This article is educational and does not replace medical advice. Prescription medication requires review by a licensed clinician and, when appropriate, a valid prescription. Compounded medications are not FDA-approved, and the FDA does not verify their safety, effectiveness or quality before marketing. Treatment eligibility is an individual clinical decision.

Written by Dr. Parmis Mojarab, DO·Reviewed by Kim Callender, NP, FNP-BC·Published July 12, 2026·Last reviewed July 12, 2026·Methodology v1.0

GLP-1 medications and telehealth

GLP-1 receptor agonists are the most effective pharmacological weight-management and glycemic-control tools available in 2026. This hub covers the molecules, the brands, compounded options and how to evaluate providers.

Quick answer

GLP-1 (glucagon-like peptide-1) receptor agonists reduce appetite and improve blood-sugar control. The class includes semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), plus older and investigational agents. This hub routes you to molecule guides, brand pages, cost analysis and provider reviews.

Explore this topic

Tirzepatide

Dual GIP/GLP-1 agonist — the highest average trial weight loss

Semaglutide

The most widely used GLP-1 agonist

Best GLP-1 programs

Independently scored provider ranking

GLP-1 cost guide

Every pricing pathway compared

Compounded GLP-1

What compounding is and its current limits

Microdosing

Low-dose protocols: evidence vs marketing

GLP-1 side effects

Common and serious effects across the class

GLP-1 eligibility

Who qualifies and how clinicians decide

Provider directory

Every provider we track

Regulatory contextCompounded drugs are <b>not FDA-approved</b>: the agency does not review them for safety, effectiveness or quality before they are marketed. Federal law also bars compounding drugs that are <b>essentially a copy</b> of a commercially available approved product — a bar that is lifted only while the drug is on the FDA shortage list. Both shortages are over. The FDA declared the tirzepatide shortage resolved on October 2, 2024 and the semaglutide shortage resolved on February 21, 2025, and enforcement discretion ended for all compounders between February 18 and May 22, 2025. On April 30, 2026 the FDA went further, proposing to exclude semaglutide, tirzepatide and liraglutide from the 503B bulks list on a finding of no clinical need. Routine compounding of these molecules is therefore no longer lawful on the basis that made the market — a fact most comparison sites still describe as "permanent legitimacy." It is not.

Sources

U.S. Food and Drug Administration — approval and compounding status.
Primary clinical literature cited on child pages.
Our methodology and source standards.

Spotted an error? Submit a correction.

How to use this section

Everything in this section is built on the same two commitments, and it is worth stating them before you read anything else.

Every price carries an evidence status. Verified means we hold a dated capture of the provider's own page. Reported — pending verification means a provider or a third party reports it and we have not captured it ourselves. Evaluation in progress means verification is pending and we are not asserting the fact. We do not upgrade a price to Verified because another comparison site published it — sites in this category contradict each other routinely, and a figure repeated by three affiliate blogs is still one unverified figure.

Every clinical claim traces to a primary source. FDA labels and guidance for regulatory status; PubMed-indexed randomised trials for efficacy; ClinicalTrials.gov for trial design. Patient forums are never used as evidence of price, safety or efficacy, and animal research is never presented as proof of a human clinical effect.

The context that applies to everything here

Compounding statusCompounded medications are not FDA-approved as finished products, and the FDA does not review them for safety, effectiveness or quality before marketing.

Three facts sit underneath every page in this section, and if you take nothing else from it, take these.

Brand prices collapsed, and most comparison sites have not updated. Brand Zepbound is now $299-$449 through LillyDirect. Brand Wegovy is $349 through NovoCare, and the oral Wegovy tablet is $149. Foundayo, Lilly's approved oral GLP-1, starts at $149. With commercial insurance that covers them, either brand can be roughly $25 a month. Against that, a compounded programme priced above $299 is charging more than the FDA-approved drug.

The legal basis for compounding these molecules narrowed sharply in 2025. The FDA declared both shortages resolved and enforcement discretion ended for every class of compounder between February and May 2025. The surviving route requires a prescriber to document a clinical difference for the individual patient — which is what "personalized dosing" and "microdose" programmes are, as a matter of regulatory mechanics rather than clinical innovation.

