of B6 for less than $10.
Prepare Protein-Rich Meals & Snacks
GLP-1 medications reduce appetite, which can lead to muscle loss if protein intake is too low. Prioritizing protein-rich foods like chicken, fish, eggs, and Greek yogurt helps maintain muscle, keeps you full longer, and supports metabolism.
Need a recommendation here.
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Manage Water & Electrolytes
Since GLP-1s slow digestion, dehydration, and electrolyte imbalances can become a problem. The side effects of diarrhea and vomiting can also cause you to lose essential hydration.
Drinking enough water and replenishing sodium, potassium, and magnesium helps prevent dizziness, headaches, and constipation. Ashley recommends LMNT Zero Sugar Electrolytes.
Pick a Probiotic
GLP-1s can slow gut motility, sometimes leading to bloating or digestive discomfort. In fact, the horror stories of nausea and diarrhea side effects kept me away from GLP-1s for a while. However, by adding a probiotic while changing my meal routines, I've had minimal side effects.
Taking a probiotic or eating fermented foods like yogurt, kimchi, and sauerkraut can support gut health and digestion while on these medications. One of our favorites is Nordic Naturals Daily Probiotic.
Get Nutrition Support
I reached out to Ashley Legg at Legg Day Fitness to get help with my meals and routines. I didn't want a "diet"; I wanted to change my relationship with food. She helped me understand with one-on-one nutritional counseling how to make better choices tailored to the needs of the GLP-1 journey. Plus, she offers much-needed accountability and check-ins without pressure or judgment.
GLP-1 Nutrition Coaching and Meal Planning Available Now
Reach out to Ashley Legg today for a free, no-obligation conversation about starting meal planning and nutrition coaching as you progress on semaglutide or tirzepatide. Taking the medicine is just part of the formula. The work you put in is that much easier with Legg Day Fitness as your cheerleader. Plus, you can subscribe to Legg Day On-Demand Fitness for workouts that are easy, flexible, and done from the comfort of your home. It costs less than $1 a day.
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