How to Choose a Compounded Tirzepatide Provider and Pharmacy

There is no official list of the best compounded tirzepatide providers or pharmacies, and FDA does not approve or license any pharmacy.¹ Compounded tirzepatide is not FDA-approved, and FDA does not review it for safety, effectiveness or quality before it is sold.² FDA recommends an FDA-approved drug, such as Zepbound, when one is available and appropriate for you, and says compounded drugs should be used only when an approved drug cannot meet your medical needs.^{3, 2}

If you and your prescriber decide a compounded product is right for you, a legitimate provider meets these basics:

1. A clinician licensed in your state reviews your health history, can explain why a compounded product fits your medical needs better than an approved drug, and writes a prescription.^{4, 2}
2. The company tells you which pharmacy will fill it, and that pharmacy is licensed in your state.^{5, 6}
3. The company never calls its product FDA-approved, generic or the same as a brand-name drug.¹

An approved drug is often the clearer choice: when insurance covers Zepbound, you qualify for Medicare's GLP-1 Bridge, you want a pill, you have type 2 diabetes, or you can pay Lilly's self-pay price for Zepbound, which, as of October 3, 2026, is $299 per 28 days at the 2.5 mg starting dose and then $399 to $449 with on-time refills (see prices and FDA-approved options).⁷ If you may not fit the approved uses, start with your own doctor.

This page does not rank companies, and its checks work on any provider, including PlexusDx. On this page: what the rules allow, six checks, prices, claims to walk away from, FDA-approved options, risks and PlexusDx's answers.

What lawful compounded tirzepatide looks like after the shortage

While tirzepatide was in shortage, compounders had more room to make it. FDA declared the shortage resolved in late 2024 (confirmed December 19, 2024), and its grace periods for compounders ended in March 2025, so these rules apply now.⁸

State-licensed pharmacies (section 503A) may compound tirzepatide for an individual patient's prescription. They may not regularly, or in large amounts, make products that are essentially copies of a drug you can buy, such as Zepbound or Mounjaro. The exception is when the prescriber decides and documents that a change makes a significant difference for that patient.⁸ A prescription listing only the patient's name and the formula does not count.⁹ For now, FDA says it does not intend to act against a pharmacy that fills four or fewer prescriptions of such a copy in a calendar month.⁸ State boards of pharmacy oversee these pharmacies day to day, and federal manufacturing quality rules (CGMP) do not apply to them.⁵

Outsourcing facilities (section 503B) register with FDA, which inspects them on a risk-based schedule, and they must follow CGMP.⁵ They may compound from bulk ingredient (the raw active ingredient) only if it is on FDA's 503B bulks list or the drug is in shortage. As of FDA's April 2026 update, tirzepatide was on neither list, so these facilities are restricted from compounding it that way.⁸ On April 30, 2026, FDA proposed formally excluding tirzepatide from that list after finding no clinical need, and said it would decide after considering public comments.¹⁰ After an extension, comments closed on July 30, 2026, and as of October 3, 2026, FDA had not announced a final decision.¹¹

Semaglutide is in the same position. FDA declared its shortage resolved on February 21, 2025. It was on neither list as of the April 2026 update, and the April 30 proposal covers it too.^{8, 10}

What this means for you. Under FDA's guidance, a lower price alone does not stop a compounded drug from counting as essentially a copy of an approved one, such as Zepbound.⁹ So if price is your only reason, look first at the brand-name routes under FDA-approved options. FDA also said on February 6, 2026 that it intends to restrict the GLP-1 ingredients used in mass-marketed compounded drugs.¹² Before you prepay for several months, ask what happens to your treatment and any unused months if the pharmacy can no longer make it.

Six checks to run before you pay

FDA warns that people buying compounded drugs online may not know which pharmacy made the drug or whether it is properly licensed, and it encourages research before you use an online pharmacy or telehealth service.⁵ So ask which pharmacy will fill your prescription, then check it, or see whether your own doctor can prescribe compounded tirzepatide. Short on time? Do checks 1 to 4.

