What is the Difference Between GLP-1 and Compounded GLP-1?

‍Have you ever wondered what compounded GLP-1 medications are and how they differ from other GLP-1 drugs? If yes, you’re not alone. It’s not uncommon for these compounded alternatives to appear on one’s screen when searching for weight loss treatment options. Additionally, they often stand out as being more accessible, but do they deliver similar results? 

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As you’re trying to decide what’s best for you on your slim-down journey, it helps to have some clarity surrounding compounded and branded GLP-1s. Therefore, we will explore the differences between the two so that you can make the most informed decision for your needs.

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Understanding Glucagon-Like Peptide 1 and Semaglutide 

Before we explain what compounded medications are, it’ll help first to clarify what they’re derived from. 

When you hear people talking about glucagon-like peptide (GLP) 1 receptor agonists or semaglutide, they’re referring to a class of medications that help with type 2 diabetes, weight loss, chronic kidney disease, and more. 

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The medication mimics the naturally occurring GLP-1 hormone that’s released in the gut after eating. This insulin-stimulating hormone aids with appetite suppression, gastric emptying, and blood sugar control.

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Branded  GLP-1 Medications

Semaglutide is an active ingredient currently available under three different brand names: Ozempic, Wegovy, and Rybelsus. We’ll describe each of them below, so you have some context. 

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1. Ozempic

In 2017, the Ozempic injection was approved by the U.S. Food and Drug Administration (FDA) for use in adults with type 2 diabetes. It’s designed to be administered once a week in conjunction with diet and exercise, and has a max dosage of 2 milligrams (mg). 

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Ozempic has been a revolutionary drug for managing diabetes, but people also quickly realized that it had an interesting side effect: weight loss. Suddenly, individuals without diabetes were seeking the medication as a weight loss aid, leading to a surge in off-label use. 

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To clarify, off-label prescribing doesn’t mean that a drug isn’t safe or effective for the person being prescribed the medication -- it simply implies that an individual is using it for a reason other than what it was approved for. 

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2. Wegovy 

To ensure the efficacy of semaglutide for weight management, additional research was conducted, including the STEP (Semaglutide Treatment Effect in People with Obesity) clinical trial program. The results from these trials were positive and eventually led to Wegovy receiving FDA approval as a chronic weight management medication in June 2021. It’s the first once-weekly GLP-1 receptor agonist to obtain approval for this reason. 

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In many ways, Wegovy is simply a higher-dose version of Ozempic, as they both contain the same active ingredient. However, the intended recipient of the medication is different. For instance, Wegovy is for adults with obesity, which is defined as having a body mass index (BMI) of 30 kilograms (kg) or more. It’s also approved for the following: 

• Adults who are overweight (27 kg or more) with at least one weight-related condition, such as hypertension, type 2 diabetes, or dyslipidemia. 
• Pediatric patients (12 and older) with a BMI at or above the 95th percentile for their age and sex. 

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3. Rybelsus 

Unlike Ozempic and Wegovy, Rybelsus is a semaglutide tablet, available in 3, 7, and 14 mg doses. It’s meant to be taken once daily, and is currently FDA-approved for adults with type 2 diabetes. However, some healthcare professionals have prescribed Rybelsus off-label for weight management, especially if a patient is opposed to injections. It’s also been an alternative for some during times when there was a shortage of Ozempic and Wegovy. 

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There have been clinical studies done on higher oral semaglutide doses to assess its efficacy in adults without diabetes, and the results have been promising. 

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For example, researchers of the OASIS 1 trial evaluated the effect of a 50 mg oral dose of semaglutide. They found that participants lost an average of 15.1% of their total body weight over a 68-week period. This was on par with the results of injectable GLP-1 receptor agonists, so it may get FDA approval for weight management in the next year or two. 

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Accessing compounded GLP-1 medications is just one click away »‍

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Compounded Semaglutide, Custom Medications

Often confused with being a generic version of a drug, a compounded medication is one that has been customized in some way to meet the unique needs of a patient. It means that the mass-produced formulation was either unavailable or unsuitable for the patient's requirements. 

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However, in what ways might they differ from the brand-name version, and potentially benefit you? We’ll shed some light on that below. 

