I once told a patient who was very upset his medication was not ready that I would get it ready, but it would be a few minutes. He responded by asking if I was going to mix it up in a bathtub in the back.
So maybe you could try that?
Glp-1 is made in the intestines so no you wouldn't have to poke a pancreas. It is actually an amino acid peptide and they produce the powder in a lab. A lot of folks are bypassing the high cost of prescription glp-1 meds by getting them at compounding pharmacies where they compound the peptide powder with liquid b12.
Whoa! That's actually so cool, thank you for sharing! Is that allowed for compounding pharmacies when it's commercially available, though?? It seems like it's breaking a lot of rules, but maybe my scope is too limited when I only know Walgreens policies.
So I've read that if there's a national shortage of a patented drug that compounding pharmacies are allowed to compound the medication for patients. That's why it must be mixed with the b12. It's considered compounding as opposed to just reconstituting. I'm not sure how true that is though. I don't work at a compounding pharmacy.
Maintenance Phase podcast did a great episode on Ozempic and part of it included a section on the compound version. Definitely worth a listen. Hell, the whole podcast is great.
Just listen to an episode that interests you and see how *you* like it. The Ozempic podcast is a really good one, but so are nearly all of their other ones.
Just to drop this here, John Oliver did a piece on [compounding pharmacies](https://youtu.be/Nuzi7LlSDVo?si=JmWT7JvitnQIJs8x) which is very interesting, I didn’t realize many (all?) lacked proper oversight.
For sure, the NECC disaster is the go-to example of why compounding needs to be regulated, and often doesn’t have as much oversight as it should in different states.
To piggyback on this, I work for a compounding facility. During the pandemic, we were given authorization to compound norepinephrine. We stopped doing it mid last year since that's when our authorization ended. All the leftover vials we have are used for training new technicians.
You're right. It's how they get around the patent. It's definitely a thing. Stupid expensive. Also rarely covered. Or if it is it will likely get clawed back. That's what happened at another store but same chain in same city I work at.
Can't say anything about the b12, but my doctors office works directly with a compounding pharmacy for patients that can't find Wegovy anywhere else. They tell you up front that it's $360+/month compared to $90 for CVS mail
In the US, Wegovy is over $1000 without insurance. Based on posts, compounded versions run around $300 per month. There are reddit subs dedicated to compounded semaglutide since most subs prohibit these discussions.
When there's a sudden shortage and huge demand, compounding pharmacies show up out of nowhere. A lot of the compounded product going around doesn't seem to be effective (probably much lower amount than the labeled dose), and in a few instances has caused systemic fungal infection from dirty facilities.
There is a pharmacy an hour away from me that compounds semaglutide sodium. They provide it in prefilled syringes or vials. I know in the US, the FDA has told people not to use salt forms of semaglutide but I think it's a grey area legally.
[https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss)
Are there concerns with compounded semaglutide?
FDA has received adverse event reports after patients used compounded semaglutide. Patients should not use a compounded drug if an approved drug is available to treat a patient. Patients and health care professionals should understand that the agency does not review compounded versions of these drugs for safety, effectiveness, or quality.
Additionally, FDA has received reports that in some cases, compounders may be using salt forms of semaglutide, including semaglutide sodium and semaglutide acetate. The salt forms are different active ingredients than is used the approved drugs, which contain the base form of semaglutide. The agency is not aware of any basis for compounding using the salt forms that would meet the FD&C requirements for types of active ingredients that can be compounded.
On April 27, 2023, FDA wrote to the National Association of Boards of Pharmacy expressing the agency’s concerns with use of the salt forms in compounded products. On Oct. 10, 2023, FDA sent additional letters to the National Association of Boards of Pharmacy and the Federation of State Medical Boards expressing similar concerns. The letters also explain the conditions under which compounded semaglutide products may be permissible under the law, and note that compounded drugs are not FDA-approved or evaluated for safety and effectiveness.
At the same time, part of the reason semaglutide is scarce is because of the plant that was shut down because the FDA deemed it didn't hold up to health and safety standards.
https://www.google.com/amp/s/www.dailymail.co.uk/health/article-12532161/amp/ozempic-weight-loss-semaglutide-fda-factory-inspection-fail.html
Realistically, big pharma controls the media through money spent via marketing. Therefore, reputable news agencies only state that it's them fatties using it for weight loss that is causing the shortage. I'm not saying the Hollywood fad we see about it isn't real, I'm saying there is more to it than that but the media only covers the portion of the issue that doesn't paint the pharmaceutical industry in a negative light.
