Online GLP-1 Programs Compared: Prices, Renewals and Refunds

Two questions decide most of this choice. Will an FDA-approved brand-name drug suit you? FDA recommends an approved drug when one is available and appropriate, and says compounded drugs, which a pharmacist or physician mixes for an individual patient, should be used only when a patient's medical needs cannot be met by an approved drug.^{1, 2, 3} And how will the program bill you, including if you stop?

We compared six compounded programs (TrimRx, Willow, Good Life Meds, Polly, Gala GLP-1 and Embody), two brand-name telehealth services (Ro and Curai Health), the drugmakers' own pharmacies (LillyDirect and NovoCare) and PlexusDx.

On October 3, 2026, the six compounded programs listed compounded semaglutide or tirzepatide injections and tablets at $79 to $399 a month, depending on the drug, the plan length and any promotion; Embody's gum forms cost more. The lowest were "starting at," promotional or first-month prices at Embody and Good Life Meds; the highest, $399, was tirzepatide at Willow, and at TrimRx and in Embody's Start program after the first month.^{4, 5, 6, 7, 8}

At the doses the labels set for long-term use, the drugmakers' pharmacies charged $299 a month for the Wegovy pill, $349 to $399 for the Wegovy pen, and $399 to $449 for Zepbound with on-time refills and before needles. None of these prices includes a prescriber's fee, and some starting doses cost less for the first month or two.^{9, 10, 11, 12}

Compounded drugs are not FDA-approved, and FDA does not review them for safety, effectiveness or quality before they are sold.³ Billing differs as much as price: most programs charge automatically until you cancel, the lowest monthly rates often mean paying for months at once, and most refund little once a prescription reaches the pharmacy. Each program's terms are under renewal, prepaid plans and refunds.

How the programs were chosen. We included each company that people named in more than 1,000 Google searches in which our earlier articles on these programs appeared, from July 2025 to September 2026. Eight companies besides PlexusDx, which publishes this page, met that bar; within each group below they appear in order of those searches, with PlexusDx after the other compounded programs. We added the drugmakers' own pharmacies, which fill prescriptions for their brand-name drugs. Price played no part. This is not every online GLP-1 program: companies that fell outside this rule were left out, and that says nothing about them.

"Not stated" means the pages we checked, listed under Sources, did not say. We did not use or test the other programs for this page.

Which kind of program fits your situation

This is general information to narrow the field; your prescriber decides which drug suits you, and the label warnings below can rule a drug out.

Compounded semaglutide or tirzepatide, paid in cash: TrimRx, Willow, Good Life Meds, Polly, Gala GLP-1, Embody and PlexusDx. These may suit you if your prescriber decides a compounded drug meets a medical need that an approved drug cannot (see what a prescriber has to write down), and you accept a drug FDA has not approved or reviewed.³ Choose an FDA-approved drug instead if one is available and suits you, if insurance or Medicare could pay for one, or if you want an FDA-approved pill. Good Life Meds, Gala, TrimRx and PlexusDx describe brand-name routes in their entries.

A brand-name telehealth membership: Ro. It may suit you if you want an FDA-approved drug and help with insurance, including prior authorization (your plan's approval before it pays). You pay a membership fee on top of the medication.^{13, 14} Look elsewhere if you want care and medication in one price.

A low-fee online prescriber: Curai Health, for a prescription for Wegovy, Zepbound or Saxenda that you fill at a pharmacy you choose.^{15, 16} It cannot prescribe these drugs in five states; its entry links to Curai's list.¹⁵ It does not bill Medicare, Medicaid or other government insurance, and its promotional free visits are not open to Medicare or Medicaid enrollees.¹⁵

The drugmakers' pharmacies: LillyDirect for Zepbound and Foundayo if you pay cash or have commercial insurance that covers the drug, and NovoCare Pharmacy for Wegovy if you pay cash. If your commercial plan covers Wegovy, Novo's savings offer (as little as $25 per 1-, 2- or 3-month fill, with Novo's savings capped at $100 for each month of supply; not for people in government programs) is used at your own pharmacy.^{9, 10, 47, 48} You need a prescription, from your own doctor, Curai Health or a prescriber these pharmacies can connect you with.^{9, 10} If the self-pay price is out of reach, ask your doctor about covered options and see which drugmaker discounts each kind of buyer can use.