The trial evidence applies to injections. Every efficacy figure in this field — SURMOUNT, STEP, SELECT — comes from an FDA-approved subcutaneous injection. None of it was collected on a compounded preparation, a microdose, or an orally disintegrating tablet. The evidence is strong exactly where it was gathered and silent everywhere else.

How to verify any of this yourself

You should not take our word for a price, and you do not have to. Every figure here can be checked in a few minutes.

Go to the provider's own pricing page. Not a comparison site — the provider's. Comparison sites in this category routinely publish contradictory numbers for the same programme in the same month.
Find the ongoing price, not the headline. Look for the words "first month", "intro", "starting at" or "new patients". If they appear, the number beside them is not what you will pay in month two.
Add the membership. If the medication and the membership are billed separately, add them. That sum is your real monthly cost.
Ask what the highest dose costs. By email or chat, so you have it in writing.
Ask about early cancellation before you commit to a plan longer than a month.
Check the manufacturer. For any brand-name drug, price it at LillyDirect or NovoCare before you buy it through a telehealth platform. Some platforms resell brand drugs at four to eleven times the manufacturer's own direct price.

If a provider will not answer questions 4 or 5 in writing, that is itself information.

What we verify, and what we do not

Two claims on any telehealth page look identical and are not. "This provider uses a licensed pharmacy" may mean we checked a state board database, or it may mean the provider said so. Those are different epistemic states and we label them differently.

The three labels, and what each actually means
Label	Means	Example
Verified	We hold a dated capture or a primary-source confirmation	LillyDirect's $299 — from Lilly's own pricing page
Reported — pending verification	A provider or third party reports it; we have NOT captured it ourselves	Competitor prices from the July 2026 dataset; every pharmacy relationship on this site
Evaluation in progress	Verification pending. We are not asserting the fact at all	Cancellation terms we could not obtain in writing

We do not upgrade a price to Verified because another comparison site published it. Sites in this category contradict each other routinely — the dataset behind this site corrected a stored TrimRx figure of $259 that matched no current tier, and an Eden brand-Zepbound figure of $299 that was actually LillyDirect's price rather than Eden's real $1,399. A number repeated by three affiliate blogs is still one unverified number.

Three facts that apply to everything in this section

Brand prices collapsed, and most comparison pages have not updated. Brand Zepbound is $299-$449 through LillyDirect. Brand Wegovy is $349 through NovoCare, and the oral Wegovy tablet is $149. Foundayo, Lilly's approved oral GLP-1, starts at $149. With commercial coverage either brand can be roughly $25 a month. Against that, a compounded programme priced above $299 is charging more than the FDA-approved drug — and several are.

The legal basis for compounding narrowed sharply in 2025. The FDA declared both shortages resolved and enforcement discretion ended for every class of compounder between February and May 2025. The surviving route requires a prescriber to document a clinical difference for the individual patient — which is what "personalized dosing" and "microdose" programmes are, as a matter of regulatory mechanics rather than clinical innovation.

Questions to ask about the pharmacy

The pharmacy matters more than the telehealth brand on the front of the website. The telehealth company arranges the consultation; the pharmacy makes the medicine you inject.

Which specific pharmacy will fill my prescription? Not "our network" — the name of the facility.
Is it a 503A state-licensed pharmacy or a 503B FDA-registered outsourcing facility? These are different regulatory categories with different oversight, and a company can use both for different products.
In which state is it licensed, and can I look up the licence? State boards of pharmacy publish licensee databases.
What is the exact salt form and concentration? Semaglutide sodium and semaglutide acetate are not the same active ingredient as the semaglutide base in approved products, and the FDA has said they are not appropriate for compounding.
Is the vial single-dose or multi-dose? A multi-dose vial requires you to measure each dose yourself, which is the most common source of the dosing errors behind reported adverse events.
Will you provide a certificate of analysis?
Has the pharmacy received any FDA warning letter or state board action?

A provider that answers all seven in writing is demonstrating something real. A provider that will not name its pharmacy has given you an answer, whether it intended to or not.

SURMOUNT-1 — mean body-weight reduction by tirzepatide dose, 72 weeks

Jastreboff AM et al., N Engl J Med 2022 (NCT04184622), n=2,539. Dose-response is real: the effect rises with dose. These are FDA-APPROVED SUBCUTANEOUS INJECTION doses — they do not transfer to compounded, microdose or ODT products. Trial means are not individual promises.