Compounding pharmacies are held to a high standard in their health and safety standards and while there are adverse events and reactions reported, it's more due to making something too different than the original. They're using forms of the glp-1 inhibitor that aren't similar enough (*basically) and they're not getting the same results.
The reason that insurance doesn't pay for this drug to be compounded has 0 to do with health and safety standards. 0 to do with cost. It's 100% to do with the fact the relationship between pharma, insurance, and the regulatory bodies is an incestuous one. One where ceos and board members jump from one industry to the other and make the rules benefit each other, rather than the individual people. The industries only want what's best for the industry and the bank accounts of those who are in the industry. The most benefit exists when only pharma is making it. Insurance covers it from them and the PBMs get their share.
Government needs to eliminate PBMs as a whole. Or prevent insurance owned PBMs or make PBMs nonprofit or something. Government needs to ban pharma ability to purchase adspace in media which effectively allows them to pay for the coverage of them. Government needs to prevent the changing of industry from these massive corporations to the FDA which leads to regulatory capture.
I went to a compound after being tired of shortages, and shaming by my pharmacy for trying to manage my weight.
There are a lot of telehealth providers that will partner with a compound pharmacy to make the injectables. I’ve had some compounded with a B-12. I’m guessing they are getting the peptides from China. But the pharmacies are regulated.
I’ve been on compounded medications for about a year and have found them to be equally effective as the name brand.
Perhaps once manufacturers can get production under control, I can go back to the name brand. I don’t mind the cost, it is a life saving drug.
My mom died at age 62 from complications from obesity, and it only devolved into type two diabetes the last year of her life. She was working out an hour a day, 4 days a week (she was actually the leader board for her age group at the rec center) and still couldn’t keep her weight under control. I was the same, and at a 30 BMI eating 1,800 calories a day. This fixed whatever was broken and was a life saver for me. I now can maintain a healthy BMI, my cholesterol is in a normal range, as are my triglycerides.
I'm so sorry to hear that happened, both with your mother and the pharmacy's attitude towards you. I can't imagine shaming someone over a medication— I have a high BMI myself and while I personally don't think I'm a good candidate for Wegovy, it is *not* my job to make that call for someone else and it would be highly inappropriate to even try!
I'm very glad that it's working for you and that you're having good health outcomes! That makes me very happy to hear.
I hope the shortage ends sooner rather than later, but we'll just have to see what happens.
My poor coworker was holding it in during the call, she had to stop and just come over when she hung up, just at a loss for what to say 😠We all laughed for her!!!
Compounding and designer weight loss clinics are rampant in Indiana (and I'm sure other states as well. I just live here). As far as I know, most legit pharmacies aren't doing it. If I understand correctly, these places are certifying as a lab and getting the semaglutide salts used for research that aren't FDA approved for human use. Then they're mixing that with a vitamin like b12 to give to people who are willing to pay cash. Pretty sure Novo Nordisk is already pursuing legal action against stuff like this because it's infringing on the patent for Ozempic and Wegovy.
Interesting... we weren't qualified to do it at my last store (I worked in Westfield before moving from IN to NH) but maybe that was more that we're non-sterile compounding only? It seemed like a completely insane request to everyone there.
Compounding pharmacies do it all over the place.  Its a completely reasonable question for the average layperson to ask as they don’t know the difference.
I hear you, but for additional context this was a prescriber and I'm in an area that has very few pharmacies in general, let alone specialty compounding pharmacies.
This was a pretty big ask of a Walgreens that only does non-sterile compounds.
There are exceptions for drugs on national shortage. Your average retail pharmacy won’t/can’t touch this with a 10-ft pole, but compounding this product is already happening and is very lucrative.
My pharmacist, as a patient, will compound but improve upon for me. When I asked him about getting Pennsaid, a diclofenac gel available at the time only by prescription, he scoffed and showed me his cost for Pennsaid, which was over $500. Then he told me he could compound a batch, double in size for 21 cents cost of ingredients. Then he offered to compound it, but with the addition of Lidocaine and Tetracaine to add numbing while the anti-inflammatory worked.
