FAQs

Compounding is legal when a state-licensed 503A pharmacy prepares a drug for an individual patient with a prescription, or when an FDA-registered 503B outsourcing facility follows federal rules. Compounded semaglutide and tirzepatide are not FDA-approved, and federal law limits compounding copies of approved drugs now that the shortages have ended. On April 30, 2026, FDA proposed not to add semaglutide, tirzepatide or liraglutide to the 503B bulks list; no final decision had been published as of October 15, 2026.

No. Compounded semaglutide is made with the drug in Ozempic and Wegovy, but it is not the same product and it is not FDA-approved. FDA has not reviewed compounded versions for safety, effectiveness or quality, and the STEP trial results were measured with the brand product. Concentrations and added ingredients vary by pharmacy.

It depends on your coverage. In our October 15, 2026 index, the lowest all-in monthly figure per compounded program ran from $86 to $280 for tirzepatide (median $144, 28 programs) and from $49 to $169 for semaglutide (median $94, 22 programs; NexLife’s price as of November 6, 2026), counting conditional and 'as low as' prices as printed. Mondae lists lower standing rates than our editor's pick, NexLife, and Eden Health a lower semaglutide rate; NexLife charges $95 (semaglutide) or $115 (tirzepatide) a month on a 12-month plan and $109 or $129 month to month. Brand self-pay starts at $349 a month for Wegovy pens and $299 for Zepbound 2.5 mg vials. Compare the price at your maintenance dose, not the starting price.

It varies. Many commercial plans cover Wegovy or Zepbound with prior authorization, and some exclude weight management. From July 1, 2026 through December 31, 2027, the CMS Medicare GLP-1 Bridge gives eligible Medicare Part D enrollees a $50 copay for Foundayo, Wegovy or the Zepbound KwikPen. People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible for the Bridge; Medicare.gov says their Part D plan might cover a GLP-1 for those conditions.

Trial averages: 14.9% with semaglutide 2.4 mg vs 2.4% with placebo at 68 weeks (STEP 1), and 20.9% with tirzepatide 15 mg vs 3.1% with placebo at 72 weeks (SURMOUNT-1, treatment-regimen estimand). In SURMOUNT-5, tirzepatide averaged 20.2% vs 13.7% with semaglutide. Individual results vary widely, results are smaller in people with type 2 diabetes, and no program can promise a specific amount.

Many people need long-term treatment. Weight usually returns after stopping: in the STEP 1 extension, people regained about two-thirds of the weight they had lost within a year of stopping semaglutide, and in SURMOUNT-4 people switched to placebo regained 14% of body weight. Talk with your clinician before stopping.

Nausea, constipation, diarrhea and reduced appetite are common during dose increases, and most ease as the dose stabilizes. Severe or persistent abdominal pain, repeated vomiting or pain under the right ribs needs prompt medical evaluation.

The labels do not list alcohol as a contraindication, but alcohol can add to stomach upset and, in people taking insulin or a sulfonylurea, to the risk of low blood sugar. Many people report drinking less. Ask your clinician what is safe for you.

Some of the weight lost on GLP-1 therapy is lean mass. Resistance training and enough protein help preserve muscle; ask your clinician or a dietitian for a protein target that fits your kidney function and overall health.

Not during treatment. The labels say to stop Wegovy, Zepbound or Foundayo when pregnancy is recognized, and the Wegovy label says to stop at least 2 months before a planned pregnancy. Zepbound and Foundayo can make birth-control pills less reliable, so their labels advise a non-oral or backup method for 4 weeks (Zepbound) or 30 days (Foundayo) after starting and after each dose increase. Weight loss can restore ovulation, so unplanned pregnancies happen.

Follow your product label. Wegovy: if the next dose is more than 2 days away, take the missed dose as soon as possible; otherwise skip it. Zepbound: take it within 4 days (96 hours) of the missed dose; otherwise skip it. Never take two doses to catch up. For compounded products, follow your prescriber's instructions.

NexLife is a U.S. telehealth program. Its plan pages, read October 15, 2026, describe clinician review through NexLife Medical Group (medical director Adam Kennah, M.D.), name three state-licensed 503A pharmacies (Absolute Pharmacy, Premium Compounding and Boudreaux's New Drug Store), and offer care in all 50 states where its affiliated providers are licensed. It is our editor's pick at 94/100 on methodology v4.1. Compounded medications are not FDA-approved. See the affiliate disclosure in our site footer.