Approved products
Zepbound (tirzepatide) — Eli Lilly. Approved November 2023 for chronic weight management in adults with BMI ≥30, or ≥27 with a weight-related condition; December 2024 for moderate-to-severe obstructive sleep apnea in adults with obesity. Once-weekly injection, 2.5 mg to 15 mg; pens and single-dose vials.
Mounjaro (tirzepatide) — Eli Lilly. Approved May 2022 for type 2 diabetes. Same molecule and doses as Zepbound.
Wegovy (semaglutide) — Novo Nordisk. Approved June 2021 for chronic weight management; March 2024 for reducing cardiovascular death, heart attack and stroke in adults with cardiovascular disease and overweight or obesity; August 2025 for MASH. Once-weekly injection, 0.25 mg to 2.4 mg. An oral Wegovy tablet (25 mg daily) was approved December 2025.
Ozempic (semaglutide) — Novo Nordisk. Approved December 2017 for type 2 diabetes, with later cardiovascular and kidney indications. Once-weekly injection, 0.25 mg to 2 mg.
Rybelsus (semaglutide) — Novo Nordisk. Approved September 2019 for type 2 diabetes. Once-daily tablet, 3 mg to 14 mg, with the SNAC absorption enhancer.
Saxenda (liraglutide) — Novo Nordisk. Daily injection for weight management, approved 2014; generic liraglutide available since 2024. Less effective than semaglutide (STEP 8).
Compounded products
Compounded tirzepatide / semaglutide — prepared by a state-licensed pharmacy from bulk active pharmaceutical ingredient for a specific patient. Not FDA-approved or FDA-reviewed. Supplied as multi-dose vials for patient-drawn injection, or as oral, sublingual or orally disintegrating forms without published pharmacokinetic data.
Microdose — a marketing term for protocols using doses below the labeled starting or maintenance doses. No randomized trial evidence supports efficacy at sub-label doses for weight management.
Sublingual / ODT — tablets or troches dissolved under the tongue. Peptides of this size have negligible mucosal absorption without enhancers; no data establish that compounded sublingual GLP-1s deliver a meaningful dose.
Dosing terms
Titration — stepwise dose escalation to limit gastrointestinal effects. Tirzepatide: 2.5 mg for 4 weeks, then +2.5 mg every ≥4 weeks to a maximum of 15 mg. Semaglutide (Wegovy): 0.25, 0.5, 1.0, 1.7 mg for 4 weeks each, then 2.4 mg.
Maintenance dose — the dose held long-term. Tirzepatide 5, 10 or 15 mg; semaglutide 1.7 or 2.4 mg.
Units vs mg — units mark syringe volume (100 units = 1 mL on a U-100 insulin syringe); mg is drug mass. Volume to inject = dose (mg) ÷ concentration (mg/mL).
Trials
SURMOUNT-1 — tirzepatide in obesity without diabetes; −20.9% at 15 mg, 72 weeks. SURMOUNT-2 — with type 2 diabetes; −14.7%. SURMOUNT-3 — after lifestyle lead-in; additional −18.4%. SURMOUNT-4 — withdrawal; +14% regain on placebo. SURMOUNT-5 — vs semaglutide; −20.2% vs −13.7%. SURMOUNT-OSA — sleep apnea; AHI −25 to −29 events/hour.
STEP 1 — semaglutide 2.4 mg in obesity without diabetes; −14.9% at 68 weeks. STEP 2 — with diabetes; −9.6%. STEP 4 — withdrawal; +6.9% regain. STEP 5 — 104 weeks; −15.2%. STEP 8 — vs liraglutide; −15.8% vs −6.4%. STEP UP — 7.2 mg; about −20.7%.
SELECT — semaglutide in cardiovascular disease without diabetes; 20% MACE reduction over 40 months. OASIS 1 / OASIS 4 — oral semaglutide 50 mg and 25 mg for weight management.
Regulatory terms
503A pharmacy — traditional compounding pharmacy, state-licensed, compounds for individual prescriptions, exempt from certain federal requirements (CGMP, new-drug approval, adequate directions for use). 503B outsourcing facility — FDA-registered, CGMP, FDA-inspected, may compound without patient-specific prescriptions for office use. Essentially a copy — a compounded product that duplicates an approved product; prohibited except during shortage or for a documented individual clinical need. Drug shortage list — FDA list whose entries permit compounding of copies; tirzepatide removed December 19, 2024; semaglutide removed February 21, 2025. Nonresident pharmacy license — a state's permission for an out-of-state pharmacy to ship to its residents.
Pricing terms on this site
Advertised price — headline monthly price at starting dose. Maintenance price — price at highest published dose tier. Membership — separate recurring program fee. True monthly cost — maintenance price + membership + shipping + amortized consultation. 12-month all-in total — a year of true monthly cost; 3 + 9 model for dose-based plans. Flat rate — same price at every dose. Price lock — provider's stated commitment not to raise the rate while the patient remains on the plan. Verified / reported / unverified — see methodology.