1. Get your prescriber's name and check the license. A telehealth clinician must be licensed, or legally allowed, to practice in the state where you are located.⁴ Look up a doctor or physician assistant, including actions by state medical boards, on DocInfo.org.¹³ Look up a nurse practitioner on Nursys if your board of nursing shares those licenses with it (Nursys lists which do), or else on the board's own site.^{14, 15}
2. Expect a real screening and a prescription before anything ships. FDA lists a company that does not require a screening and a prescription by a licensed doctor as a warning sign.² A real screening asks about the label's warnings, including whether you or a family member has had medullary thyroid carcinoma (MTC), a type of thyroid cancer; whether you have multiple endocrine neoplasia syndrome type 2 (MEN 2); allergies to tirzepatide or any other ingredient, including added ones such as vitamin B12 or glycine; pancreatitis; severe stomach problems such as gastroparesis (very slow stomach emptying); a history of diabetic retinopathy (diabetic eye disease); pregnancy or breastfeeding, now or planned; planned surgery or sedation; and other medicines, including insulin or a diabetes medicine that makes the body release more insulin, such as a sulfonylurea (see the risks section).^{16, 17}
3. Get the pharmacy's name in writing before you pay. FDA knows of fake compounded tirzepatide with labels naming pharmacies that do not exist, or real pharmacies that did not make it.² If a company will not name its pharmacy, you cannot do the next two checks.
4. Confirm the pharmacy is licensed in your state. Every state requires pharmacies, including out-of-state ones that ship to its residents, to be licensed.¹⁸ FDA's BeSafeRx page links to each state's license search and says not to use a pharmacy that is not listed.⁶ A license does not prove a batch was made correctly, and injectable tirzepatide must be sterile,¹⁹ so ask whether the pharmacy is licensed for sterile compounding. In a secret-shopper study published in 2026, 4 of 21 facilities supplying weight-loss clinics and medical spas in two states were not.²⁰ Two private checks add a little. The National Association of Boards of Pharmacy (NABP) Safe Site Search shows whether a pharmacy website is accredited or on its Not Recommended list (an unreviewed site shows only that),¹⁸ and LegitScript's lookup shows whether a health website holds its private certification, which is not a license.²¹
5. Look up the pharmacy's FDA record. FDA's compounding actions list shows inspection findings (Form 483s), warning letters, referrals to state boards and recalls, facility by facility.²² Search FDA's warning letter database for the company's and the pharmacy's names. FDA notes that a letter's issues may have changed since.²³ If a company says its pharmacy is a 503B outsourcing facility, find it on FDA's registered list (it omits state board actions, and a Form 483 there is not a final finding)²⁴ and ask how it can compound tirzepatide given the 503B limits above.⁸
6. Ask two questions about the medicine itself. Why does a compounded product, rather than an FDA-approved drug, fit your medical needs? And does it contain anything besides tirzepatide, such as vitamin B12 or glycine, and why? See added ingredients for why this matters.

When the medicine arrives

• The label names a pharmacy you can find in your state's license search, with no spelling errors and a correct address.^{2, 6}
• The medicine looks like what you were shown or received before, in intact packaging with instructions for use.²
• Injectable medicine arrives cold; FDA advises not using any injectable GLP-1 that arrives warm or without enough refrigeration.²
• With a vial, you get the right syringe and are shown how to measure your dose. FDA says mix-ups between milliliters, milligrams and "units" may have contributed to dosing errors with compounded semaglutide vials.^{2, 25} If you think you took too much, call your prescriber or Poison Help at 1-800-222-1222, or go to an emergency room right away.¹⁶ See pens and vials.
• FDA advises throwing away a multiple-dose vial 28 days after first use, even if medicine is left or the pharmacy says it lasts longer, and using a new, sterile needle and syringe for every dose.²
• You know how to store it and its beyond-use (use-by) date. Ask the pharmacy: only 18% of 33 compounded semaglutide and tirzepatide products listed on pharmacy websites in early 2025 gave this information.¹⁷
• A licensed clinician is available to answer questions.²

If the label, packaging, temperature or contents fail these checks, do not use the medicine. Call the pharmacy and your prescriber, and report the problem to your state board of pharmacy and to MedWatch, FDA's safety reporting program.^{26, 2, 27} If another item on the list is missing, such as the right syringe for a vial, dose-measuring instructions, storage directions or a beyond-use date, or you cannot reach a clinician with questions, ask the pharmacy or your prescriber before you use the medicine.²

Comparing prices beyond the headline number

We checked six other companies' compounded tirzepatide programs on October 3, 2026, and those that listed a tirzepatide price on their websites advertised from $129 a month (Eden) to $399 a month (Willow).^{28, 29, 30, 31, 32, 33} We picked the six from companies that people searched for by name, together with tirzepatide, in Google searches that showed our older posts on this topic from July 2025 to September 2026. They are a sample, not the whole market or a ranking.

Brand-name Zepbound from LillyDirect, Lilly's direct-to-patient service, which fills orders through licensed partner pharmacies, costs $299 to $449 per 28 days with on-time refills, depending on the dose, with a prescription and subject to Lilly's eligibility rules. On time means each refill within 45 days of the last delivery; a late refill costs $499 at 7.5 mg and $699 at 10 mg or more.^{7, 34}

The $299 price is for the 2.5 mg starting dose, which is not approved for ongoing use. Needles or syringes and any prescriber's fee are extra.^{7, 35} Your dose is your prescriber's medical decision, so price should never drive it. Our tirzepatide cost page lists each dose's price and a year's cost.

