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

But then he discovered on TikTok that people could get what appeared to be the drug’s active ingredient, semaglutide, at compounding pharmacies for a fraction of the price.

Langois, of Tucson, Ariz., said he was hesitant at first, due to safety concerns, but eventually found a telehealth provider to write a prescription for him.

“I’m not 100% sure that’s what I’m getting,” Langois said. He noted, however, that he experienced feelings of fullness and weight loss, as well as nausea, a common side effect of the medication. «It’s working as it should,» he said.

Either due to cost or ongoing shortagepeople are looking for alternatives to the brand name drugs Ozempic and Wegovy, both of which contain the active ingredient semaglutide.

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

Novo Nordisk, the sole maker of Ozempic and Wegovy and the patent holder for semaglutide, said in a statement that it does not provide the ingredient to these pharmacies, leading some experts to question where pharmacies source the drug from, and whether it is semaglutide. absolutely.

“That’s the million-dollar question,” said Dr. Fatima Cody, an obesity physician at Massachusetts General Hospital in Boston who serves as a consultant to Novo Nordisk.

What are compounding pharmacies?

Compounding pharmacies mix and alter drug ingredients to create drugs tailored to the specific needs of patients, according to the Food and Drug Administration.

Compound drugs are usually created using the active ingredients of drugs. In the case of Ozempic and Wegovy, that’s semaglutide.

But compounded drugs, while they do contain FDA-approved ingredients, are not FDA-approved, which means the agency doesn’t regulate, monitor or test them, said Benjamin Jolley, a pharmacist and owner of Jolley’s Compounding Pharmacy in Salt Lake City. .

Hospitals sometimes use a compounded drug when a commercially available option isn’t ideal, according to the FDA. They can reduce the dose of pain relievers to prevent some side effects, for example, or eliminate preservatives or dyes that can cause an allergic reaction.

The FDA will also grant waivers that allow compounding pharmacists to make certain drugs if there are shortages, said Jeremy Kahn, an agency spokesman.

Do compounding pharmacies offer real semaglutide? It is safe?

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

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

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

The weekly shot, which he received at a wellness center, made him nauseous and he only lost about 15 pounds while taking it.

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

«I’ve always wanted to try it to see what it really is, but I don’t know the process,» Mills said.

Latest news on weight loss drugs

McGowan said that compounding pharmacies, in many cases, aren’t being completely transparent about how they source the drug.

Jolley, which doesn’t offer semaglutide, said compound pharmacists may give people semaglutide sodium, a cheaper, modified version of the compound that’s intended for research use only. However, semaglutide sodium is not approved by the FDA, she said, which would make the product illegal to sell.

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 Buderer Drug Company Compounding Pharmacy in Ohio, said it would essentially dilute the drug, which he said doesn’t make sense because it would make the drug less effective.

If what compounding pharmacies offer as semaglutide isn’t actually the drug, that’s ultimately a safety issue, because the FDA may not thoroughly evaluate the ingredients they’re using, McGowan said.

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

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