If price is your main reason for a compounded drug, compare the FDA-approved ones first. After the first month, Zepbound's $399 to $449 per 28-day fill, with on-time refills and before needles and any prescriber's fee, overlaps the top of the compounded tirzepatide prices below.^{9, 11} At its long-term dose, the Wegovy pill costs $299 a month before any prescriber's fee, the same monthly price Willow lists for its compounded semaglutide tablets.^{10, 12, 17} Every brand-name price and its conditions are on our page about GLP-1 prices without insurance.

If you have Medicare Part D, check Medicare's temporary GLP-1 Bridge before paying any program: if you qualify, a month of Foundayo, Wegovy or the Zepbound KwikPen (a multi-dose pen) costs a $50 copay.^{11, 18} Our UnitedHealthcare page explains who qualifies for the Bridge.

If you have other insurance, ask your plan whether it covers Wegovy, Zepbound or Foundayo for weight loss and whether it needs prior authorization. See how Zepbound prior authorization works and our pages on UnitedHealthcare, Anthem, Medicaid and TRICARE and VA coverage.

If you do not fit the approved uses described under compounded or FDA-approved, talk with your own doctor before seeking a GLP-1 from any program, including PlexusDx. Our page on GLP-1 options for people who are not obese or overweight explains what to consider.

What each program charges and includes

Each company's prices and terms are as its own pages showed them on October 3, 2026, and PlexusDx's are the company's own as of October 19, 2026. Prices change often, and the price at checkout is the one that counts. Renewal and refund terms are in the next section.

This page does not rate programs, judge whether a company is legitimate or repeat customer reviews, which we could not verify. To check any program here yourself before you pay, including the company that publishes this page, use the six checks in our guide to choosing a compounded provider, from the prescriber's license to the pharmacy's FDA record.

TrimRx

• Medicines: compounded tirzepatide, and a compounded package that its terms and its homepage's product listings call "GLP-1" without naming the drug; a May 2026 TrimRx blog post refers to TrimRx semaglutide.^{7, 19, 20} TrimRx says its providers may write a brand-name prescription, such as for Wegovy, that you fill and pay for at a pharmacy you choose, and that it does not sell or ship brand-name drugs itself. Its terms also list Ozempic and Zepbound packages, "available on a limited basis," at $1,299 and $1,399 a month.^{7, 19}
• Price: $199 for the first month of the "GLP-1" package, then $299 a month; tirzepatide $349, then $399, per its terms; medication ships monthly.^{7, 21} The homepage says "Starting at $179" and "Starting at $259" without naming a plan. The terms describe prepaid multi-month plans but list no prices for them.^{7, 19}
• Included: consultation, prescription, medication, shipping and ongoing support; the homepage says the cost stays the same as your dose changes.^{7, 19}
• Insurance, HSA and FSA: no insurance needed; eligible HSA and FSA (health savings and flexible spending account) cards accepted.^{7, 19}
• Where: the 50 states, not U.S. territories, per its terms.⁷

Willow

• Medicines: compounded semaglutide and tirzepatide, as weekly injections or daily tablets that dissolve under the tongue; its semaglutide page describes the injection as "enhanced with Cyanocobalamin (Vitamin B12)."^{22, 23}
• Price: semaglutide $299 a month and tirzepatide $399 a month, injection or tablet, as a monthly subscription; no other plan lengths are listed.^{8, 17, 22, 23, 24} Willow says costs vary by dosage, and its terms allow the fee to change with a dose increase.^{22, 25}
• Included: medication, evaluation and treatment plan, unlimited physician access, 24/7 support and free shipping.²²
• Insurance, HSA and FSA: no insurance required; HSA or FSA accepted at checkout.²²
• Where: 36 states, listed in Willow's FAQ.²²

Good Life Meds

• Medicines: compounded semaglutide and tirzepatide, which its tirzepatide page calls "Compounded Tirzepatide+" without saying what is added; its providers can also prescribe brand-name Wegovy (pen or pill), Ozempic or Zepbound.^{26, 27}
• Price: semaglutide $199 for a one-month supply at any dose before promotions; on October 3 its page headlined $99, with $199 struck through, as a "Limited Time Promotion," and the tirzepatide page showed $149, with $297 struck through.^{6, 27} The order page linked from both lists them as "starting at" $99 and $149 a month, pay as you go, says people who sign up during the promotion keep that rate for 12 months, and says the promotion ends September 2026.²⁸ Multi-month discounts are mentioned but not listed.⁶
• Included: medication, syringes, alcohol pads, expedited shipping, a doctor visit and ongoing care.⁶ Its subscription policy adds "any applicable taxes, shipping, and required service fees disclosed at checkout."²⁹
• Insurance, HSA and FSA: no insurance; HSA and FSA cards accepted, without reimbursement documents.³⁰
• Where: all 50 states.³⁰