Before you share health information with any company, get in writing what the price includes, the plan length, how often and how much you are billed, whether it renews, and what you get back if you cancel. Ask, too, whether a membership fee is added to the medication price; a plan advertised with no membership fee can still be sold as a subscription.²⁸ Our comparison of GLP-1 telehealth programs explains what to check about membership fees, renewal, cancellation and refunds. See also GLP-1 cost without insurance and paying with an HSA, FSA or CareCredit.

Claims and offers that should make you walk away

FDA has told telehealth companies which claims about compounded drugs are false or misleading.¹ On March 3, 2026, it announced warning letters to 30 of them, mainly over claims implying their drugs were the same as approved drugs and branding that implied the company made the drug.³⁶ Any of these claims is a reason to keep looking.

Walk away from these offers, too:

• No prescription, or "for research purposes only." FDA has warned sellers of tirzepatide labeled "for research purposes" or "not for human consumption" and urges people not to buy these products of unknown quality.² Buyers often get them without the supplies or know-how needed to mix, draw up and inject them, even when dosing instructions are included.^{38, 2} As of October 2026, NABP says nearly 95% of websites offering prescription-only drugs operate illegally.¹⁸
• Deep discounts, or payment only by cryptocurrency or peer-to-peer apps. FDA and NABP flag prices that seem too good to be true, though a low price alone does not prove a problem. NABP also flags sellers that accept only cryptocurrency or peer-to-peer payment.^{2, 18} See what FDA says about compounded prices.
• Experimental drugs. FDA has warned telehealth companies for marketing experimental drugs that are not part of any FDA-approved medicine, including directly to consumers. It says some, such as cagrilintide, cannot be used in compounding under federal law and have not been found safe and effective for any condition. It has also warned sellers of other unapproved GLP-1-type drugs, such as survodutide and mazdutide.²

Added ingredients, pills and under-the-tongue forms

Many compounded products add other ingredients, such as vitamin B12 (cyanocobalamin), glycine or niacinamide. An analysis of these products found little justification for the additives and said evidence on the products' safety and effectiveness is lacking.¹⁷

Adding B12 does not by itself take a product outside FDA's copy rules: FDA's own example of a combination it may still treat as essentially a copy pairs semaglutide with B12.⁸ In March 2026, Lilly, which sells brand-name tirzepatide, said its testing of compounded tirzepatide-B12 products found significant levels of an impurity formed when the two react, with unknown effects in people. Lilly scientists also described it in a peer-reviewed journal.^{39, 40} If your tirzepatide product contains B12, ask your prescriber about this report.

Pills and under-the-tongue (sublingual) forms are sold too.¹⁷ Both FDA-approved tirzepatide drugs, Zepbound and Mounjaro, are injections given under the skin, so no tirzepatide pill is FDA-approved.^{16, 41, 42} In a June 2024 open letter, Lilly said no regulator had evaluated the safety or effectiveness of oral or nasal tirzepatide.²⁶

PlexusDx's answers below say which forms and added ingredients its tirzepatide products have; the cautions in this section apply to them as they would to any other company's products.

When an approved drug, or your own doctor, is the better route

These situations point toward an approved option (terms as of October 3, 2026):

