The questions the providers don't answer.

Is compounded semaglutide safe?

Nobody can answer that with a yes. What can be said precisely is what is known and what is not. As of 31 May 2026, FDA had received 990 adverse event reports involving compounded semaglutide and more than 730 involving compounded tirzepatide. FDA does not review compounded drugs for safety, effectiveness or quality before they are sold — that is not an insult, it is the legal definition of what compounding is. FDA adds its own caveat to those counts: state-licensed pharmacies are not required to report adverse events, "so it is likely that adverse events… are underreported." The real number is higher.

Why do people overdose on this?

Two more things from the same FDA page, both practical. Discard a compounded vial 28 days after first use — FDA says to do this "even if instructions from the compounder say the medication can be used for longer." And FDA is aware of compounded products labelled with pharmacies that do not exist, or with real pharmacies that did not make the product.

A branded pen does the arithmetic for you. A vial does not. "2.5 mg" on a compounded label is a mass, and it only becomes a number of syringe units once you know that pharmacy's concentration in mg/mL. Change pharmacy, keep the same dose, and the number of units you draw changes. One provider in our set — Ivim — explains this to its customers properly; it is also the only one that admits your pharmacy "may change with each order."

What is a salt form, and why does it matter?

FDA warns that "some semaglutide products sold by compounders may be the salt forms. These salt forms… are different active ingredients than are used in the approved drugs." Not a different brand of the same thing. A different ingredient.

503A or 503B — what is the difference to me?

• Neither is FDA-approved. Start there.
• 503A pharmacies are licensed by state boards, compound against individual prescriptions, and are not required to follow Current Good Manufacturing Practice. FDA does inspect them for cause and through surveillance, but not on a routine risk-based schedule the way it inspects 503B facilities.
• 503B outsourcing facilities register with FDA, must comply with CGMP, are subject to FDA inspection, and must report adverse events.

One provider in our table tells customers that "503A pharmacies are licensed by state boards of pharmacy and are FDA-compliant." 503A is the category specifically not held to CGMP. We would want that corrected before trusting the rest of the page.

What happens if I stop taking it?

This one has proper trial data, and it is worth knowing before you start.

• Semaglutide. In the STEP 1 trial extension, participants lost 17.3% of body weight over 68 weeks. A year after stopping, they had regained two-thirds of it — 11.6 percentage points back, leaving 5.6% below where they began. Blood pressure, waist measurement and other cardiometabolic gains reverted toward baseline too.
• Tirzepatide. In SURMOUNT-4, a 36-week lead-in produced 20.9% weight loss. Participants switched to placebo then regained 14.0% over the following year, while those who stayed on the drug lost a further 5.5%.

This is why the cancellation terms in the first table matter more than the headline price. The clinical evidence says this is not a three-month purchase.

What if I restart after a gap?

What does exist is label guidance for a short gap. Wegovy's label says that if two or more consecutive doses are missed, you restart dose escalation at a lower dose. Zepbound and Mounjaro give a 4-day window to take a missed dose; Ozempic gives 5 days. Only Wegovy's label tells you to re-titrate.

Can I move my prescription to another provider?

In practice, no — and the reason is worth understanding. GLP-1s are not controlled substances, so the federal transfer rules do not apply; this is state pharmacy board territory. But a compounded preparation belongs to the pharmacy that makes it, to its own formula, so a prescription written against one pharmacy's preparation generally cannot be filled at another. Every provider we checked simply re-prescribes from scratch.

We could not find a board or FDA document stating this as a rule, so we are describing what providers do, not what the law requires.

So how do I keep my dose when I switch?

Records, not prescriptions. Under HIPAA's right of access (45 CFR 164.524) you can request a copy of your own medical records, and the provider must act within 30 days. That documentation is what lets a new clinician start you where you are instead of at 2.5 mg. SkinnyRx and Remedy Meds both confirm the practical version — they will ask about your current dose, or ask you to upload your previous prescription.

Do I keep the vials if I cancel?

Yes. Anything already shipped is yours, and no provider takes it back — but you will not be refunded for it either. MEDVi states the reason plainly: federal law generally prohibits returning prescription medication to a pharmacy for refund or reuse once dispensed.

If I prepaid six months and cancel at three, what comes back?

Less than you would expect. Shed refunds only the unshipped cycles, after re-pricing the months you already used at the standard month-to-month rate — so the multi-month discount is clawed back out of your refund. Sprout prorates the same way. This is the least understood mechanic in the category and it is why we publish month-to-month prices rather than prepay headlines.

• FDA, Concerns with unapproved GLP-1 drugs used for weight loss — adverse event counts, salt forms, 503A/503B. Updated 1 September 2026.
• FDA, Dosing errors associated with compounded injectable semaglutide — the five-to-twenty-fold overdose alert.
• FDA, Policies for compounders as national GLP-1 supply stabilises — shortage end dates, "essentially a copy," the four-prescription limit, and semaglutide with B12.
• Wilding JPH et al., Weight regain after withdrawal of semaglutide: the STEP 1 trial extension, Diabetes Obes Metab 2022. PMID 35441470.
• Aronne LJ et al., Continued treatment with tirzepatide: SURMOUNT-4, JAMA 2024. PMID 38078870.
• Custom Communications, Inc. v. FTC, 8th Cir., 8 July 2025 — the opinion vacating the click-to-cancel rule.
• FTC, In the Matter of NextMed — final order 3 December 2025.
• 45 CFR 164.524 — HIPAA right of access, and the 30-day deadline.
• Manufacturer cash prices read from NovoCare and LillyDirect, September 15, 2026.
• Every cancellation term, minimum commitment and billing cycle was read off that provider’s own terms pages on September 15, 2026. None of it came from an affiliate site.

Nothing on this page is medical advice. It is a description of prices, contracts and published evidence. Whether a GLP-1 is right for you is a question for a clinician who knows your history.