Polly (formerly Piper)

• Medicines: compounded semaglutide and tirzepatide, as weekly injections.³¹
• Price: semaglutide is $179 a month on a month-to-month plan, $166 a month on a 3-month plan or $135 a month on a 6-month plan. Tirzepatide is $279, $216 or $199 a month, and the price is the same at every dose (help-center articles dated April 30, 2026).^{32, 33} The 3- and 6-month plans are charged upfront: $498 or $810 for semaglutide, $648 or $1,194 for tirzepatide.^{33, 34}
• Included: consultation, prescription, medication, overnight shipping, care-team support, syringes and alcohol pads.³⁵
• Insurance, HSA and FSA: self-pay, does not bill insurance; accepts HSA and FSA cards.^{31, 35}
• Where: all 50 states.³¹

Gala GLP-1

• Medicines: compounded semaglutide and tirzepatide, and brand-name Ozempic from $1,299 a month cash.^{36, 37, 38, 39}
• Price: $199 a month on its semaglutide and tirzepatide pages, whose buttons say "$179/mo," with no plan named. The homepage says prices start at $199 "with a 3-month plan," set at checkout, but not whether that plan is charged at once. A higher dose costs nothing extra.^{36, 37, 38}
• Included: medication, medical evaluation and ongoing support ("all-included," in Gala's words).^{38, 40}
• Insurance, HSA and FSA: insurance not required. For Ozempic, Gala checks your coverage and accepts FSA and HSA.^{36, 39}
• Where: all 50 states.³⁶

Embody

• Medicines: weekly "GLP-1" and "GLP-1 / GIP" injections, which its site describes as compounded; its terms name semaglutide and tirzepatide and also list a gum form of each.^{4, 5}
• Price: the homepage, under a "Fall Sale" banner offering $200 off, says "starting at" $79 a month for GLP-1 and $129 for GLP-1/GIP, set by a 4-, 12-, 24- or 52-week plan shown at checkout.⁴ Its terms (April 24, 2026) list semaglutide injection at $199 a month, or $169, $159 or $149 a month on 3-, 6- or 12-month bundles, so the bundles cost $507, $954 or $1,788, each sold as one purchase.^{5, 41} Tirzepatide costs $100 a month more. A separate "Start" program charges $99 (semaglutide) or $149 (tirzepatide) for the first month, then $299 or $399; in that program the gum forms cost $50 more each month.⁵
• Included: medication, consultations, a 24/7 support line and free expedited delivery; the price does not rise if your dose changes on the same medication.^{4, 41}
• Insurance, HSA and FSA: its clinicians do not contract with any insurance plan, including Medicare and Medicaid; the homepage says "HSA/FSA Approved."^{4, 5}
• Where: "certain states," listed by customer service on request.⁵

PlexusDx (publisher of this page)

