A month of Wegovy costs about $1,349 in cash. A month of compounded semaglutide, from a telehealth site, costs about $99. Both contain semaglutide. They are not the same medicine, and the difference is worth understanding before you decide, because it is not only a difference of price.
What compounded actually means
A compounded drug is made to order by a pharmacy for one named patient, under a prescription written for them. It is a real and long-standing part of medicine: it is how a child gets a liquid version of a tablet, or how somebody allergic to a dye gets the drug without it.
What it is not is an approved product. The FDA does not review a compounded drug for safety, effectiveness, strength or quality before it is sold. Nobody has verified that the vial in your hand holds what the label says. That is not an accusation about any particular pharmacy. It is the category: an approved medicine carries that assurance and a compounded one never has.
Some compounded versions have used semaglutide salts, a chemically different form of the molecule, which the FDA has said it has not reviewed and which is not the ingredient in the approved drug.
The gap is real
That gap is why this page exists. It is not a marketing exaggeration and it is not a trick. An approved drug carries the cost of the trials that proved it works, a marketing authorisation, and a manufacturer's supply chain. A compounding pharmacy carries none of those. The saving is genuine, and so is what you give up for it.
It comes in a vial, and that is the part to slow down on
Branded Wegovy and Zepbound arrive as a pen. The dose is dialled or already fixed, and you press it against your skin. Compounded semaglutide and tirzepatide are typically shipped as a vial with a supply of syringes. You measure and draw the dose yourself.
The consequences reported were severe nausea and vomiting, dangerously low blood sugar, dehydration, fainting and hospital admission. By 30 April 2025 the FDA had received 520 adverse event reports involving compounded semaglutide and 480 involving compounded tirzepatide.
This is the most useful paragraph on this page. If you go ahead, do not guess at the first dose. A pharmacist will walk you through drawing it, in person, for nothing, and that is true whether or not they dispensed it.
The ground is narrowing
Mass compounding of these drugs was permitted because they were in shortage. Those shortages ended, tirzepatide in late 2024 and semaglutide in February 2025, and the FDA's enforcement discretion for outsourcing facilities ended in March 2025. In April 2026 the agency proposed excluding semaglutide, tirzepatide and liraglutide from the list of substances outsourcing facilities may compound at all, on the basis that there is no clinical need for it.
Patient-specific compounding by a 503A pharmacy, on a prescription written for you, is the narrower route that remains. A seller operating there should say so plainly. If a site will not tell you which pharmacy makes its product and under which section, that is an answer.
What it is not
The tablet is not the shortcut it looks like
Some sellers offer a compounded GLP-1 as a dissolvable tablet or a drop held under the tongue, and often price it above the injection. The appeal needs no explaining: there is no needle, and nothing to draw up. The difficulty is whether any of it reaches your blood.
There is an approved tablet, Rybelsus, so the route itself is not the objection. It works by being co-formulated with SNAC, which raises the pH right around the tablet and shields the molecule from the stomach long enough to cross the wall. The enhancer is the invention. Semaglutide on its own does not survive the journey, which is why the injection existed first.
A compounded dissolvable tablet is not that formulation. Stanford Medicine and Pharmacy Times have both noted that these oral and sublingual versions have never been through a clinical trial, and that there is no data on how much of the dose is absorbed. That is a different and worse problem than the one the rest of this page describes. Elsewhere the question is whether the vial holds what the label says. Here the question is whether a medicine that is in the tablet ever gets out of it.
With the injection you at least know the dose went in. If you are choosing between the two and the tablet costs more, that is the wrong direction for the money to point.
What to ask before you buy
Four questions, and a seller worth using answers all four without hedging: which pharmacy compounds it and under which section, whether it is semaglutide base or a salt, whether it ships as a vial or a pen, and what the price becomes once any introductory period ends. The last one catches more people than the first three.
Two sellers we can name, and what we know about them
HealthRX is LegitScript-certified, says on its own product pages that the preparation is compounded by a licensed 503A pharmacy on a patient-specific prescription, and states plainly that it is not the branded product. It ships a four-week vial supply, so the paragraph above about your first dose applies. Its published prices are about $99 a month for semaglutide and $179 for tirzepatide.
MEDGm
MEDGm sells compounded semaglutide and tirzepatide at $169 a month, covering the consultation, lab work and the medication. It names its compounding pharmacies in its terms — RedRock, HealthWarehouse, Precision Medicine and Triad Rx, with addresses and telephone numbers — which is more than most sellers will do, and its safety page says the product is a vial "self-administered with a needle and syringe". So the paragraph above about your first dose applies here too.
Three things it does not say on the product page. Its terms disclose that images on the site "may be generated or enhanced using artificial-intelligence technologies", so treat the before-and-after photographs as illustration. A clinician decides whether you qualify after you have paid. And the page we link to also sells the dissolvable tablet at $239 — the product the section above is about, and the one we would not buy.
Those links pay us if you sign up. Everything above is said anyway, including the parts that cost us the commission, because a page that tells you only the good half is worth nothing to you.
And what the approved drug actually costs
Before deciding, price the real thing, at the cash price rather than the list price a telehealth page quotes to make its own number look better. Semaglutide here, and tirzepatide here. Manufacturers now sell some of these direct, well under the pharmacy counter price, and that route involves no compounding at all.
The sellers above list the branded drugs too. MEDGm shows Wegovy and Zepbound at "$99 membership + medication cost" — a fee, plus a number it does not publish, and it is worth noticing which half is absent. Novo publishes theirs outright: $149 a month for the Wegovy pill and $349 for the pen, bought direct, with no membership of any kind. When one price can be read in full and the other only in half, price the full one first and make the other prove it beats it.