Are Compounded Semaglutide and Tirzepatide Safe?
Weight ManagementWeight Loss

The Risks of Buying Compounded GLP-1 Drugs Online

The Risks of Buying Compounded GLP-1 Drugs Online
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Updated on January 27, 2026
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Note: Compounded drugs are not approved by the U.S. Food and Drug Administration (FDA) and may carry greater risks than FDA-approved treatments.

Despite new rules limiting their manufacture, compounded GLP-1 drugs — off-brand formulations of semaglutide and tirzepatide, the active ingredients in the blockbuster diabetes and weight-loss drugs Ozempic, Wegovy, Mounjaro, and Zepbound — are still widely available online and from alternative sources such as medical spas. Many experts warn that compounded GLP-1s are less safe than the brand-name medications.

These alternative weight-loss drugs, typically less expensive, surged in popularity when brand-name GLP-1 manufacturers couldn’t keep up with demand. Today, those shortages are no longer happening in the United States, and compounding pharmacies have been barred from making essential copies of brand-name weight-loss drugs.

 But compounders still have the latitude to make and market custom GLP-1 drugs by changing a drug’s dosage, ingredients, or route of administration.

Even safe and properly prepared compounded drugs may carry unique risks because of their unregulated nature. What’s more, some online sellers are peddling unapproved or counterfeit compounded drugs, which may be dangerous or ineffective.

If you’re considering GLP-1 therapies, it’s important to understand the risks involved with buying compounded drugs and to speak with your provider about them.

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What Are Compounded GLP-1 Drugs?

Compounded drugs are custom-made medications prepared by licensed pharmacies, often used when FDA-approved versions do not meet a patient's specific needs. For example, you may need a compounded drug because you have an allergy to an inactive ingredient, require a different dosage than is available, or if there’s a shortage of the prescription medicine.

 They also may be less expensive than name-brand options.
Compounded drugs are legal and fill a vital need in the American healthcare system for people who cannot take the FDA-approved drugs that they require. But when custom drug formulations are mass-produced and marketed broadly, compounding pharmacies may be operating in a gray area of the law.

The Risks of Compounded GLP-1 Drugs

Drugs made by a compounding pharmacy are not necessarily unsafe, but these medications don’t undergo the rigorous testing, standardization, and regulatory oversight required for FDA-approved drugs. This means their quality, consistency, and safety can vary. Some research suggests compounded GLP-1 drugs are associated with higher risks of adverse health events like diarrhea, gallbladder inflammation, and suicidal ideation.

Many clinicians are happy to prescribe compounded GLP-1 weight loss drugs, but some experts caution that the limited oversight may expose patients to unnecessary risks. Juliana Simonetti, MD, a co-director of the comprehensive weight management program at the University of Utah in Salt Lake City, says anyone buying compounded drugs from a questionable source runs the risk of using medications that pose safety risks.

“I'm very clear in telling my patients to not get compounded versions,” she says. “I feel their pain and desperation, but I'm telling them not to do it because these are dangerous practices.”

Other experts agree with that opinion. Andrew Kraftson, MD, the director of the weight navigation program at Michigan Medicine in Ann Arbor, believes strongly in the value of medications like semaglutide and understands why people are scrambling to get them. He points out that obesity is highly stigmatized and undertreated.

“There's this sense of urgency that's driving people to make rash decisions,” he says. “They feel like, ‘This is out there now. I should have been on it yesterday.'”

But without FDA oversight, Dr. Kraftson says, compounded versions are too risky. “It's problematic that there is this inherent conflict of interest,” he says about providers who might be willing to compromise safety in pursuit of profit.

Dosing Errors

One of the biggest concerns with compounded GLP-1 drugs is the potential for dosing errors.

FDA-approved medications come in standardized amounts with clear labeling, but compounded versions may be prepared in varying concentrations or mixed with other ingredients like vitamins or glycine.

Additionally, providers may miscalculate the doses, and patients typically have to draw compounded GLP-1 drugs from a vial with a syringe, introducing more chances for errors, including underdosing, overdosing, or inconsistent treatment, potentially leading to ineffective weight loss, unexpected side effects, or more serious health complications.

Dosing with compounded GLP-1 drugs can be confusing, Simonetti says. She recommends asking the manufacturer how many milligrams of active ingredients are in each dose. Though the exact formula of these drugs may be a mystery, knowing how much active ingredient is in each dose can help clinicians aid their patients with diet and medication management.

“A lot of compounded drugs come in units,” Simonetti says. “I have no idea how many milligrams are in the unit, especially if they are mixing it with other ingredients.”

Salt Forms

Some compounding operations may use “salt forms” of semaglutide, such as semaglutide sodium or semaglutide acetate. The FDA notes that these contain different active ingredients than the base semaglutide in FDA-approved medications.