• Medicines: compounded semaglutide and tirzepatide, and Microdose GLP-1, made with either one. Using either drug at lower doses than the FDA labels approve for ongoing use, or spacing doses further apart than they say, is off-label. Zepbound's label approves 5, 10 or 15 mg of tirzepatide a week for ongoing use, and Wegovy's 1.7 or 2.4 mg of semaglutide a week by injection (7.2 mg for some adults) or 25 mg a day as tablets.^{11, 12} Forms: weekly injection or daily orally disintegrating tablet (ODT) for each drug, priced alike. Injections carry added vitamin B12 or glycine, with no version free of both; only California residents choose which in the intake; elsewhere it varies by pharmacy and is not shown at checkout. Lone Star says an add-in needs the patient's clinical needs behind it. Tablet ingredient lists are not published. No tirzepatide tablet is FDA-approved, while FDA-approved semaglutide tablets are Rybelsus (also labeled as Ozempic tablets) and Wegovy tablets; FDA has not approved any compounded semaglutide tablet. Microdose injections, made with B12, run 0.12 to 0.5 mg of semaglutide or 0.5 to 1.5 mg of tirzepatide weekly; tablet doses are for the prescriber to set. Reported allergies go to the physician, and B12 and glycine are absent from the intake's allergy checklist. Prescriptions are written, or declined, by clinicians from Lone Star Virtual Health, PlexusDx's provider team, and filled by state-licensed 503A compounding pharmacies; you can name a pharmacy you want, subject to availability and legal limits. If no pharmacy is requested, the one assigned is named in the patient portal after approval, the step that also triggers the charge. PlexusDx does not sell or ship brand-name medications. If you would prefer a brand-name, FDA-approved medication, your provider may write a prescription you can fill at the pharmacy of your choice.
• Price: compounded tirzepatide is $189, $169, $149 or $129 a month on a 1-, 3-, 6- or 12-month plan (as of October 19, 2026); compounded semaglutide is $149, $129, $109 or $99 a month, and Microdose GLP-1 $99, $89, $79 or $69. The 1-month plan is charged each month; the 3-, 6- and 12-month plans are charged in full, upfront: $507, $894 or $1,548 for tirzepatide, $387, $654 or $1,188 for semaglutide, and $267, $474 or $828 for Microdose GLP-1. Prescriptions last up to six months, so a 12-month plan includes a renewed clinical review.
• Included: provider care, any live visits a clinician requires, the medication, any injection supplies and shipping, with no separate shipping charge. For the same medication and plan, the price does not rise solely because your Lone Star clinician changes your dose; switching medications moves you to the new treatment's price.
• Insurance, HSA and FSA: self-pay, with no insurance billing; people on Medicaid cannot enroll, even paying out of pocket. Eligible HSA and FSA payment methods are accepted, and PlexusDx can provide itemized documentation; your plan administrator and tax law decide eligibility and reimbursement.
• Where: all 50 states, for both its prescribers and its pharmacies. Live visits: Lone Star requires one before a first prescription in AL, AR, GA, NM, ND, TN, VA and WV, and at every visit, renewals included, in DC, LA, MS and RI; elsewhere it may use asynchronous care when state rules and the clinical situation allow (full state names in our provider guide).

When another route may suit you better than PlexusDx: if you want insurance to pay, a program that supplies a brand-name drug itself, or Medicare's GLP-1 Bridge. And if another program's prices, billing or refund terms suit you better, that is a sound reason to choose it.

Ro

• Medicines: FDA-approved brand-name drugs only, including Wegovy (pill or pen), Foundayo and the Zepbound KwikPen.^{13, 14}
• Price: a membership of $39 for the first month, refunded if you are not eligible. After that it is $888 prepaid for a year ($74 a month), $534 prepaid every 6 months ($89 a month), $297 prepaid every 3 months ($99 a month) or $149 billed monthly. Medication is billed separately, at cash prices Ro says match LillyDirect, NovoCare and TrumpRx.¹⁴
• Membership includes: a personalized treatment plan, provider messaging and check-ins, insurance help, coaching and lab testing if needed, but not the medication.¹⁴
• Insurance, HSA and FSA: checks coverage for Ozempic, Wegovy and Zepbound autoinjector pens and handles the paperwork; the Wegovy pill, Foundayo and Zepbound KwikPen are cash-pay only.^{13, 14} Ro does not accept HSA or FSA cards, but says you can submit a detailed receipt to your HSA provider.⁴²
• Where: not stated.

Curai Health

• Medicines: its clinicians may prescribe Wegovy (pill or pen), Zepbound or Saxenda, and do not prescribe compounded or off-label weight-loss drugs.¹⁵
• Price: chatting with its AI assistant is free. On October 3, 2026, Curai's page gave visitors two different answers about seeing a clinician. Some were told that unlimited visits cost $29 a month, or $49 per video visit or $39 per live-chat visit, with the exact price shown before they choose and pay; others were told that seeing a clinician is free. The same page also offers "a free telehealth visit," which its footer describes as a promotion not open to Medicare or Medicaid enrollees.¹⁵ You buy the medication separately at a pharmacy you choose.^{15, 16}
• Insurance, HSA and FSA: does not bill Medicare, Medicaid or other government insurance; HSA and FSA not stated.¹⁵
• Where: cannot prescribe these drugs in 5 states and requires a live visit in 4, listed on Curai's weight page.¹⁵