• Your insurance covers Zepbound. If your commercial plan covers Zepbound single-dose pens for an approved use, Lilly's savings card can bring a 1-, 2- or 3-month fill to as little as $25 until it ends December 31, 2026. Savings are capped at $100 per month of supply and $1,300 per calendar year, so you may pay more than $25 if your plan's share is higher. People with government coverage, such as Medicare, Medicaid or TRICARE, cannot use it.³⁴ See which savings offers fit your coverage, our guide to Zepbound prior authorization and appeals if your plan requires approval or has said no, and our pages on Medicaid and TRICARE and VA coverage.
• You have Medicare Part D. Since July 1, 2026, Medicare's temporary GLP-1 Bridge has covered Foundayo, Wegovy and the Zepbound KwikPen for a $50 copay per one-month supply if you meet its BMI and health criteria.⁴³ See how the Bridge works and who qualifies, or check Medicare.gov.
• You want brand-name Zepbound and will pay cash. LillyDirect sells Zepbound vials and KwikPens at the self-pay prices above.⁷ For the KwikPen, that price comes through a Lilly self-pay card, which covers up to 11 fills a calendar year and ends December 31, 2026.³⁴ Never share a KwikPen or its needles with anyone, even if you change the needle; you could give or get a serious infection.^{16, 41} If you take compounded tirzepatide now, see switching to Zepbound.
• You would rather take a pill. Used with a reduced-calorie diet and more physical activity, Foundayo (orforglipron) and Wegovy (semaglutide) tablets are FDA-approved for long-term weight reduction in adults with obesity, or overweight with a weight-related condition. Each carries a boxed warning about thyroid C-cell tumors and must not be used with a personal or family history of MTC or with MEN 2.^{44, 45}
  • Other warnings. Like tirzepatide, each warns about pancreatitis, gallbladder disease, severe stomach and bowel side effects (neither is recommended with severe gastroparesis), kidney injury from dehydration, serious allergic reactions, worsening diabetic eye disease in people with type 2 diabetes, and food entering the lungs during anesthesia. Each can also cause low blood sugar, including in adults without type 2 diabetes, and the risk is higher with insulin or a sulfonylurea. Wegovy's label also warns about a faster resting heart rate, and Foundayo is not recommended with severe liver impairment.^{44, 45}
  • Pregnancy and breastfeeding. Both labels say to stop when pregnancy is recognized, and Wegovy's says to stop at least 2 months before a planned pregnancy. Neither pill is recommended while breastfeeding.^{44, 45}
  • Birth control. Foundayo's label advises effective birth control during treatment and, for people on birth control pills, a non-pill or added barrier method for 30 days after starting and after each dose increase.⁴⁴
  • Other medicines. Some medicines, such as ritonavir and simvastatin, interact with Foundayo. Semaglutide tablets raised levothyroxine levels in a study.^{44, 45}
  Read the Foundayo and Wegovy labels with your prescriber. Prices: GLP-1 cost without insurance and Foundayo cost with insurance.
• You have type 2 diabetes. Mounjaro is the tirzepatide brand FDA approved, along with diet and exercise, to improve blood sugar in adults and children 10 and older with type 2 diabetes. Its label carries the same boxed warning and warnings as Zepbound's (the risks section below follows Zepbound's label), but its pregnancy advice differs. It says to use Mounjaro in pregnancy only if the possible benefit justifies the possible risk to the baby, and it notes that poorly controlled diabetes in pregnancy carries risks for mother and baby too.⁴¹ Talk with the clinician who manages your diabetes, and if you are pregnant or plan to be, tell them rather than stopping on your own.

If you may not fit the approved uses. Zepbound is approved, with a reduced-calorie diet and more activity, for adults with obesity, or overweight with a weight-related condition, and for moderate to severe obstructive sleep apnea in adults with obesity. In its main weight-loss trial, obesity meant a BMI of 30 or more, and overweight a BMI of 27 to under 30 with a condition such as high blood pressure, abnormal cholesterol, sleep apnea, or heart or blood vessel disease.¹⁶ Compounded tirzepatide has no approved uses of its own, and using tirzepatide outside Zepbound's and Mounjaro's approved uses is off-label.² If that may be you, start with your own doctor; see GLP-1s if you are not obese or overweight.

Risks to raise at your screening, and when to get help

These risks and warning signs come from the Zepbound (tirzepatide) prescribing information and Medication Guide. FDA says compounded drugs carry more risk than approved drugs because FDA does not review them,³ so treat this list as the minimum. It is general information, not medical advice: ask your prescriber how each point applies to you before you start or change treatment. If a warning sign below says to stop using it and get help right away, do that first.

• Thyroid tumors (boxed warning). Tirzepatide caused thyroid C-cell tumors in rats; whether it causes them in people, including medullary thyroid carcinoma (MTC), is not known. Do not use it if you or a family member has had MTC, or if you have MEN 2. Tell your provider about a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.¹⁶
• Serious allergic reactions, including anaphylaxis and angioedema (swelling), have been reported; do not use it if you are seriously allergic to tirzepatide or any of its other ingredients. Stop using it and get medical help right away for swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or dizziness, or a very fast heartbeat.¹⁶ Compounded products can contain other ingredients,¹⁷ so ask for the full list.
• Pancreatitis, including fatal cases, has occurred with GLP-1 drugs and Zepbound. Stop using it and call your provider right away for severe stomach pain that will not go away; it may spread to your back.¹⁶
• Gallbladder problems, such as gallstones and inflammation, happen more often. Call your provider right away for upper stomach pain, fever, yellow skin or eyes, or clay-colored stools.¹⁶
• Severe stomach and bowel side effects can occur, and Zepbound is not recommended with severe gastroparesis (very slow stomach emptying). Tell your provider if stomach problems are severe or do not go away.¹⁶
• Dehydration and kidney injury. Kidney injury, sometimes needing dialysis, has been reported, mostly after dehydration from nausea, vomiting or diarrhea. Drink fluids, and tell your provider right away if these do not go away.¹⁶
• Low blood sugar can happen, including in adults without type 2 diabetes, and the risk is higher with insulin or with a diabetes medicine that makes the body release more insulin, such as a sulfonylurea. Signs include shakiness, sweating, confusion, a fast heartbeat and hunger. Before you start, ask your provider how to recognize and manage it.¹⁶
• Diabetic eye disease. People with type 2 diabetes and a history of diabetic retinopathy should be monitored for it getting worse, and anyone with type 2 diabetes should report vision changes.¹⁶
• Surgery and sedation. Food or liquid entering the lungs has been reported in people taking GLP-1 drugs who had general anesthesia or deep sedation. Tell all your providers that you take it before any scheduled procedure.¹⁶
• Pregnancy and breastfeeding. It may harm an unborn baby, and Zepbound's label says to stop it once pregnancy is recognized. It may pass into breast milk, so talk with your provider before using it while breastfeeding.¹⁶
• Pills you take by mouth. Tirzepatide slows stomach emptying, which can change how pills are absorbed. Birth control pills may work less well, so the label advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and after each dose increase. Your prescriber may also watch medicines such as warfarin more closely. Ask which birth control method fits you.¹⁶
• Other GLP-1 drugs. Using it with other tirzepatide products or any other GLP-1 drug is not recommended.¹⁶

