Online advertisements for GLP-1 medications have become common across social media, but University of Mississippi researchers urge caution when considering purchase. The U.S. Food and Drug Administration has found that many online offerings from compounded pharmacies have false or misleading labels and improperly handled materials. Graphic by Clara Turnage/University Marketing and Communications
Online ads offer affordable alternatives to GLP-1s, but researchers urge caution
The skyrocketing demand for GLP-1 weight-loss medications has led to a surge in compounding pharmacies producing similar products at lower prices, but researchers warn that these medications are not always as safe as they claim.
The U.S. Food and Drug Administration recently issued a warning against using unapproved GLP-1 drugs for weight loss, citing quality concerns, false or misleading labels, counterfeit drugs and more than 1,600 reports of adverse effects associated with compounded GLP-1 medications.
Liang-Yuan Lin, a doctoral candidate in pharmacy administration, and Sujith Ramachandran, an associate professor of pharmacy administration at the University of Mississippi, urge people seeking GLP-1 medications to use credible sources and FDA-approved products.
“People assume – and many websites advertise it this way – that compounded versions are just the generic versions of Ozempic or Zepbound, and that’s not true,” Lin said. “Generic drugs always have to go through the FDA’s standards showing equivalence to the branded products. Compounded drugs go through a very different pathway at the FDA.”
Another misconception is that because a product lists the same active ingredients, it is equivalent to the name brand, she said.
“In reality, the compounded product includes a completely different formulation, including inactive ingredients, manufacturing quality, labeling, patient instructions, etc.,” Lin said. “All of these details can be totally different in a compounded medication than what you would find in a branded product.”
Compounding pharmacies provide medications that are not commercially available and often prepare them to fit a patient’s specific needs. If a patient is allergic to a dye or inactive ingredient used in a generic or branded medication, compounding pharmacies can provide a medication that avoids the allergen.
But compounding pharmacies are also not subject to FDA approval, meaning oversight of compounding pharmacies is not robust and can result in compromises in the safety, effectiveness or quality of the drugs being sold.
For patients seeking GLP-1s, this difference can be important, Ramachandran said.
“The most important thing people need to know is to be so careful when buying these drugs online,” the Ole Miss researcher said. “The demand for these drugs is soaring, and insurers are continuing to not cover these drugs, expecting and pushing patients to buy them online and pay in cash, but those compounding pharmacies are so dangerous.
“We have heard horror stories about patients showing up at the hospital with problems because of the compounded drugs. I would encourage patients to be very, very careful buying drugs from these online retailers.”
Aside from the product’s ingredients, GLP-1s are ideally administered under medical care, Lin said. Online services often do not provide this support.
“We have seen that the products are not the same,” she said. “But these websites are also not carefully screening their patients and evaluating whether the person needs the medication.
“That lack of clinical oversight is dangerous for patient safety. If you do go with the compounded option and you need to adjust the dose or if you have complications, who will you call? Who will be responsible?”
Branded, FDA-approved GLP-1 products are sold online, but they require a prescription. Any product offering GLP-1 medication without a prescription is illegal and unsafe, the researchers said.
“The cost might be a little bit higher compared to compounded versions, but it’s much safer and you get a product that is FDA-approved,” Lin said.
Some online retailers offer their own clinician to approve the drug’s use, but a recent study found that 92% of GLP-1 websites prescribed the medication with little to no oversight, and many did not screen patients for potential allergies or other conditions that would prevent use.
Ramachandran recommended patients go through their usual care providers instead.
“I would encourage patients to not buy GLP-1 medications online, but if you’re going to buy it online, at least go see your primary care physician first,” he said. “These online retailers will have their own physicians that you ‘see’ to get a medication, but at least talk to your own doctor before you go down that road in order to make sure you’re doing this as safely as you can.”
By Clara Turnage
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