LillyDirect

• What it is: Lilly's pharmacy service for Zepbound and Foundayo. It needs a valid prescription and can connect you with a prescriber; no program fee is listed.⁹
• Price: Zepbound, as a KwikPen or vials, costs $299 for the first 28-day fill at the 2.5 mg starting dose, which its label limits to 4 weeks. Each later 28-day fill costs $399 to $449, but the $449 price at the higher doses needs each refill within 45 days; refill later and those doses cost $499 to $699. Needles cost extra. Foundayo, a daily pill, costs $149 a month for its first two months, then $199 to $299 (30 tablets). Its 2.5 mg and 5.5 mg prices are reduced only through December 31, 2026, then go back to $199 and $299, and its top doses cost $349 unless each refill comes within 45 days.^{9, 11, 43, 44} The offers' other conditions are on our GLP-1 cost page; our tirzepatide cost page adds up a year of Zepbound fills, and Foundayo with insurance has its own page.
• Insurance, HSA and FSA: lower prices for some commercially insured patients, government plans excluded; Zepbound is listed as HSA/FSA eligible, varying by plan.⁹ Lilly's terms for the self-pay card behind the KwikPen's prices say you agree not to seek payment or reimbursement for a KwikPen bought with the card from "any insurance plan, healthcare reimbursement account, or other third-party payer."⁴⁵ Ask LillyDirect and your plan administrator before paying for a KwikPen with HSA or FSA money.
• Where: not stated; free delivery or pickup.⁹

NovoCare Pharmacy

• What it is: Novo Nordisk's pharmacy for Wegovy. It needs a prescription and can connect you with a prescriber; no program fee is listed.¹⁰
• Price: the Wegovy pill costs $149 for the first month's starting dose, then $199 to $299 a month (30 tablets). The Wegovy pen costs $349 a month, or $399 for the 7.2 mg Wegovy HD; a month is a box of 4 weekly pens (28 days).^{10, 12} New patients pay $199 for each of their first two pen fills at the two starting strengths if the prescription is written and reaches NovoCare Pharmacy by December 31, 2026, and the boxes ship by January 31, 2027; NovoCare says pricing will be updated after December 31, 2026.^{46, 47} Our semaglutide cost page adds up a year of fills.
• Insurance, HSA and FSA: self-pay only; it does not bill insurance or accept copay cards. With commercial coverage, Novo's savings offer is used at your local pharmacy. Its page for health care professionals says it accepts payment from FSA/HSA accounts.^{46, 47, 48}
• Where: its terms say the offer is valid in the U.S. and its territories, and the pharmacies in its network are together licensed to dispense into all 50 states, D.C. and Puerto Rico; free home delivery.^{10, 46}

Renewal, prepaid plans, cancelling and refunds

The six compounded programs and Ro charge your card automatically until you cancel, and PlexusDx's plans also renew automatically; the drugmakers' pharmacies price each fill separately and describe no subscription.^{5, 7, 9, 10, 22, 29, 40, 49, 50} This is what each program's own terms say about stopping, paying ahead and getting money back.

PlexusDx's rows in the two tables below come from its Refund & Cancellation Policy, effective September 30, 2026. That policy and PlexusDx's Terms of Service also set these terms:

• Prepaid plans: a 3-, 6- or 12-month plan is charged in full once a clinician approves treatment, which can be before the pharmacy prepares or ships it, and your payment method may be verified when you enroll. The monthly figures in PlexusDx's entry are for comparison. If you cancel, treatment already paid for stays available through the term while it remains clinically appropriate.
• Renewal: plans renew automatically for the same length unless you cancel or pause.
• Twelve-month plans: because a prescription lasts up to six months, a 12-month plan includes a renewed clinical review, and PlexusDx sends a reminder before the prescription runs out. If the review is not completed, shipments pause and your unused prepaid time is kept.
• Shipping: included in the plan price, with no separate shipping charge; the pharmacy typically prepares and ships an order within 3 to 5 business days of approval.
• Not in the plan price: outside laboratory testing, emergency or specialist care, in-person services, "patient-caused replacement medication, extraordinary early-fill costs," and taxes or government charges.

