Compounded versions are now only permissible in narrow clinical circumstances such as a documented allergy to a branded excipient and must come from a licensed 503A or 503B pharmacy
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They slow down gastric emptying (so food stays in the stomach a bit longer) which helps moderate how fast sugar hits the bloodstream
Some patients experience nausea, constipation, reflux, fatigue, appetite suppression, diarrhea, abdominal discomfort, dizziness, or difficulty eating enough protein
Compounded semaglutide and tirzepatide were banned in May 2025, and the FDA has been escalating enforcement against grey market peptide vendors throughout 20252026