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FDA Approval & Testing Process 

Although practitioners can prescribe either Wegovy or compounded semaglutide to help individuals lose weight, they haven’t both undergone the same testing and approval process. 

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‍As mentioned earlier, Wegovy has been FDA-approved, indicating that it has undergone clinical trials to assess its effectiveness, safety, and other relevant factors. To achieve approval, the medication had to be carefully evaluated by a team of experts to determine that the benefits outweigh the risks for the intended population when used to treat a specific condition. 

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In comparison, compounded semaglutide is not FDA-approved. A big part of this is because they’re either used to mitigate a shortage or accommodate an individual's unique needs. While high-level review and oversight are important, the process of preclinical research and market approval can take 10 years or more, which isn’t reasonable when people need medications promptly. 

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During the semaglutide shortage, it’s possible that many people may have experienced worsening health outcomes without compounded semaglutide.  

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Brand-Name vs. Compounded GLP-1 Ingredient Profiles

Compounded GLP-1 medications include the same active ingredient (semaglutide) as Wegovy, Ozempic, and Rybelsus. Yet, this still doesn’t make them the same drug. 

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For one, some compounding pharmacies use semaglutide acetate, which is a semaglutide salt that doesn’t meet FDA guidelines. In contrast, the brand-name GLP-1s are made with a semaglutide base. It’s best for compounding pharmacies to utilize a semaglutide base as well, and to purchase it from an FDA-registered supplier, as those do meet certain federal requirements.  

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Additionally, there are some compounded GLP-1 versions that contain vitamin B12 as an inactive ingredient, which isn’t found in either of the commercially available drugs. 

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Another thing to consider is if someone has an allergy to one of the inactive ingredients found in the brand-name versions. Fridays co-founder, Dr. Sina Arham, shares that “With compounded semaglutide, that allergen can be removed, allowing you to use the medication safely.” 

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Adjusted Dosage Strength 

Each of the trade-name drugs has specific available dosage strengths that were developed based on the clinical trials they underwent. However, in some cases, what is available may not be the most appropriate option for a patient. 

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Let’s say you go to a doctor who believes GLP-1s could be beneficial, but they want you to start on a lower dose than what’s commercially available. Or maybe you’ve lost weight and want to maintain your results with microdosing. In either scenario, a compounding pharmacy could personalize your dose with compounded semaglutide, allowing you to follow a dose escalation schedule that better accommodates your needs. 

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GLP-1 and Compounded GLP-1 Dosage Forms 

Currently, the brand-name GLP-1 drugs are either available as an injection or an oral tablet. But what happens if a patient can’t utilize them in those dosage forms? 

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‍If their provider believes that a GLP-1 weight management medication may improve their health outcomes, they can collaborate with a compounding pharmacy to customize one that fits the patient's health preferences. 

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Compounded semaglutide versions may be made in the following forms: 

• Nasal sprays
• Oral capsules 
• Orally disintegrating tablets 
• Sublingual drops (administered under the tongue)

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The Manufacturing Process

One significant way that brand-name and compounded GLP-1s differ is in the entity that produces them. 

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The drug company, Novo Nordisk, manufactures each of the previously mentioned trade-name medications. Compounded medications, on the other hand, are produced by either a state-licensed pharmacy or physician, or an FDA-registered outsourcing facility. 

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Pre-filled Injection Pens vs. Syringe 

At this time, Wegovy and Ozempic are only available as prefilled pens, meaning the device is already filled with medication upon arrival. Compounded semaglutide injections, though, are often dispensed in a vial. This requires individuals to fill the syringe with the recommended dose of medicine from the vial prior to injecting it.   

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Purchase your compounded GLP-1 from state-regulated pharmacies here!

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Join Fridays for Compounded GLP-1 Drugs

Now that you understand how compounded GLP-1 medications and the brand-name ones differ, you might be wondering where you can find reputable compounding pharmacies that prioritize your safety. Well, that’s where Fridays comes in. 

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At Fridays, we make it easy for individuals to gain access to compounded medications that can help them along their weight loss journey. However, just because we make the process seamless doesn’t mean we overlook what’s most important: your well-being and safety. That’s why we only work with state-regulated compounding pharmacies that adhere to strict regulatory standards. 

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Start Losing Weight with GLP-1 Medication Today »

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