The policy and Terms also cover pauses, renewal reminders and price changes, delayed shipments, and what happens if PlexusDx can no longer provide a prepaid plan. We did not check the other programs' terms on these points, so this page does not compare them.

One price, or a membership plus medication

At Ro and Curai Health, care is separate from the medication, which you pay for on its own, while the six compounded programs each describe one price covering the prescriber's care and the medication.^{4, 6, 7, 14, 15, 22, 35, 38} For example, after the first month TrimRx's compounded tirzepatide package is $399, care included. After the first month on Ro's monthly plan, the $149 membership plus the FDA-approved Zepbound KwikPen at the doses that follow the starting dose ($399 to $449, the top price with on-time refills) comes to $548 to $598 a month.^{7, 14}

"No membership fee" does not mean no subscription. What each company says, next to how it bills:

• Gala's homepage says "No membership fee," and its refund policy describes "membership in the subscription program," charged when you complete the intake form.^{36, 40}
• Embody's homepage says "No membership or hidden fees," and its policy says your "membership in the subscription program" begins when you pay.^{4, 41}
• Good Life Meds says "No membership, no price increases, only pay as you go," and its treatments are subscriptions that renew automatically.⁶
• Polly lists "no membership or consultation fees," and its plans renew until you email to stop them.^{35, 49}
• TrimRx's terms list no membership fee, and its packages are billed automatically according to your plan.⁷
• PlexusDx's plans have no separate membership fee, and they renew automatically until you cancel or pause. Its checkout calls the purchase a plan, its card charges read PlexusDx, and the checkout step, which spells out the cost, how renewal works and the refund policy, comes after opening questions on height, weight and current GLP-1 use but before the remaining health history; product pages show prices beforehand.

First-month prices often rise in month two: TrimRx, Embody's "Start" program and Ro all charge less for the first month, as their entries show. The drugmakers' introductory offers, some ending December 31, 2026, are on our GLP-1 cost page.

How to stop the next charge

Refunds, including plans paid ahead

The lowest monthly rates usually mean paying for months at once. Polly's 6-month tirzepatide plan is one $1,194 charge, $480 less than six months at its month-to-month price, but it is not refundable after the first month.^{33, 34} Embody's bundles, PlexusDx's 3-, 6- and 12-month plans and Ro's prepaid memberships are also paid ahead, as their entries show, and TrimRx's terms describe prepaid plans without listing their prices.^{5, 7, 14, 41}

Before you pay anyone

Get these terms in writing before you enter a card number, and keep a copy of the checkout page:

• which drug and form you will receive, and whether anything is added to it
• the plan length, and the amount and date of each charge
• whether the plan renews on its own, and how far ahead you must cancel
• what you get back if you are not prescribed or you stop early
• the names of the prescriber's practice and of the pharmacy that will fill the prescription, so you can check both licenses
• how to reach the prescriber quickly about a serious side effect (see the warning signs)

For paying from a health savings or flexible spending account, see paying with an HSA, FSA or CareCredit; if you might later move to Zepbound, see what a change from compounded tirzepatide involves.

Compounded or FDA-approved: what the difference means

Compounded semaglutide and tirzepatide are not FDA-approved or reviewed, and they are not generics, which must be FDA-approved; FDA says skipping that review makes compounded drugs higher risk.^{1, 3, 53} Our provider guide explains the law on compounded GLP-1s.

Zepbound, Wegovy (injection or tablets), Foundayo and Saxenda (liraglutide) are FDA-approved for weight loss in adults with obesity, or with overweight plus at least one weight-related health problem. Each is approved for use with a reduced-calorie diet and more physical activity.^{11, 12, 44, 54} In the main Zepbound and Wegovy weight-loss trials, obesity meant a body mass index (BMI) of 30 or more, and overweight a BMI of 27 to under 30 with at least one weight-related condition.^{11, 12}

Ozempic is approved only for adults with type 2 diabetes, including to improve blood sugar along with diet and exercise; it is not approved for weight loss. Prescribing it for weight loss is off-label, a decision for the prescriber, and some programs here list it.⁵⁵

Tablets, gum and added ingredients. Willow lists compounded semaglutide and tirzepatide tablets that dissolve under the tongue, and Embody's terms list a gum form.^{5, 22} PlexusDx's forms are given in its entry above. FDA has not approved or reviewed any compounded tablet or gum.³ The FDA-approved GLP-1 pills for weight loss are Wegovy tablets and Foundayo; Lilly's tirzepatide medicines, Zepbound and Mounjaro, are injections, and no tirzepatide pill is FDA-approved.^{11, 12, 44, 56} Willow's semaglutide injection has added vitamin B12; in a July 2024 alert, FDA said the safety and effectiveness of combining semaglutide with other ingredients had not been established.^{23, 57} Our provider guide covers compounded pills and added ingredients.