The most common side effects listed for Zepbound are nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, injection site reactions, tiredness, allergic reactions, belching, hair loss and heartburn.¹⁶

Concerns specific to compounded products. As of May 31, 2026, FDA had received more than 730 adverse event reports associated with compounded tirzepatide. It is likely an undercount, because state-licensed pharmacies that are not outsourcing facilities need not report them. A report does not always mean the drug caused the problem. Some may be tied to compounded tirzepatide prescribed at doses beyond the approved label.² Report side effects to your prescriber and to MedWatch.²⁷

PlexusDx's answers to the same checks

PlexusDx publishes this page and has a financial interest in compounded tirzepatide, so weigh its answers with that in mind. The compounded tirzepatide prescribed to people who enroll through PlexusDx is not FDA-approved, like all compounded tirzepatide.² Answers are as of October 19, 2026.

• Why a compounded product instead of Zepbound (basic 1 and check 6). Lone Star Virtual Health says its chart templates require the prescribing physician to document, for each patient, why the compounded formulation meets that patient's needs better than an available FDA-approved drug such as Zepbound, and to explain that reason to the patient, including that compounded medicines are not FDA-approved. Lone Star names no usual reason, since the reason has to fit the individual, and any reason involving an added ingredient such as vitamin B12, vitamin B6 or glycine must be supported by that patient's clinical needs. As the legal section explains, a lower price alone does not count.
• Who prescribes (check 1). PlexusDx does not practice medicine. PlexusDx's prescribing clinicians are provided by Lone Star Virtual Health, and they, not PlexusDx, decide whether to prescribe, at what dose and whether to continue treatment. You are told who your treating provider is after you finish the intake form, which comes after you enter card details but before you are charged. PlexusDx and Bask Health, the telehealth platform PlexusDx uses, both vet Lone Star and its physicians; PlexusDx has not published dated license checks for individual prescribers, so run check 1 yourself once you have the name. Lone Star uses licensed physicians only, never nurse practitioners, so DocInfo is the one lookup you need. PlexusDx does not sell or ship brand-name prescription medicines. If you would prefer a brand-name, FDA-approved medicine, your provider may write a prescription that you can fill at the pharmacy of your choice.
• Screening before anything ships (check 2). A clinician reviews your health information and decides whether treatment is appropriate, and PlexusDx does not guarantee that anyone will qualify. You must be 18 or older, and PlexusDx does not take patients who are enrolled in Medicaid, even if they would pay for treatment themselves. PlexusDx may verify your payment method when you enroll, but the treatment charge is taken only if a clinician approves treatment; if not, you owe $0. The same rules cover compounded tirzepatide, compounded semaglutide and Microdose GLP-1, and Lone Star says its physicians review every intake and make the final decision. You need a BMI of 25 or more if you have not taken a GLP-1 drug in the past two months, or 22 or more to continue treatment if you have. Zepbound's weight-management approval starts at a BMI of 30, or 27 when a weight-related condition is present, so starting treatment below those levels would be off-label; the intake notes that your physician will explain any proposed off-label use before treatment begins. Every patient is asked about a personal or family history of thyroid cancer, a family history of MEN 2, pancreatitis or pancreatic cancer, gallbladder disease, gastroparesis or inflammatory bowel disease, gastric bypass in the past six months, a past or present eating disorder such as anorexia or bulimia, suicidal thoughts in the past year, kidney disease, recent semaglutide or tirzepatide, diabetes medicines, and allergies, including to any ingredient of brand-name GLP-1 drugs; female patients are also asked about pregnancy, breastfeeding and plans to become pregnant. Some answers end the intake, among them pancreatitis, gastroparesis, pregnancy or breastfeeding, and taking insulin, a sulfonylurea, a meglitinide or a DPP-4 inhibitor; others, such as gallbladder disease or a family history of thyroid cancer, go to the physician to weigh. The intake does not ask by name about medullary thyroid carcinoma, whether you have MEN 2 yourself, diabetic retinopathy, planned surgery or sedation, or an allergy to vitamin B12 or glycine, so raise any of these yourself. By Lone Star's own policy (not a guide to what state law requires), the first visit is live in Alabama, Arkansas, Georgia, New Mexico, North Dakota, Tennessee, Virginia and West Virginia, and renewals there may then happen without a live visit when appropriate. Every visit, renewals included, is live in the District of Columbia, Louisiana, Mississippi and Rhode Island. In all other states, care may be given without a live visit (asynchronously) where state requirements and the patient's clinical situation allow.
• Which pharmacy, its license and its record (checks 3 to 5). The medicine is compounded by a pharmacy, not by PlexusDx. PlexusDx uses only state-licensed 503A compounding pharmacies. If a prescription is appropriate, you can ask for a particular pharmacy, subject to availability and legal requirements; otherwise one is assigned. The name of an assigned pharmacy shows up in the patient portal only after a clinician approves treatment, and approval is what triggers the charge, so PlexusDx does not meet check 3 before you pay unless you request a pharmacy you have already checked. Its answers here also leave out whether each pharmacy holds a sterile compounding license and the dates and results of PlexusDx's own checks of pharmacy licenses, discipline records and FDA actions; PlexusDx relies on Bask Health, its telehealth platform, to vet the pharmacies in Bask's network. Once you know your pharmacy's name, you can run checks 4 and 5 yourself.