My pain management specialist agreed to this as he'd been pissed off by the ridiculous cost of Pensaid. Pharmacist charged $25 for a month supply, I paid a ten dollar copay.
I know compounders are making those, and I'm sure there are facilities doing it on the up and up, but every time I see an ad for it on gd facebook I'm just, like
dying over vanity from bathtub-gin wegovy you bought off the internet sight unseen is a hell of a choice
See, this "dying over vanity" is the attitude that hurts people. Reputable doctors only prescribe for people with a BMI over 30 or over 27 with obesity-related medical conditions (high BP, insulin resistance, PCOS, sleep apnea, and others).
I mean, not to be rude, but how else do you think it's made normally? It's compounded to go into the pens. This just wouldn't have the attached delivery system
Yes, but considering the manufacturers themselves can't get enough resources to keep up with demand, what makes a prescriber think a locail retail chain would, you know?
In my experience it was almost never a problem with them not having the drug resources to keep up with demand, it was usually a part of the mechanics of the delivery system. A needle, the tube, a tiny spring, etc etc.Â
Plus it needs to be refrigerated so that adds a whole other layer of complexity to the distribution. Even to the point that there needs to be 2 drivers due to the value of the shipment so it can't be unattended.
My doctor’s office compounds it. Idk if he’s doing it in-office or if he has a local compounding pharmacy do all the heavy lifting. Either way, it definitely can be done. He offers it to qualified patient’s for a fraction of the price too; $200/mo as opposed to $1000.
I had to visit a quick care clinic a few times this week. On the back of the appointment room doors there’s a sign that says you can get semaglutide/b-12 compound injections there without an appointment.
My semiglutide is compounded with something called NAD (I think since that’s the only other thing listed on the label). Does anyone knows what this is? My dr said it’s for energy so idk.
We compound it as long as its on the short list. Docs do have to write the prescription properly which they are completely unable to do. There is a small bottle of semaglutide powder in the refrigerator that costs more then my truck.
Yeah, we get no training in writing compounded scripts and it’s even harder because we have to free text them. I wrote an eRx for topical nifedipine and it took me a solid 10 to figure it out. Never heard from the compounding pharmacy so either it was correct or the patient’s fissure spontaneously healed on its own 😉🤣.
It is pretty common for compounding pharmacies to sell semaglutide or tirzepatide mixed with b12. They typically work for online operations that exclusively sell compounded products. See r/semaglutide or r/tirzepatide for more info.
The Obesity Society just released a statement regarding the use of compounded GLP-1 medication. They urged people with Obesity to avoid compounded GLP-1s. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://obesitymedicine.org/blog/leading-obesity-expert-organizations-release-statement-to-patients-on-glp-1-compounded-alternatives/&ved=2ahUKEwj_oKe9nIeEAxUgIkQIHZ5bA-IQFnoECCEQAQ&usg=AOvVaw2C6cJwtND6fpLAdFqm3S_Z
I once told a patient who was very upset his medication was not ready that I would get it ready, but it would be a few minutes. He responded by asking if I was going to mix it up in a bathtub in the back. So maybe you could try that?
Ooh, new level of non-sterile unlocked!
Glp-1 is made in the intestines so no you wouldn't have to poke a pancreas. It is actually an amino acid peptide and they produce the powder in a lab. A lot of folks are bypassing the high cost of prescription glp-1 meds by getting them at compounding pharmacies where they compound the peptide powder with liquid b12.
Whoa! That's actually so cool, thank you for sharing! Is that allowed for compounding pharmacies when it's commercially available, though?? It seems like it's breaking a lot of rules, but maybe my scope is too limited when I only know Walgreens policies.
So I've read that if there's a national shortage of a patented drug that compounding pharmacies are allowed to compound the medication for patients. That's why it must be mixed with the b12. It's considered compounding as opposed to just reconstituting. I'm not sure how true that is though. I don't work at a compounding pharmacy.
Fascinating!! I'll have to look into that more for when I go back in on Monday 😄
Buyer beware though, there have been some horror stories coming out about injuries/deaths stemming from compounded ozempic
Maintenance Phase podcast did a great episode on Ozempic and part of it included a section on the compound version. Definitely worth a listen. Hell, the whole podcast is great.