Doses and vials. FDA has received reports of side effects, some needing hospital care, that may be related to mistakes in measuring doses of compounded semaglutide injections, and others, some serious, that may be related to compounded doses, or dose increases, beyond what the approved labels describe. It says to throw away a multiple-dose vial 28 days after first use, even if medicine is left and even if the compounder's instructions say it can be used longer. It also says to use a new sterile needle and syringe for every dose, and not to use an injectable GLP-1 that arrives warm.³ If too much is taken, the approved drugs' Medication Guides say to call your prescriber or Poison Help (1-800-222-1222) or go to an emergency room right away.^{11, 12} Ask your prescriber or pharmacist to show you how to measure your dose, and see our pages on pens and vials for compounded drugs and checking a delivery when it arrives.

Safety questions to settle with any program's prescriber

Whichever program you use, expect its prescriber to ask about the points below. The FDA labels for Zepbound, Wegovy, Foundayo, Saxenda and Ozempic make them reasons not to take a drug, or to take extra care. Compounded semaglutide and tirzepatide have no label of their own. FDA says many side effects reported with them look like the approved drugs', and that reports are probably undercounted, because most compounding pharmacies need not report them, so read these points as applying to them too.³

• Thyroid cancer. All five labels carry a boxed warning about thyroid C-cell tumors and rule the drugs out for anyone with a personal or family history of medullary thyroid carcinoma (MTC) or with multiple endocrine neoplasia syndrome type 2 (MEN 2). Tirzepatide, semaglutide and liraglutide caused these tumors in rodents. Orforglipron, the drug in Foundayo, does not act on the GLP-1 receptor in rats or mice, so those studies could not test the risk. It does act on the human receptor, and whether the rodent findings with other GLP-1 drugs matter for people is not known. Nor is it known whether any of these drugs causes MTC in people.^{11, 12, 44, 54, 55}
• Allergy. None is for anyone who has had a serious allergic reaction to the drug or its ingredients.^{11, 12, 44, 54, 55}
• Pregnancy and breastfeeding. Zepbound, Wegovy, Foundayo and Saxenda may harm a developing baby; their labels say to stop when a pregnancy is recognized. Ozempic's says it may pose risks and should be used in pregnancy only if the benefit justifies the risk, so anyone taking it for weight loss should call the prescriber as soon as a pregnancy is known. Wegovy's and Ozempic's say to stop at least 2 months before a planned pregnancy, and Foundayo's advises effective birth control during treatment. Breastfeeding is not recommended with Wegovy tablets or Foundayo.^{11, 12, 44, 54, 55}
• Birth-control pills. Zepbound may make them less effective: its label says to switch to a non-pill method, or add a barrier method, for 4 weeks after starting and after each dose increase. Foundayo's label says the same for 30 days. If you are prescribed compounded tirzepatide, ask whether this applies to you.^{11, 44}
• Other medicines. The Zepbound, Wegovy, Foundayo and Saxenda labels advise against taking another GLP-1 drug at the same time, which matters if you switch programs. Foundayo's label says to avoid some medicines that sharply raise or lower the amount of Foundayo in your blood (ritonavir, an HIV medicine that is also part of Paxlovid, a COVID-19 treatment, is its example). It also says to take no more than 20 mg a day of simvastatin, a cholesterol medicine. These drugs slow stomach emptying, which can change how other pills are absorbed: Wegovy's label reports levels of levothyroxine, a thyroid hormone, about a third higher with semaglutide tablets, and Zepbound's names warfarin, a blood thinner, as a drug to monitor. Give your prescriber or a pharmacist a full list of what you take.^{11, 12, 44, 54, 58, 59, 60, 61, 62}
• Stomach and liver conditions. None of these drugs is recommended for people with severe gastroparesis (very slow stomach emptying), and Foundayo is not recommended with severe liver disease.^{11, 12, 44, 54, 55}
• Multi-dose pens. The Zepbound KwikPen, the Wegovy FlexTouch and the Ozempic and Saxenda pens each hold several doses, and their labels say never to share one with anyone, even after changing the needle, because sharing can spread infections.^{11, 12, 54, 55}

