When Robin Langois, 58, was prescribed the weight-loss drug Vegovy last year, she couldn’t afford the high price tag because her insurance wouldn’t cover it.
But she later learned on TikTok that people could get semaglutide, the drug’s active ingredient, from compounding pharmacies for a fraction of the price.
Langois, of Tucson, Arizona, said she was initially hesitant because of safety concerns, but eventually found a telehealth provider who could write her a prescription.
Langois said, “I’m not 100% sure that’s what I’m getting.” She noted, however, that she is experiencing nausea, a common side effect of the drug, along with feelings of fullness and weight loss. “It’s working as it should,” she said.
Because of either cost or ongoing shortages, people are looking for alternatives to the brand-name drugs Ozempic and Vegovy, which both contain Active ingredient semaglutide.
Some people, like Langois, are turning to compounding pharmacies for weight loss drugs.
Novo Nordisk, the sole maker of Ozempic and Vigovi 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 the pharmacies are getting the drug — and whether it Semaglutide is absolutely.
“It’s the million-dollar question,” said Dr. Fatima Cody, a physician specializing in obesity at Massachusetts General Hospital in Boston, who serves as a consultant to Novo Nordisk.
What are compounding pharmacies?
According to the Food and Drug Administration, compounding pharmacies mix and alter drug ingredients to create drugs tailored to specific patient needs.
Compounded medicines are usually made using the active ingredients in the medicines. In the case of Ozempic and Vegovy, it’s semaglutide.
But compounding drugs — while they contain FDA-approved ingredients — are not FDA-approved themselves, which means they are not regulated, monitored or controlled by the agency, said Benjamin Jolly, a pharmacist and owner of Jolly’s Compounding Pharmacy in Salt Lake City. are not tested.
According to the FDA, hospitals will sometimes use a compounded drug when commercially available alternatives are not ideal. They may lower the dose of pain medication to prevent certain side effects, for example, or remove preservatives or dyes that may cause an allergic reaction.
The FDA will also grant exemptions that allow compounding pharmacists to make certain drugs when there is a shortage, said Jeremy Kahn, a spokesman for the agency.
Are Compounding Pharmacies Offering Genuine Semaglutide? Is it safe?
Dr. Chris McGowan, who runs a weight loss clinic in Cary, North Carolina, has noticed that mixed versions of Vegovy and Ozempic are growing in popularity.
“What I’m hearing from patients is, ‘Oh, hey, I heard about this compounded semaglutide. Can I try that?'” he said.
Mary Morgan Mills, 32, of Raleigh, North Carolina, came to McGowan after taking a compounded version of semaglutide for about a year.
The weekly injection, which he got at a wellness center, made him vomit, and he only lost about 15 pounds while taking it.
“I felt bamboo,” she said, “I still have bottles of it in my fridge.”
Mills said, “I’ve always wanted to test it to see what it really is, but I don’t know the procedure.”
Latest News on Weight Loss Drugs
McGowan said that compounding pharmacies, in many cases, are not fully transparent about how they are obtaining the drug.
Jolie, which doesn’t offer semaglutide, said it’s possible that compounding pharmacists could give people semaglutide sodium, a cheaper and modified version of the compound that’s for research use only. Semaglutide sodium, however, is not approved by the FDA, he said, which would make the product illegal to sell.
He added that compounding pharmacists can also buy higher doses of semaglutide from wholesalers and then separate it into smaller doses or mix it with other pharmaceutical ingredients.
Matt Buderer, a pharmacist and owner of Buderer Drug Company Compounding Pharmacy in Ohio, said this would essentially dilute the drug, which he said doesn’t make sense because it would make the drug less effective.
McGowan said that if what compounding pharmacies are offering as semaglutide isn’t actually the drug, it’s ultimately a safety issue, as the ingredients they’re using need to be fully evaluated. Can’t be done.
“I’m telling patients to be very, very careful when considering any kind of compound semaglutide or compounded tirgepatide, which is another drug we’re currently offering in compound form,” he added. (Tirzepatide is a diabetes drug made by Eli Lilly that also has weight loss effects.)
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