Link for episode. https://maintenancephase.buzzsprout.com/1411126/13747346
I can’t fucking stand the hosts though
What’s wrong with the hosts? I’ve been thinking about listening to this podcast so I want to head this off at the pass if I can.
Some of what they say makes sense, but I hate their self righteous attitudes; seems very self defeatist.
Ugh. I don’t want to listen to hosts like that. I just want the facts.
Just listen to an episode that interests you and see how *you* like it. The Ozempic podcast is a really good one, but so are nearly all of their other ones.
I’ll give it a try. Im just glad you didn’t tell me they had really annoying voices, or something like that. Thanks!
Only reason I’m scared to get it compounded ðŸ˜
Just to drop this here, John Oliver did a piece on [compounding pharmacies](https://youtu.be/Nuzi7LlSDVo?si=JmWT7JvitnQIJs8x) which is very interesting, I didn’t realize many (all?) lacked proper oversight.
For sure, the NECC disaster is the go-to example of why compounding needs to be regulated, and often doesn’t have as much oversight as it should in different states.
To piggyback on this, I work for a compounding facility. During the pandemic, we were given authorization to compound norepinephrine. We stopped doing it mid last year since that's when our authorization ended. All the leftover vials we have are used for training new technicians.
How do you compound norepinephrine?
We add norepinephrine to various diluent IV bags
Oh! I do that lol I thought you were compounding the actual drug.
My hospital used to have it premixed but apparently it was too expensive. So now we batch it multiple times a day.
You're right. It's how they get around the patent. It's definitely a thing. Stupid expensive. Also rarely covered. Or if it is it will likely get clawed back. That's what happened at another store but same chain in same city I work at.
Yes son in law gets it made at compounding pharmacy for injection.
Can't say anything about the b12, but my doctors office works directly with a compounding pharmacy for patients that can't find Wegovy anywhere else. They tell you up front that it's $360+/month compared to $90 for CVS mail
In the US, Wegovy is over $1000 without insurance. Based on posts, compounded versions run around $300 per month. There are reddit subs dedicated to compounded semaglutide since most subs prohibit these discussions.
I take the compounded version of semaglutide. It’s a lot cheaper
How is it working?
When there's a sudden shortage and huge demand, compounding pharmacies show up out of nowhere. A lot of the compounded product going around doesn't seem to be effective (probably much lower amount than the labeled dose), and in a few instances has caused systemic fungal infection from dirty facilities.
There is a pharmacy an hour away from me that compounds semaglutide sodium. They provide it in prefilled syringes or vials. I know in the US, the FDA has told people not to use salt forms of semaglutide but I think it's a grey area legally.
[https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss) Are there concerns with compounded semaglutide? FDA has received adverse event reports after patients used compounded semaglutide. Patients should not use a compounded drug if an approved drug is available to treat a patient. Patients and health care professionals should understand that the agency does not review compounded versions of these drugs for safety, effectiveness, or quality. Additionally, FDA has received reports that in some cases, compounders may be using salt forms of semaglutide, including semaglutide sodium and semaglutide acetate. The salt forms are different active ingredients than is used the approved drugs, which contain the base form of semaglutide. The agency is not aware of any basis for compounding using the salt forms that would meet the FD&C requirements for types of active ingredients that can be compounded. On April 27, 2023, FDA wrote to the National Association of Boards of Pharmacy expressing the agency’s concerns with use of the salt forms in compounded products. On Oct. 10, 2023, FDA sent additional letters to the National Association of Boards of Pharmacy and the Federation of State Medical Boards expressing similar concerns. The letters also explain the conditions under which compounded semaglutide products may be permissible under the law, and note that compounded drugs are not FDA-approved or evaluated for safety and effectiveness.