All five labels also warn of pancreatitis, which has been fatal in some people on GLP-1 drugs; gallbladder disease; stomach and bowel side effects, sometimes severe; dehydration from vomiting or diarrhea, which can lead to kidney injury; and serious allergic reactions. They also warn that food or liquid can enter the lungs under anesthesia or deep sedation, so tell anyone planning a procedure that you take one.^{11, 12, 44, 54, 55}

These drugs can cause low blood sugar, most often with insulin or a sulfonylurea, another type 2 diabetes medicine. The Zepbound, Wegovy and Foundayo labels also report it in adults without type 2 diabetes, and Saxenda's in children 12 and older without diabetes. All but Saxenda's label warn that diabetic eye disease (retinopathy) can worsen in people with type 2 diabetes, and the Wegovy and Saxenda labels warn of a faster heart rate.^{11, 12, 44, 54, 55}

The labels' Medication Guides say to stop the medicine for two kinds of warning signs:

• severe stomach pain that will not go away, sometimes felt in the back: call your prescriber right away
• signs of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or a very fast heartbeat: get medical help right away^{11, 12, 44, 54, 55}

They also list these signs, among others, to report to your prescriber:

• nausea, vomiting or diarrhea that will not stop (right away, and drink fluids)
• gallbladder signs, such as upper-stomach pain, fever, yellow skin or eyes, or clay-colored stools (right away)
• a lump or swelling in the neck, hoarseness, trouble swallowing or shortness of breath, which may be signs of thyroid cancer
• signs of low blood sugar, such as shakiness, sweating, dizziness, confusion or a fast heartbeat
• stomach problems that are severe or will not go away
• vision changes, if you have type 2 diabetes
• on Wegovy or Saxenda, a racing or pounding heartbeat that lasts several minutes^{11, 12, 44, 54, 55}

Sources

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11. ZEPBOUND (tirzepatide) injection: prescribing information and Medication Guide (revised 8/2026), Eli Lilly and Company, via DailyMed, National Library of Medicine, accessed October 3, 2026.
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18. Weight loss drugs, Centers for Medicare & Medicaid Services (Medicare.gov), accessed October 3, 2026.
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20. TrimRx vs Eden Health: Cost and Pricing Compared (published May 12, 2026, updated May 20, 2026), TrimRx, accessed October 3, 2026.
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34. Do the multi-month plans bill monthly or upfront, and are they refundable? (help-center article dated May 8, 2026), Polly, accessed October 3, 2026.
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How we made this page

This page replaces nine older PlexusDx posts about these programs; none of their text, prices or ratings was carried over. Comparing programs means reading each company's own pages on the same day, so on October 3, 2026, AI tools opened the pricing pages of the ten other programs and drugmaker pharmacies, the terms, refund and help pages of the eight telehealth programs, and the FDA, DailyMed, Medicare.gov and MedlinePlus pages in the sources list, and the ten other entries carry that date. They recorded the exact wording behind each price, term and table cell and drafted the text and tables, and a script redid the arithmetic.

An AI fact-check then compared each statement and table cell with its source. Later AI review passes looked for clinical, regulatory, search-quality, reader and PlexusDx-claim problems, and AI editing passes re-opened the sources to fix them. These checks match wording to sources; they are not a doctor's or a lawyer's judgment. 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.

The program list follows one rule: every company named in more than 1,000 Google searches that showed one of the older posts (Search Console, July 2025 to September 2026). Eight companies besides PlexusDx met it, and the next had about 300. We did not sign up with, buy from or test the other programs for this page, and none of the links is an affiliate link.

PlexusDx's entries are the company's own statements as of October 19, 2026: its plan, renewal, cancellation and refund terms follow its Refund & Cancellation Policy and Terms of Service, effective September 30, 2026, and Jay Hastings confirmed its prices in writing on October 3, 2026. He reviewed and approved this version on October 19, 2026. PlexusDx sells compounded GLP-1 treatment, so we have a financial interest in this topic. Program, pharmacy and drug names belong to their owners and are used only to identify them, and our editorial policy applies to this page.