The trial record

Tirzepatide — the complete pivotal trial record, with citations
Trial	Design	n	Dose	Duration	Primary result	Citation
SURMOUNT-1	Phase 3, randomised, double-blind, placebo-controlled	2,539	5 / 10 / 15 mg SC weekly	72 wks	−15.0% / −19.5% / −20.9% vs −3.1% placebo	Jastreboff, NEJM 2022; NCT04184622
SURMOUNT-2	Phase 3, RCT, in type 2 diabetes	938	10 / 15 mg SC weekly	72 wks	−12.8% / −14.7% vs −3.2% placebo	Garvey, Lancet 2023; NCT04657003
SURMOUNT-3	Phase 3, RCT, after 12-wk intensive lifestyle lead-in	806	Max tolerated (10/15 mg)	72 wks	−18.4% additional, vs +2.5% placebo	Wadden, Nat Med 2023; NCT04657016
SURMOUNT-4	Randomised WITHDRAWAL after 36-wk open-label lead-in	670	Max tolerated	88 wks	Continue: −5.5% further. Withdraw to placebo: +14.0% REGAINED	Aronne, JAMA 2024; NCT04660643
SURMOUNT-5	Phase 3b, OPEN-LABEL, active-controlled head-to-head	751	Max tolerated vs semaglutide	72 wks	−20.2% vs semaglutide −13.7%, p<0.001	Aronne, NEJM 2025; NCT05822830
SURPASS-2	Phase 3, RCT, type 2 diabetes, active-controlled	1,879	5 / 10 / 15 mg vs semaglutide 1 mg	40 wks	HbA1c −2.01 to −2.30% vs −1.86%	Frías, NEJM 2021; NCT03987919
SURPASS-CVOT	Phase 3, cardiovascular outcomes, vs dulaglutide	13,299	Max tolerated	~4.5 yrs	Non-inferior for MACE; not superiority vs placebo	Nicholls, 2024; NCT04255433

The caveats that belong with the numbersThree things must travel with every one of those numbers.

1. They are means, not promises. A −20.9% mean in SURMOUNT-1 contains people who lost far more and people who lost almost nothing. A trial average tells you what happened to a population; it does not tell you what will happen to you.

2. Every one is an FDA-APPROVED SUBCUTANEOUS INJECTION. No trial in this table tested a compounded preparation, a microdose regimen, or an orally disintegrating tablet. When these figures appear on a page selling a compounded ODT, evidence has been moved across a dosage form without justification.

3. All were funded by Eli Lilly, which manufactures tirzepatide. That is normal in drug development and does not make the results false — these are large, peer-reviewed studies. It belongs in the citation anyway, and it matters most in SURMOUNT-5, where the funder made the winning drug and the trial was open-label.

SURMOUNT-1 — dose-response is real: mean body-weight change at 72 weeks

Jastreboff AM et al., N Engl J Med 2022, n=2,539 (NCT04184622). The effect rises with dose — which is precisely why a ~1mg 'microdose' cannot be expected to produce the headline result. FDA-approved subcutaneous injection.

What the trials do and do not coverThe boundary of the evidence, for this treatment. Every efficacy figure on this page comes from a trial of an FDA-approved subcutaneous injection. None of it was collected on a compounded preparation, a microdose regimen, or an orally disintegrating tablet.

The evidence is strong exactly where it was gathered and silent everywhere else. The gap between those two things is where most of the marketing in this industry operates, and recognising it is the single most useful skill a patient in this market can have.

Dosing, titration, and what it does to your bill

Tirzepatide titration — the FDA label schedule (Zepbound)
Period	Dose	What it is for
Weeks 1–4	2.5 mg	Tolerance-building only. This dose is not intended to produce weight loss. If your provider's price is quoted at 2.5 mg, that is not the price of treatment.
Weeks 5–8	5 mg	First therapeutic dose (−15.0% in SURMOUNT-1).
Weeks 9–12	7.5 mg	Escalate only if tolerated.
Weeks 13–16	10 mg	A common maintenance dose (−19.5%).
Weeks 17–20	12.5 mg	Escalate only if tolerated.
Week 21+	15 mg	Maximum maintenance dose (−20.9%).