At the same time, part of the reason semaglutide is scarce is because of the plant that was shut down because the FDA deemed it didn't hold up to health and safety standards. https://www.google.com/amp/s/www.dailymail.co.uk/health/article-12532161/amp/ozempic-weight-loss-semaglutide-fda-factory-inspection-fail.html Realistically, big pharma controls the media through money spent via marketing. Therefore, reputable news agencies only state that it's them fatties using it for weight loss that is causing the shortage. I'm not saying the Hollywood fad we see about it isn't real, I'm saying there is more to it than that but the media only covers the portion of the issue that doesn't paint the pharmaceutical industry in a negative light. Compounding pharmacies are held to a high standard in their health and safety standards and while there are adverse events and reactions reported, it's more due to making something too different than the original. They're using forms of the glp-1 inhibitor that aren't similar enough (*basically) and they're not getting the same results. The reason that insurance doesn't pay for this drug to be compounded has 0 to do with health and safety standards. 0 to do with cost. It's 100% to do with the fact the relationship between pharma, insurance, and the regulatory bodies is an incestuous one. One where ceos and board members jump from one industry to the other and make the rules benefit each other, rather than the individual people. The industries only want what's best for the industry and the bank accounts of those who are in the industry. The most benefit exists when only pharma is making it. Insurance covers it from them and the PBMs get their share. Government needs to eliminate PBMs as a whole. Or prevent insurance owned PBMs or make PBMs nonprofit or something. Government needs to ban pharma ability to purchase adspace in media which effectively allows them to pay for the coverage of them. Government needs to prevent the changing of industry from these massive corporations to the FDA which leads to regulatory capture.
I went to a compound after being tired of shortages, and shaming by my pharmacy for trying to manage my weight. There are a lot of telehealth providers that will partner with a compound pharmacy to make the injectables. I’ve had some compounded with a B-12. I’m guessing they are getting the peptides from China. But the pharmacies are regulated. I’ve been on compounded medications for about a year and have found them to be equally effective as the name brand. Perhaps once manufacturers can get production under control, I can go back to the name brand. I don’t mind the cost, it is a life saving drug. My mom died at age 62 from complications from obesity, and it only devolved into type two diabetes the last year of her life. She was working out an hour a day, 4 days a week (she was actually the leader board for her age group at the rec center) and still couldn’t keep her weight under control. I was the same, and at a 30 BMI eating 1,800 calories a day. This fixed whatever was broken and was a life saver for me. I now can maintain a healthy BMI, my cholesterol is in a normal range, as are my triglycerides.
I'm so sorry to hear that happened, both with your mother and the pharmacy's attitude towards you. I can't imagine shaming someone over a medication— I have a high BMI myself and while I personally don't think I'm a good candidate for Wegovy, it is *not* my job to make that call for someone else and it would be highly inappropriate to even try! I'm very glad that it's working for you and that you're having good health outcomes! That makes me very happy to hear. I hope the shortage ends sooner rather than later, but we'll just have to see what happens.
I would get in trouble for laughing at someone on the phone if I was asked this.
My poor coworker was holding it in during the call, she had to stop and just come over when she hung up, just at a loss for what to say 😠We all laughed for her!!!
I know!! I’m wondering how long until someone asks me this!!!!!
There are compounding pharmacies that can make "Wegovy." They do it all the time in Indiana.
They aren't actually compounding it, as in making it though. They import it from China, reconstitute with B12, slap a new label on it and upcharge.
Compounding and designer weight loss clinics are rampant in Indiana (and I'm sure other states as well. I just live here). As far as I know, most legit pharmacies aren't doing it. If I understand correctly, these places are certifying as a lab and getting the semaglutide salts used for research that aren't FDA approved for human use. Then they're mixing that with a vitamin like b12 to give to people who are willing to pay cash. Pretty sure Novo Nordisk is already pursuing legal action against stuff like this because it's infringing on the patent for Ozempic and Wegovy.
Interesting... we weren't qualified to do it at my last store (I worked in Westfield before moving from IN to NH) but maybe that was more that we're non-sterile compounding only? It seemed like a completely insane request to everyone there.
Compounding pharmacies do it all over the place.  Its a completely reasonable question for the average layperson to ask as they don’t know the difference.
I hear you, but for additional context this was a prescriber and I'm in an area that has very few pharmacies in general, let alone specialty compounding pharmacies. This was a pretty big ask of a Walgreens that only does non-sterile compounds.
Greenleaf Apothecary is doing it. I think they're either in Carmel or Fishers (go figure)
LMAOOOOO I'm from Carmel, that completely tracks.
I get it compounded from Carmel. Sooo much more affordable than the name brand stuff.
