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Since they debuted, injectable GLP-1 drugs like Ozempic have been in high demand. In addition to treating diabetes and obesity, these medications have cardiovascular benefits, and there’s evidence they may curb addiction and possibly even protect against some types of cancer, which has only further broadened their appeal. But for people who hate needles, these medications hold a glaring, obvious drawback: They require taking a weekly shot.
Now, though, on platforms like Instagram and Facebook, ads for oral knock-off versions of GLP-1 drugs are proliferating. After the brand-name GLP-1 drugs went into shortage in 2022, a booming industry of “compounding” pharmacies and telehealth clinics arose to offer copies of the medications, as they are legally permitted to do when shortages exist. But unlike the pharma giants that produce the originals, these virtual clinics and specialty pharmacies are offering versions of semaglutide and tirzepatide for weight loss that are taken by mouth. They offer lozenges, tablets, pills, cheek gels, drops, and dissolving strips, promising to deliver the same active ingredients as the trademark medications without the injections.
It’s an appealing prospect—especially since these drugs are offered at a fraction of the price of their name-brand counterparts and are often shipped overnight after a prospective patient fills out a quick online questionnaire. A month’s supply of semaglutide lozenges with vitamin B6 added from the telehealth startup Strut, for example, costs $149 without insurance, versus Wegovy’s $1,000-plus price tag.
“As a pharmacist, I can appreciate the excitement in the rise in oral semaglutide, since it is an easier route than injectables,” says Melinda Lee, a pharmacist who runs the pharmaceutical packaging company Parcel Health as well as a GLP-1 drug availability database. Oral versions also don’t need to be refrigerated like injectables, which makes them easier to ship and store. But although she understands the enthusiasm, Lee remains skeptical. While taking a drug by mouth might be more appealing than a needle, when it comes to GLP-1s, the evidence that they’re as effective just isn’t there yet, she says.
Unlike the brand-name drugs Ozempic, Wegovy, Mounjaro, and Zepbound, compounded versions haven’t been rigorously tested in clinical trials, and they’re not approved by the Food and Drug Administration. And although by law they must contain the same active ingredient as the drug they mimic, these orally formulated medications may not work nearly as well as the injectable drugs.
Maria Daniela Hurtado Andrade, an obesity specialist at the Mayo Clinic in Jacksonville, Florida, says she doesn’t recommend oral compounded GLP-1 medications to her patients. “I do not consider them, I do not prescribe them, and I do not endorse them,” she says.