• Forms and added ingredients (check 6). PlexusDx's Terms of Service say formulations and added ingredients may vary by pharmacy and fill. PlexusDx's products include Microdose GLP-1, which can contain tirzepatide or semaglutide. Dosing below the label is off-label: Zepbound's label approves 5, 10 or 15 mg a week for ongoing use and 2.5 mg only to start treatment.¹⁶ Compounded tirzepatide comes as a weekly injection or as a daily tablet dissolved under the tongue, which PlexusDx calls an orally disintegrating tablet (ODT), at the same plan price. Every tirzepatide injection in PlexusDx's catalog contains added vitamin B12 or glycine, and none comes without one. The intake lets only California residents pick one; elsewhere it depends on the pharmacy and the checkout screen does not show which, so ask your clinician before approval if it matters, and check the label. Lone Star says a reason that relies on the added ingredient must be supported by your own clinical needs. PlexusDx has not published full ingredient lists for its tablets. No tirzepatide tablet is FDA-approved. The Microdose tirzepatide injection, also made with vitamin B12, rises from 0.5 mg to 1.5 mg a week, all below Zepbound's 2.5 mg starting dose; for a Microdose tablet, ask the prescriber what daily dose is planned. An allergy you report does not end the intake but goes to the physician, who decides whether treatment is appropriate; the intake's allergy checklist names brand-name GLP-1 drugs, not vitamin B12 or glycine, so add those yourself. What this page says about added ingredients applies to these products as it does to anyone else's.
• When the medicine ships (arrival checks). After approval, the pharmacy typically prepares and ships your prescription within 3 to 5 business days. Carrier transit starts only after UPS has the package, which follows that preparation time, and standard shipping has no separate charge. No signature is required. Report damage, missing medicine or a suspected temperature problem as soon as possible, generally within 24 hours of delivery, as PlexusDx's Refund & Cancellation Policy asks.
• Price and terms in writing. PlexusDx is self-pay and does not bill health insurance. Its compounded tirzepatide plans cost (as of October 19, 2026):
  • 1-month plan: $189, charged monthly
  • 3-month plan: $507, charged up front ($169 a month)
  • 6-month plan: $894, charged up front ($149 a month)
  • 12-month plan: $1,548, charged up front ($129 a month)
  Microdose GLP-1 plans (dosing below the label is off-label) are $99 a month on a 1-month plan, or $267, $474 or $828 charged up front for a 3-, 6- or 12-month plan ($89, $79 or $69 a month). Longer plans are charged in full once a clinician approves treatment; the monthly figures are for comparison. Prescriptions last up to six months, so a 12-month plan includes a renewed clinical review; if it is not completed, shipments pause and unused prepaid time is kept.
• What the price includes, and renewal. Under PlexusDx's Terms of Service, the plan price covers the clinicians' care, including any live visit they require, the medicine, injection supplies and shipping. It does not cover outside lab tests, in-person, specialist or emergency care, patient-caused replacement medication, extraordinary early-fill costs, or taxes and government charges. For the same medication and plan, your price does not increase solely because your Lone Star clinician changes your prescribed dose, and switching medications moves you to the price for the new treatment. There is no separate membership fee: the plan price is the only program fee. Plans renew automatically for the same length at your existing price unless you cancel or pause. Checkout calls it your plan, and charges appear on card statements as PlexusDx. Prices are on PlexusDx's product pages before you begin. Inside the intake, the medicine choice shows starting prices, and the checkout step shows the plan price, renewal terms and Refund & Cancellation Policy; it comes after a few opening questions, including your height, weight and any GLP-1 drug you take now, and before the rest of the health questions.
• Cancelling, pausing and refunds. After approval, you can ask to cancel for a full refund until the prescription is sent to the pharmacy; after that, it generally cannot be cancelled or refunded just because you changed your mind, cancelled or paused the plan. To stop a renewal, cancel or pause in PlexusDx's self-service portal before the renewal charge is processed, or send a request to support at least 3 business days before it. Cancelling does not create a prorated refund (a refund for the unused time) of the current prepaid term, though treatment already paid for stays available while it remains clinically appropriate. If your prescriber stops treatment for medical reasons, or PlexusDx can no longer provide it and no appropriate alternative is available or accepted, PlexusDx refunds prepaid months not yet dispensed, at the monthly rate you actually paid. The full terms are in PlexusDx's Refund & Cancellation Policy, and our program comparison shows how renewal and refund terms differ across programs.
• How PlexusDx describes its products. The claims table above applies to PlexusDx's own pages. As of October 19, 2026, PlexusDx's pages say compounded tirzepatide is not FDA-approved and do not call it generic, the same as a brand-name drug or proven in trials, present PlexusDx as the compounder, or say it comes from an FDA-approved, FDA-licensed or FDA-registered pharmacy.
• Where it is available. PlexusDx's prescribers and its pharmacies cover all 50 states.
• Questions after you start. Ongoing oversight by your prescriber is part of the plan price. For a medical emergency, including severe symptoms like those in the risks section, call 911 or get in-person emergency care right away, as PlexusDx's Safety Information page says. Company contact: PlexusDx, Inc., 6110 McFarland Station Drive, #604, Alpharetta, GA 30004; support@plexusdx.com.