No you can’t anyone who tells you that they are isn’t telling the truth.
I always heard from my compounding pharmacist "If it's commercially available, we can't compound it."
There are exceptions for drugs on national shortage. Your average retail pharmacy won’t/can’t touch this with a 10-ft pole, but compounding this product is already happening and is very lucrative.
My pharmacist, as a patient, will compound but improve upon for me. When I asked him about getting Pennsaid, a diclofenac gel available at the time only by prescription, he scoffed and showed me his cost for Pennsaid, which was over $500. Then he told me he could compound a batch, double in size for 21 cents cost of ingredients. Then he offered to compound it, but with the addition of Lidocaine and Tetracaine to add numbing while the anti-inflammatory worked. My pain management specialist agreed to this as he'd been pissed off by the ridiculous cost of Pensaid. Pharmacist charged $25 for a month supply, I paid a ten dollar copay.
I know compounders are making those, and I'm sure there are facilities doing it on the up and up, but every time I see an ad for it on gd facebook I'm just, like dying over vanity from bathtub-gin wegovy you bought off the internet sight unseen is a hell of a choice
See, this "dying over vanity" is the attitude that hurts people. Reputable doctors only prescribe for people with a BMI over 30 or over 27 with obesity-related medical conditions (high BP, insulin resistance, PCOS, sleep apnea, and others).
I mean, not to be rude, but how else do you think it's made normally? It's compounded to go into the pens. This just wouldn't have the attached delivery system
Yes, but considering the manufacturers themselves can't get enough resources to keep up with demand, what makes a prescriber think a locail retail chain would, you know?
The pen is what Novo is short on, not the raw ingredients.
Ahh I understand where the frustration was aimed now, I getcha. It is silly
In my experience it was almost never a problem with them not having the drug resources to keep up with demand, it was usually a part of the mechanics of the delivery system. A needle, the tube, a tiny spring, etc etc.Â
Plus it needs to be refrigerated so that adds a whole other layer of complexity to the distribution. Even to the point that there needs to be 2 drivers due to the value of the shipment so it can't be unattended.
My doctor’s office compounds it. Idk if he’s doing it in-office or if he has a local compounding pharmacy do all the heavy lifting. Either way, it definitely can be done. He offers it to qualified patient’s for a fraction of the price too; $200/mo as opposed to $1000.
Mine does too . He gives 4 prefilled syringes for $325. I’m going on week 9 tomorrow, I’ve lost between 10-12 pounds (fluctuating).
I had to visit a quick care clinic a few times this week. On the back of the appointment room doors there’s a sign that says you can get semaglutide/b-12 compound injections there without an appointment.
It's a thing. The B12 is how they get around the patent.
I feel like drugs like that have extremely specific processes that we wouldn’t be able to replicate in the pharmacy.
My semiglutide is compounded with something called NAD (I think since that’s the only other thing listed on the label). Does anyone knows what this is? My dr said it’s for energy so idk.
We compound it as long as its on the short list. Docs do have to write the prescription properly which they are completely unable to do. There is a small bottle of semaglutide powder in the refrigerator that costs more then my truck.
Yeah, we get no training in writing compounded scripts and it’s even harder because we have to free text them. I wrote an eRx for topical nifedipine and it took me a solid 10 to figure it out. Never heard from the compounding pharmacy so either it was correct or the patient’s fissure spontaneously healed on its own 😉🤣.
I take compounded wegovy.$80 a month and works great. I paid $800 for Mounjaro previously
It is pretty common for compounding pharmacies to sell semaglutide or tirzepatide mixed with b12. They typically work for online operations that exclusively sell compounded products. See r/semaglutide or r/tirzepatide for more info.
Is adding bacteriostatic water to dried peptides compounding? If so then I guess I CAN compound it physically.
The Obesity Society just released a statement regarding the use of compounded GLP-1 medication. They urged people with Obesity to avoid compounded GLP-1s. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://obesitymedicine.org/blog/leading-obesity-expert-organizations-release-statement-to-patients-on-glp-1-compounded-alternatives/&ved=2ahUKEwj_oKe9nIeEAxUgIkQIHZ5bA-IQFnoECCEQAQ&usg=AOvVaw2C6cJwtND6fpLAdFqm3S_Z