Imitations of the drugs Ozempic and Wegovy are spreading on the market. Are they safe?

By Berkeley Lovelace Jr, Reynolds Lewis and Marina Kopf -

Last year, when Robin Langois, 58, was prescribed Wegovy, a weight-loss medication, he couldn't afford its high price because his insurance didn't cover it.

But he later discovered on TikTok that people could get what appeared to be the drug's active ingredient, semaglutide, at specialty pharmacies for a fraction of the price.

Langois, of Tucson, Ariz., said he was hesitant at first for safety reasons, but eventually found a telehealth provider who wrote the prescription.

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“I'm not 100% sure what I'm getting,” Langois says.

However, she has experienced feelings of fullness and weight loss, as well as nausea, a common side effect of the drug.

“It works as it should,” she stated.

Whether it's cost or scarcity, people are looking for alternatives to the brand-name drugs Ozempic and Wegovy, both of which contain the active ingredient semaglutide.

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Some people, like Langois, turn to compounding pharmacies for these hard-to-find medications.

Novo Nordisk, the sole maker of Ozempic and Wegovy and the patent holder for semaglutide, said in a statement that it does not supply the ingredient to these pharmacies, leading some experts to question where the pharmacies source the drug from, and whether try semaglutide.

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“That's the million-dollar question,” says Dr. Fatima Cody, an obesity physician at Massachusetts General Hospital (Boston) and a consultant to Novo Nordisk.

What are compounding pharmacies?

According to the Food and Drug Administration (FDA), compounding pharmacies mix and modify drug ingredients to create medications tailored to the specific needs of each patient. 

Compound medicines are usually created from the active ingredients of drugs.

In the case of Ozempic and Wegovy, it is semaglutide. 

But the compounded drugs — even though they contain FDA-approved ingredients — aren't FDA-approved, meaning they aren't regulated, supervised or tested by the agency, said Benjamin Jolley, a pharmacist and owner of Jolley's Compounding Pharmacy in Salt Lake City. .

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According to the FDA, hospitals sometimes turn to compounded drugs when the commercial option is less than ideal.

For example, they can reduce the dose of the pain reliever to avoid some side effects, or eliminate preservatives or dyes that could cause an allergic reaction. 

The FDA will also grant exemptions that allow compounding pharmacists to make certain drugs in the event of a shortage, according to Jeremy Kahn, an agency spokesman.

Do pharmacies offer genuine semaglutide compounding?

It is safe?

Dr. Chris McGowan, who runs a weight-loss clinic in Cary, North Carolina, has noticed that the composite versions of Wegovy and Ozempic are becoming more popular.

“What I hear from patients is, 'Oh hey, I've heard of this compound semaglutide.

May I try it on?".

Mary Morgan Mills, 32, of Raleigh, North Carolina, came to McGowan after taking what she was told was a compounded version of semaglutide for a year. 

The weekly shot, which he received at a wellness center, made him nauseous, and he only lost about 15 pounds while taking it.

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"I felt duped," she said, adding that she still had "bottles of that in my fridge."

“I've always wanted to go get it tested to see what it really is, but I don't know the process,” Mills said.

McGowan said that, in many cases, compounding pharmacies are not fully transparent about how they source the drug.

The antidiabetic drug Ozempic (semaglutide) manufactured by the Danish pharmaceutical company Novo Nordisk.

Joel Saget/AFP via Getty Images

Jolley, which doesn't offer semaglutide, said compounding pharmacists may be giving people semaglutide sodium, a cheaper, modified version of the compound that's only intended for research.

However, the FDA has not approved semaglutide sodium, so its sale would be illegal.

Compounding pharmacists could also be buying larger doses of semaglutide from wholesalers and then separating it into smaller doses or mixing it with other pharmaceutical ingredients.

Matt Buderer, a pharmacist and owner of Ohio's Buderer Drug Company Compounding Pharmacy, said that would essentially dilute the drug, which he doesn't think makes sense, as it would make it less effective.

If what the compounding pharmacies are offering as semaglutide is not actually the drug, it is ultimately a safety issue, because the ingredients they are using may not be thoroughly evaluated by the FDA.

“What I tell patients is to be very careful when considering any form of compounded semaglutide or compounded tirzepatide, which is another drug that we're seeing currently offered in a compounded form,” he said.

(Tirzepatide is a diabetes drug made by Eli Lilly that also has slimming effects.)