It’s unclear if these salt forms have different chemical and pharmacologic properties that could impact their safety and effectiveness. The agency also states that there is no lawful basis for using these salts in compounding.

Unapproved Drugs

A black market seems to have developed for the sale of experimental weight loss drugs, including retatrutide and cagrilintide.

 These drugs are still undergoing trials and are not yet FDA-approved for any use in people, including in compounded products.

While studies show these experimental drugs may be very effective for weight loss, their safety profiles, effective dosages, and long-term effects remain unknown — using them could be dangerous. Gastrointestinal issues like nausea, vomiting, and diarrhea are common side effects of the drugs, and some people using retatrutide experienced more serious consequences like bone fractures and kidney issues, possibly linked to rapid weight loss.

Counterfeit Drugs and Fraud

Some online suppliers engage in definitively illegal practices. One survey of the online marketplace identified more than a hundred websites claiming to sell semaglutide that can be ordered without a prescription.

 Pharmacies cannot legally provide GLP-1 drugs without a doctor's prescription.

 Medications from illegal sources may be especially dangerous.
When one group of researchers ordered semaglutide from six websites, three suppliers never sent any product at all and instead demanded more money; they were outright scams. The other three providers did send some medicine containing semaglutide, but lab tests showed that the active ingredient was included in inaccurate concentrations. One of the samples was contaminated with endotoxin and may have been poisonous.

Hundreds of boxes of counterfeit drugs have also flooded the market. These can be difficult to identify, but an FDA warning provides the information you need to make sure you don’t have an illegal Ozempic copycat.

Reducing the Risks

For those who choose to purchase compounded semaglutide, there are ways to mitigate your risk. Simonetti recommends checking the FDA's list of registered compounding pharmacies.

“This is a good place to start. You still don't know what you are getting, but going with a [pharmacy] on this list reduces the risk that you're injecting yourself with bacteria,” she says.

The National Association of Boards of Pharmacy also has a database that allows people to search for pharmacies to weed out those that may be fraudulent.

Ask your doctor if they have a compounding pharmacy that they trust, says Tenille Davis, PharmD, the chief advocacy officer of the Alliance for Pharmacy Compounding. She also says people should call the pharmacies to ask about their quality programs and to get information on how sterile their products are. The pharmacy should be willing to provide a certificate of purity that says that the medicine is pure and sterile.

“If the pharmacist is hesitant to discuss these kinds of things, I would choose another pharmacy,” Davis says.

The Takeaway

  • Compounded GLP-1 drugs are less expensive alternatives to brand-name weight loss medications like Ozempic and Wegovy, but they are not subject to strict FDA testing or oversight.
  • Even when purchased from a licensed compounding pharmacy, these formulations may pose risks, including dosing errors, contamination, or variations in potency.
  • Some online suppliers engage in illegal practices, such as fraud, the sale of unapproved drugs, or providing drugs without requiring a prescription.
  • Anyone considering compounded GLP-1 drugs should consult their healthcare provider and use only licensed compounding pharmacies.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Mountain J. Compounded Weight Loss Medications: What Are They and What Are Their Risks? Brown University Health. March 18, 2025.
  2. FDA Clarifies Policies for Compounders as National GLP-1 Supply Begins To Stabilize. U.S. Food and Drug Administration. April 28, 2025.
  3. Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A of the Federal Food, Drug, and Cosmetic Act. U.S. Food and Drug Administration. January 2018.
  4. FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss. U.S. Food and Drug Administration. September 25, 2025.
  5. Pitts PJ. FDA Regulatory Failures in Enforcing Limits on GLP-1 Compounding Puts Patients at Risk: How to Protect and Advance the Public Health Through More Robust Regulatory Oversight and Timely Legislative Action. Journal of the Academy of Public Health. August 6, 2025.
  6. Axelsen K. Telling the Good from the Bad Compounded GLP-1 Drugs. American Enterprise Institute. June 18, 2025.
  7. Wootton-Cane N. Urgent Warning Over Illegal Weight Loss Jabs ‘Not Approved for Humans’ Offered for Sale on TikTok. The Independent. September 14, 2025.
  8. Retatrutide (And Other Things That You Shouldn’t Be Compounding). Alliance for Pharmacy Compounding.
  9. Retatrutide Melts Fat Fast but at a Cost Warn Experts. Diabetes.co.uk. March 3 2025.
  10. Garvey WT et al. Coadministered Cagrilintide and Semaglutide in Adults With Overweight or Obesity. The New England Journal of Medicine. June 22, 2025.
  11. Jastreboff A et al. Triple–Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial. The New England Journal of Medicine. June 26, 2023.
  12. Ashraf AR et al. Safety and Risk Assessment of No-Prescription Online Semaglutide Purchases. JAMA Network Open. August 2, 2024.
  13. Miller AE et al. Federal Regulation of Medication Dispensing. StatPearls. June 20, 2023.
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