Sources

1. FDA to Telehealth Companies: What to Know When Promoting Compounded Drugs, U.S. Food and Drug Administration, accessed October 3, 2026.
2. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss, U.S. Food and Drug Administration, accessed October 3, 2026.
3. Compounding when Drugs are on FDA's Drug Shortages List, U.S. Food and Drug Administration, accessed October 3, 2026.
4. Getting started with licensure, U.S. Department of Health and Human Services (Telehealth.HHS.gov), accessed October 3, 2026.
5. Compounding and the FDA: Questions and Answers, U.S. Food and Drug Administration, accessed October 3, 2026.
6. Locate a State-Licensed Online Pharmacy (BeSafeRx), U.S. Food and Drug Administration, accessed October 3, 2026.
7. Zepbound (tirzepatide) | LillyDirect, Eli Lilly and Company, accessed October 3, 2026.
8. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize, U.S. Food and Drug Administration, accessed October 3, 2026.
9. Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A of the FD&C Act: Guidance for Industry (January 2018), U.S. Food and Drug Administration, accessed October 3, 2026.
10. FDA Proposes to Exclude Semaglutide, Tirzepatide, and Liraglutide on 503B Bulks List (April 30, 2026), U.S. Food and Drug Administration, accessed October 3, 2026.
11. List of Bulk Drug Substances for Which There Is a Clinical Need Under Section 503B of the Federal Food, Drug, and Cosmetic Act; Extension of Comment Period (June 26, 2026), Food and Drug Administration, Federal Register, accessed October 3, 2026.
12. FDA Intends to Take Action Against Non-FDA-Approved GLP-1 Drugs (February 6, 2026), U.S. Food and Drug Administration, accessed October 3, 2026.
13. DocInfo: Look Up Your Doctor, Federation of State Medical Boards, accessed October 3, 2026.
14. Nursys, National Council of State Boards of Nursing, accessed October 3, 2026.
15. QuickConfirm License Verification Boards of Nursing, National Council of State Boards of Nursing (Nursys), accessed October 3, 2026.
16. ZEPBOUND (tirzepatide) injection: prescribing information and Medication Guide, Eli Lilly and Company, via DailyMed, National Library of Medicine, accessed October 3, 2026.
17. Compounded Semaglutide and Tirzepatide Products Use Unique Formulations but Efficacy and Safety Largely Unknown, Belcourt J, Sapowadia A, White CM, The Annals of Pharmacotherapy, 2026, accessed October 3, 2026.
18. Buy Safely, National Association of Boards of Pharmacy (Safe.Pharmacy), accessed October 3, 2026.
19. General Chapter <797> Pharmaceutical Compounding – Sterile Preparations, U.S. Pharmacopeia, accessed October 3, 2026.
20. Postshortage Compounded GLP-1 RA Market in 2 States With Potentially High Demand, DiStefano MJ, et al., JAMA Health Forum, 2026, accessed October 3, 2026.
21. Website Certification Status, LegitScript, accessed October 3, 2026.
22. Compounding: Inspections, Recalls, and other Actions, U.S. Food and Drug Administration, accessed October 3, 2026.
23. Warning Letters, U.S. Food and Drug Administration, accessed October 3, 2026.
24. Registered Outsourcing Facilities, U.S. Food and Drug Administration, accessed October 3, 2026.
25. FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products, U.S. Food and Drug Administration, accessed October 3, 2026.
26. An Open Letter From Eli Lilly and Company Regarding Certain Practices Related to Mounjaro and Zepbound (June 20, 2024), Eli Lilly and Company, accessed October 3, 2026.
27. MedWatch: The FDA Safety Information and Adverse Event Reporting Program, U.S. Food and Drug Administration, accessed October 3, 2026.
28. Doctor-Guided Tirzepatide GLP-1 Weight Loss Plans, Eden, accessed October 3, 2026.
29. Compound Tirzepatide, Willow, accessed October 3, 2026.
30. GLP-1 + GIP (Tirzepatide), Yucca Health, accessed October 3, 2026.
