Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been in high demand since their approval by the U.S. Food and Drug Administration for weight loss and treatment of type 2 diabetes. This demand has led to shortages of these medications, which are sold under brand names like Ozempic and Wegovy. Medication shortages make it possible for pharmacies to sell compounded versions of FDA-approved drugs, including GLP-1 RAs.

The question is whether advertising by online pharmacies for compounded GLP-1 RAs meets U.S. government requirements to be “truthful, non-misleading and accurate.” Transparency and full disclosure in these ads are important because 11 percent of people taking compounded GLP-1 RAs get them from online pharmacies.

Medication shortages make it possible for pharmacies to sell compounded versions of FDA-approved drugs, including GLP-1 RAs.

Compounded medications contain the same active ingredient as their FDA-approved counterparts but may contain different inactive ingredients. They are not FDA-approved because the Agency has not verified their safety and efficacy.

Researchers from Yale University analyzed the advertising practices of 79 websites selling compounded GLP-1 RAs. They found that consumers were often presented with incomplete or misleading information about the medications, and this could put them at risk, Ashwin Chetty, lead author on the study, told TheDoctor. “It is possible more harm can be done than good if patients are not fully informed,” he said.

The analysis of the websites offering compounded GLP-1RAs revealed:

  • All 79 sites sold compounded semaglutide (brand names Ozempic and Wegovy); 57 sites sold compounded tirzepatide (brand names Zepbound and Mounjaro); and three sites sold compounded liraglutide (brand names Saxenda and Victoza).
  • Fifty-two sites displayed a mark of certification to show consumers its products met certain standards, and 50 of these displayed LegitScript certification — a service designed to detect, monitor and screen for problematic products.
  • Two sites did not provide prescriptions for compounded GLP-1 RAs and required a prior prescription.
  • Eleven web sites did not disclose that their GLP-1 RAs were compounded, and seven sites mistakenly referred to compounded medications as generic.
  • Thirty-four sites disclosed that compounded GLP-1 RAs are not FDA-approved.
  • Twenty-nine sites stated or implied the drugs they offered were approved.
  • Thirty-nine sites did not report any warnings about possible side effects precautions and contraindications from compounded GLP-1RAs.

The concern is that patients may take compounded GLP-1 RAs only knowing the benefits of these medications and without understanding the risks. They might experience side effects that lead them to discontinue the medication, and discontinuing GLP-1 RAs could lead to weight regain or weight cycling, also known as yo-yo dieting, Chetty, a medical student at Yale, explained.

Compounded medications contain the same active ingredient as their FDA-approved counterparts but may contain different inactive ingredients. They are not FDA-approved because the Agency has not verified their safety and efficacy.

Many compounding sites have their own doctors. If they are only seeing a patient for this one issue, they might not understand the consumer as a whole person, Alissa Chen, senior author on the study, told TheDoctor. “If you are considering taking these medications, talk to your physician, who really knows you, your health history and what other medications you are on.”

The study and a related editorial are published in JAMA Health Forum.