Date of Completion

Spring 5-1-2026

Thesis Advisor(s)

Charles M. White

Honors Major

Pharmacy Studies

Disciplines

Other Pharmacy and Pharmaceutical Sciences | Pharmacy Administration, Policy and Regulation

Abstract

Purpose: To identify unique compounded semaglutide and tirzepatide products that existed after the shortage grace period ended and to assess their characteristics.

Methods: Researchers searched for compounding pharmacies using specific terms on Google. They collected the formulation, ingredients, dosage, and monthly cost of products. Researchers also contacted compounding company websites with available information to ascertain further information about products.

Results: Researchers identified 26 sites selling a total of 86 semaglutide or tirzepatide products. Of the included products, 33 were unique, and 41 products were essentially copies of FDA-approved products. Unique formulations included sublingual solution (n=9), sublingual tablets (n=5), and orally disintegrating tablets (n=3). Eighty percent of the 74 products, regardless of formulation, had single APIs while 20% were combination products [semaglutide with cyanocobalamin (11%), tirzepatide with niacinamide (5%), semaglutide with glycine and cyanocobalamin (1%), tirzepatide with glycine and cyanocobalamin (1%), semaglutide with or without docusate and ondansetron (1%), and tirzepatide with or without docusate and ondansetron (1%)]. Twelve websites provided clear contact information, and only four companies responded to queries.

Conclusion: Compounding pharmacies are offering both copies of FDA-approved semaglutide or tirzepatide products and unique formulations, some with co-formulated active ingredients, online. People may be turning to compounding companies for GLP-1 and GLP-1/GIP receptor agonists due to shortages and cost concerns, but whether those products offer clinical equivalence is unclear. The accessibility of these websites is notable but raises concern: while more patients are receiving treatment through this alternative path, the safety of these options may not match their convenience.

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