31. Personalized Weight Loss Programs That Work, TrimRx, accessed October 3, 2026.
32. Personalized Telehealth Care (weight-loss page), MEDVi, accessed October 3, 2026.
33. Personalized Telehealth Care, ElixaMD, accessed October 3, 2026.
34. Zepbound (tirzepatide): Full Terms and Conditions, Eli Lilly and Company, accessed October 3, 2026.
35. Online Pharmacy Service Options for Select Lilly Medicines | LillyDirect, Eli Lilly and Company, accessed October 3, 2026.
36. FDA Warns 30 Telehealth Companies Against Illegal Marketing of Compounded GLP-1s (March 3, 2026), U.S. Food and Drug Administration, accessed October 3, 2026.
37. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1), Jastreboff AM, et al., New England Journal of Medicine, 2022, accessed October 3, 2026.
38. Bypassing Prescribers and Pharmacists: Online Purchasing of Semaglutide and Tirzepatide "For Research Purposes", Belcourt J, Ly P, White CM, The Annals of Pharmacotherapy, 2025, accessed October 3, 2026.
39. An open letter from Eli Lilly and Company warning of potential patient safety risks associated with tirzepatide compounded with vitamin B12 (March 12, 2026), Eli Lilly and Company, accessed October 3, 2026.
40. A novel, widespread impurity in mass-compounded tirzepatide/B12 products: potential patient safety implications, Jordan B, et al., Expert Opinion on Drug Safety, 2026, accessed October 3, 2026.
41. MOUNJARO (tirzepatide) injection: prescribing information, Eli Lilly and Company, via DailyMed, National Library of Medicine, accessed October 3, 2026.
42. Drugs@FDA data: approved products containing tirzepatide (openFDA), U.S. Food and Drug Administration, accessed October 3, 2026.
43. Weight loss drugs (Medicare GLP-1 Bridge), Centers for Medicare & Medicaid Services (Medicare.gov), accessed October 3, 2026.
44. FOUNDAYO (orforglipron) tablets: prescribing information, Eli Lilly and Company, via DailyMed, National Library of Medicine, accessed October 3, 2026.
45. WEGOVY (semaglutide) injection and tablets: prescribing information, Novo Nordisk, via DailyMed, National Library of Medicine, accessed October 3, 2026.

How we made this page

This page replaces three older PlexusDx posts that ranked tirzepatide sellers and repeated prices and claims, some about PlexusDx, that we could not support; none of their text was kept. Whether compounded tirzepatide is lawful depends on FDA statements issued at different times, so AI tools opened each document listed under Sources on October 3, 2026, including FDA's April 2026 clarification of its rules for compounders, its 2018 guidance on copies of approved drugs, its April 2026 bulks-list proposal, its warnings to telehealth companies, four drug labels, and each license and record lookup in the six checks, to confirm what it shows and leaves out. An AI tool then drafted the text from those sources. Later AI checks matched each cited statement to its source, compared statements about PlexusDx with PlexusDx's published policies and records as of October 19, 2026, and flagged medical, legal, search-policy and reader problems, and the draft was revised in response. Those automated checks are not a medical or legal review, and this page is not legal advice. We did not use or test any other company's GLP-1 program for this page, and no link here pays us a commission. Jay Hastings, who is responsible for this page, reviewed and approved this version on October 19, 2026. Dr. Asad K. Niazi, MD, MPH, reviewed the medical content on October 17, 2026. He is co-founder and CEO of Lone Star Virtual Health, the company that provides PlexusDx's prescribing clinicians, so he has a business relationship with PlexusDx. PlexusDx sells compounded GLP-1 treatment, so we have a financial interest in this topic. This page follows our editorial policy.