Compounded semaglutide and tirzepatide: what you should know

Some patients in the UAE are offered a compounded GLP-1, or consider one because it costs less. Compounding has a legitimate place in medicine, and the concerns about compounded GLP-1 products relate to how they are made, tested and marketed.

What does compounding mean?

Compounding is the preparation of a medication by a pharmacy for an individual patient, for example in a different strength, in a liquid form for a patient who cannot swallow tablets, or without an ingredient a patient is allergic to. It has a legitimate role in medicine when a licensed product cannot meet a specific medical need.

A compounded GLP-1 is different. It is prepared from an active pharmaceutical ingredient obtained by the pharmacy, often combined with added substances, and marketed to many patients as an alternative to Mounjaro, Wegovy or Ozempic. The manufacturing process, the ingredient supply, the stability of the finished product and the dose each injection delivers have not been assessed the way they are for a licensed medicine.

Is a compounded product the same medicine?

A compounded product is not the same medicine as the licensed one. The US Food and Drug Administration (FDA) states in its statement on unapproved GLP-1 drugs that compounded semaglutide and tirzepatide have not been reviewed for safety, effectiveness or quality before they are marketed. The same statement notes that some compounders use salt forms of semaglutide, such as semaglutide sodium or semaglutide acetate, which are different active ingredients from the one in the approved medicines.

A licensed medicine comes with a known dose in each pen or tablet, a tested shelf life, a storage specification and a leaflet. The dose, stability and shelf life of a compounded product have not been verified by a regulator, and a patient cannot check them at home. Our page on Mounjaro explains what the licensed product contains and how our endocrinologists prescribe it.

What do the regulators say?

The FDA’s statement on unapproved GLP-1 drugs says that unapproved GLP-1 products, including compounded semaglutide and tirzepatide, are not reviewed by the agency for safety, effectiveness or quality before they are marketed. The FDA has received reports of dosing errors with compounded injectable semaglutide, some requiring hospital treatment, and reports of patients taking doses above the approved label.

The same FDA page advises patients to obtain a prescription from their doctor, to fill it at a licensed pharmacy, and not to use an injectable GLP-1 product that arrives warm. In the UAE, the Emirates Drug Establishment approves medicines for the market, and the licensed products listed below are dispensed through licensed pharmacies.

What did recent analyses find?

A previously unidentified impurity

Scientists at Eli Lilly, the manufacturer of Mounjaro, tested samples of compounded tirzepatide combined with vitamin B12 obtained from the US market and reported the results in Expert Opinion on Drug Safety in 2026. They identified a widespread and previously unidentified impurity, formed by a chemical reaction between tirzepatide and certain forms of vitamin B12, present at substantial levels in the products tested. The authors state that the clinical effects of the impurity are unknown. The study was carried out by the manufacturer of the licensed product, and the authors disclosed this.

Added ingredients with little justification

Researchers at the University of Connecticut School of Pharmacy reviewed compounded semaglutide and tirzepatide products marketed online and published their findings in the Annals of Pharmacotherapy in 2026. Of 33 unique products, 48% combined the GLP-1 with ingredients such as cyanocobalamin (vitamin B12), glycine, niacinamide, docusate or ondansetron, and only 18% reported a beyond-use date and storage conditions. The authors found little justification for adding nutrients to an injectable GLP-1 and described the popularity of these products as concerning given the lack of evidence for safety and efficacy.

Why do some compounded products contain added ingredients?

Adding an ingredient such as vitamin B12 or niacinamide makes a product different from the licensed medicine, which in some markets is a condition for compounding it, and it allows the product to be marketed as personalised. The added ingredient is sometimes described as reducing nausea or supporting energy, although the Annals of Pharmacotherapy review found little justification for it. The Eli Lilly analysis shows that an added ingredient can also react with the active ingredient.

What is the situation in the UAE?

Compounded GLP-1 products became widespread in the US during a period when the licensed medicines were in short supply. In the UAE, licensed Mounjaro (tirzepatide), Wegovy and Ozempic injections, the Wegovy pill and Foundayo (orforglipron) are all approved and available through licensed pharmacies, so there is no supply reason to use a compounded product here.

Cost is the other reason patients consider the compounded route. Medication prices in the UAE are the official pharmacy prices. The medication price for Mounjaro is AED 1,734 per month, the same at every dose from 2.5 mg to 15 mg. Endocare adds no markup to the official pharmacy price and does not earn on medication. Your endocrinologist confirms the price of the other medications at the consultation, as it varies with the prescribed dose. Our page on what Mounjaro costs and our pricing page set out the options.

Patients are also offered GLP-1 products through social media, messaging apps and overseas websites. Our articles on buying Mounjaro online in the UAE and on whether you can buy Mounjaro, Ozempic or Wegovy over the counter explain why a prescription and a licensed pharmacy are the safe route, and why counterfeit pens are a separate problem from compounding.

What does Endocare prescribe, and why?

Endocare prescribes licensed GLP-1 medications only, dispensed through licensed pharmacies in the UAE. Your endocrinologist will assess whether a GLP-1 medication is appropriate for you, select between the licensed options from your assessment, and review the dose with you at each monthly follow-up. Dose decisions are made by your endocrinologist together with you at the monthly follow-up, in roughly four-week increments, based on your weight loss response, how well you tolerate the medication and your body composition trends. There is no automatic increase after four weeks.

A licensed medicine delivers a known dose, has a tested shelf life and storage specification, and is supported by clinical trials that measured what it does over more than a year. A compounded product offers none of those assurances. Patients who are considering microdosing to make a pen last longer can discuss their dose with their endocrinologist. Patients should not decide by themselves to start a GLP-1 medication. A doctor’s review is critical to ensure the treatment is safe and appropriate for the individual.

Frequently asked questions

Is compounded tirzepatide the same as Mounjaro?

Compounded tirzepatide is not the same as Mounjaro. Mounjaro is the licensed tirzepatide product, manufactured under an approval that covers its manufacturing, dose, stability and clinical evidence. A compounded product names the same active ingredient but has not been through that review, and analyses of compounded tirzepatide products have found added ingredients and a previously unidentified impurity.

Is compounded semaglutide safe?

It has not been shown to be. The FDA states that compounded semaglutide is not reviewed for safety, effectiveness or quality, and it has received reports of dosing errors and of products using salt forms of semaglutide that are different active ingredients. Endocare does not prescribe compounded semaglutide.

Why is a compounded product cheaper?

A compounded product has not been through the clinical trials, manufacturing standards and regulatory review that a licensed medicine must complete. Its ingredients, stability and dose accuracy are also not verified by a regulator. In the UAE, licensed medication prices are the official pharmacy prices, and Endocare adds no markup to them.

Why do some compounded products contain B12 or B6?

Adding an ingredient makes the product different from the licensed medicine and allows it to be marketed as personalised. A 2026 review in the Annals of Pharmacotherapy found little justification for adding nutrients, and scientists at Eli Lilly reported that tirzepatide can react with certain forms of vitamin B12 to form an impurity whose clinical effects are unknown.

Is compounding legal in the UAE?

The legal status of compounding is a matter for the UAE regulator. Licensed GLP-1 medications are approved for use in the UAE and available through licensed pharmacies. Endocare prescribes those licensed products only.

What does Endocare use?

Endocare prescribes licensed Mounjaro, Wegovy and Ozempic injections, the Wegovy pill and Foundayo, dispensed through licensed pharmacies in the UAE. Your endocrinologist will choose between them from your assessment. Endocare adds no markup to the official pharmacy price.