Is that safe and effective for weight loss?

When Robin Langois, 58, was prescribed the weight-loss drug Wegovy last year, she couldn’t afford the hefty price tag because her insurance wouldn’t cover it.

But she later found out on TikTok that people could get their hands on the drug’s active ingredient, semaglutide, from compounding pharmacies for a fraction of the price.

Langois, of Tucson, Arizona, said she was hesitant at first due to safety concerns, but eventually found a telehealth provider to write her a prescription.

“I’m not 100% sure it’s what I’m getting,” Langois said. However, she noted that she has experienced feelings of fullness and weight loss, as well as nausea, a common side effect of the drug. “It works as it should,” she said.

Either because of cost or ongoing shortages, people are looking for alternatives to the branded drugs Ozempic and Wegovy, both of which contain the active substance semaglutide.

Some people, like Langois, turn to compounding pharmacies for the hard-to-get weight loss drugs.

Novo Nordisk, the sole manufacturer of Ozempic and Wegovy and the patent holder of semaglutide, said in a statement that it doesn’t supply the ingredient to these pharmacies, leading some experts to question where pharmacies get the drug — and whether it’s semaglutide at all.

“That’s the million-dollar question,” said Dr. Fatima Cody, a physician specializing in obesity at Massachusetts General Hospital in Boston and advisor to Novo Nordisk.

What are compounding pharmacies?

Compound pharmacies mix and alter drug ingredients to create medications tailored to specific patient needs, according to the Food and Drug Administration.

Compound medicines are usually made using the active ingredients in medicines. In the case of Ozempic and Wegovy, that is semaglutide.

But compounded drugs — although they contain FDA-approved ingredients — aren’t themselves FDA-approved, meaning they aren’t regulated, monitored or tested by the agency, said Benjamin Jolley, a pharmacist and owner of Jolley’s Compounding Pharmacy in Salt. Lake City.

Hospitals will sometimes use a compounded drug if a commercially available option isn’t ideal, according to the FDA. They may reduce the dose of painkillers to prevent certain side effects, for example, or remove preservatives or dyes that could cause an allergic reaction.

The FDA will also grant waivers that will allow compounding pharmacists to make certain drugs if there is a shortage, said Jeremy Kahn, a spokesman for the agency.

Do compounding pharmacies offer real semaglutide? Is it safe?

Dr. Chris McGowan, who runs a weight-loss clinic in Cary, North Carolina, has noticed that compound versions of Wegovy and Ozempic are growing in popularity.

“What I hear from patients is, ‘Oh, hey, I heard about this semaglutide compound. Can I try that?’” he said.

Mary Morgan Mills, 32, of Raleigh, North Carolina, came to McGowan after taking what she said was a compound version of semaglutide for about a year.

The weekly injection, which she received at a wellness center, made her feel nauseous and she only lost about 15 pounds while taking it.

“I felt cheated,” she said, adding that she still had “bottles of it in my fridge.”

“I’ve always wanted to get it tested to see what it really is, but I don’t know the process,” said Mills.

Latest news on weight loss drugs

McGowan said that in many cases compounding pharmacies are not completely transparent about how they buy the drug.

Jolley, who doesn’t offer semaglutide, said it’s possible compounding pharmacists could give people semaglutide sodium, a cheaper and modified version of the compound that’s only for research. However, semaglutide sodium is not approved by the FDA, he said, which would make the sale of the product illegal.

Compounding pharmacists could also buy high doses of semaglutide from wholesalers and then separate it into smaller doses or mix it with other drug ingredients, he said.

Matt Buderer, a pharmacist and owner of the Buderer Drug Company Compounding Pharmacy in Ohio, said this would essentially dilute the medication, which he says doesn’t make sense, as it would make the drug less effective.

Ultimately, if what compounding pharmacies offer as semaglutide isn’t really the drug, it’s a safety concern because the ingredients they use may not be thoroughly evaluated by the FDA, McGowan said.

“What I tell patients is to be very careful when considering any form of compound semaglutide or compound tirzepatide, which is another drug that we’re currently seeing being offered in a compound form,” he said. (Tirzepatide is a diabetes medication created by Eli Lilly that also has weight loss effects.)

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Is that safe and effective for weight loss?

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