Whether it’s due to an allergy or other reasons, compounding pharmacies can help tailor a custom-made medication to meet your needs. And when drug shortages happen, they can play an important role, too.

Two semaglutide injections, Ozempic and Wegovy, have recently been affected by shortages. Given the demand, some compounding pharmacies jumped at the opportunity to fill a medical need. By mixing up semaglutide injections from scratch, they could help people continue treatment — and at a lower cost.

Under certain conditions, the FDA allows pharmacies to make medications that are in shortage. But many people are questioning how and where pharmacies are getting semaglutide in the first place. And a closer look has revealed that some sources fall short of federal safety requirements. Because of this, certain states have banned compounded semaglutide altogether.

If you’re unable to access Ozempic or Wegovy, compounded semaglutide may seem like a tempting alternative. But is it worth the risk?

Compounded semaglutide is not the same as Ozempic or Wegovy
Ozempic and Wegovy are both FDA-approved medications. That means they’ve gone through rigorous testing and review to ensure that they’re safe and effective for their intended uses. During the approval process, the FDA also signed off on where and how Ozempic and Wegovy are made.

Compounded medications are different. They’re made by specialized pharmacies that source pharmaceutical-grade active ingredients and combine them to make a finished product. These medications have an important place in medicine, but they also have their own unique risks. And there are a few differences between commercial and compounded semaglutide products to consider.

Testing and approval
Compounded semaglutide injections are custom-made. So, they don’t go through the same rigorous testing and approval process as Ozempic or Wegovy. In other words, the FDA has not evaluated their safety and effectiveness. And in a recent release, the FDA stated that it has received reports of safety problems in people using compounded semaglutide.

Ingredients
When making semaglutide injections, pharmacies will use a recipe that’s likely different from Ozempic or Wegovy. And compounded semaglutide may contain different or extra ingredients, which we’ll cover later.

Medication delivery and storage
Ozempic and Wegovy are only available as prefilled injection pens. Compounded semaglutide injections are usually dispensed in a vial. That means you’ll need to draw up your specific dose with a syringe prior to injecting. Storage requirements and shelf life will also likely be different, depending on how the injections are being made.

Some semaglutide injections are being sold without a prescription
Just like Ozempic or Wegovy, compounded semaglutide injections require a prescription. Avoid buying semaglutide vials being sold online without a prescription. They’re often sold as “research chemicals,” which are unregulated and not intended for human use.Pharmacies may be using unauthorized forms of semaglutide
Ingredients used to compound medications must meet certain federal requirements. But some semaglutide injections are being made with ingredients that do not appear to meet these requirements.

Semaglutide salts
Semaglutide salts, like semaglutide acetate or sodium, are different from what’s contained in Ozempic and Wegovy. Commercial forms of semaglutide are made with semaglutide base (not salts), which is available through their manufacturer, Novo Nordisk. But Novo Nordisk has said that it does not sell this ingredient to pharmacies for compounding.

Unauthorized sources
If pharmacies are able to get semaglutide base, it must be made by a facility that’s registered with the FDA. However, it’s possible that pharmacies may be purchasing semaglutide base from facilities that don’t meet this requirement, raising quality and safety concerns.

Non-pharmaceutical grade products
Some pharmacies may be purchasing semaglutide that’s labeled “for research use only” to make the injections. As mentioned above, these chemicals are unregulated and are not meant to be used in people. So, they don’t meet the federal requirements for compounding.

Compounded semaglutide injections may contain additional ingredients not found in Ozempic or Wegovy
Some compounded semaglutide injections may contain extra ingredients, like vitamin B12. These additions may be advertised as helping to make semaglutide work better or lessen side effects. But there’s no evidence in humans to support this. And studies haven’t been done to determine if adding these ingredients to semaglutide is safe, either.

Only certain pharmacies can compound injectable medications
Compounded semaglutide injections must be made in a sterile environment to prevent contamination. And some states require certain certifications or licensing to provide these services. If the regulatory requirements for compounding semaglutide are met, only pharmacies with the proper equipment, training, and facilities are legally able to make the injections.

Sterile compounding requirements are in place to help protect you from serious problems, like infections. This can happen if you’re exposed to contaminated injections. Getting compounded semaglutide from an unqualified pharmacy can put you at risk.

Cheaper doesn’t mean better
Compounded semaglutide may be advertised as a lower-cost alternative to Ozempic or Wegovy. But there are some risks to consider, as covered above. And the quality of the injections you receive depends on the pharmacy making them and where they’re getting their ingredients.

Keep in mind: The FDA allows pharmacies to compound versions of FDA-approved medications in certain situations, but cost isn’t one of them. And if a drug shortage is resolved, this typically means that the medication should no longer be compounded.