Why titration decides your real priceTitration is where cost is actually decided, and almost no pricing page says so.

The advertised price is usually the 2.5 mg price. On a programme that escalates with dose, the rate you are quoted at signup is for a dose the label explicitly describes as a starting dose — not a treatment dose. Ask what you will pay at 10 mg, and compare that number instead.

A 'microdose' of ~1 mg/week sits below every dose in SURMOUNT. The trials used 5, 10 and 15 mg. A microdose is not a discounted route to the SURMOUNT result; it is a different product with a smaller expected effect and no equivalent trial evidence.

Safety, contraindications and monitoring

Tirzepatide carries a boxed warning for thyroid C-cell tumours, based on rodent data. It is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. This is not a precaution to weigh; it is a hard stop.

Serious but less common risks include pancreatitis, gallbladder disease (cholelithiasis and cholecystitis), acute kidney injury secondary to dehydration from vomiting or diarrhoea, diabetic retinopathy complications in people with existing retinopathy, and hypoglycaemia when combined with insulin or a sulfonylurea. Severe abdominal pain radiating to the back warrants urgent assessment for pancreatitis, not a message to a chat widget.

Before starting, a clinician should establish a baseline: weight and BMI, blood pressure, HbA1c or fasting glucose, a lipid panel, and renal and hepatic function. During treatment, tolerance should be reviewed at each escalation step rather than escalated automatically on a calendar.

Adverse events — tirzepatide 15 mg vs placebo (SURMOUNT-1)

Percentage of participants reporting each event. Gastrointestinal effects dominate, are usually mild-to-moderate, and are most pronounced during dose escalation. Source: SURMOUNT-1, N Engl J Med 2022.

Discontinuation: what the withdrawal trial found

SURMOUNT-4 — what happens when you stop (randomised withdrawal)

Aronne LJ et al., JAMA 2024, n=670 (NCT04660643). After a 36-week open-label lead-in, participants randomised to placebo regained ~14% of body weight over the following 52 weeks; those who continued lost a further ~5%. This is the single most important trial for understanding the true cost of treatment.

In SURMOUNT-4 — the randomised withdrawal trial — participants taken off tirzepatide after a 36-week lead-in regained roughly 14% of body weight over the following year, while those who continued lost a further ~5%. This is the trial that most changes the arithmetic of treatment, and it is almost never cited on a pricing page.

The consequence is financial as much as clinical. If holding the result requires holding the medication, then the figure that matters is not the introductory price, and not even the annual price. It is the indefinite monthly price. Anyone selecting a provider on the strength of a first-month rate is optimising the wrong variable entirely.

Questions to ask your clinician

Given my history — specifically thyroid, pancreatic and gallbladder — is a GLP-1 appropriate for me at all?
What baseline laboratory work will you order before I start?
What is my target dose, and how quickly will we escalate?
Which side effects should make me call you rather than wait it out?
What is the plan for maintenance, and what happens if I stop?
Will I see the same clinician at each follow-up, or a different one each time?

Compounded, brand, microdose, ODT — four different products

These words are used interchangeably in marketing and they are not interchangeable at all. The distinction decides what evidence applies to what you are actually buying.

What each product is, and what evidence supports it
Product	Regulatory status	Trial evidence
Brand Zepbound / Mounjaro (injection)	FDA-approved. Reviewed for safety, effectiveness and quality before marketing.	Direct. SURMOUNT and SURPASS tested exactly this product.
Brand Foundayo (oral, orforglipron)	FDA-approved. Its own trial programme.	Direct, for that product.
Compounded tirzepatide (injection, full dose)	NOT FDA-approved. No premarket review of safety, effectiveness or quality.	None for the compounded product itself. Same molecule, same route — but the product in your hand was never in a trial.
Microdose (~1 mg/wk)	NOT FDA-approved.	None. Sits BELOW every dose in SURMOUNT (5/10/15 mg). Expect a smaller effect.
ODT / oral compounded	NOT FDA-approved.	NONE. No trial has ever tested it. Oral bioavailability for these peptides is a real pharmacological problem and is unpublished for this product.