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Compounded Semaglutide & Tirzepatide in 2026: FDA Rules, Safety Risks, and How to Choose a Legitimate Pharmacy Joshua Silva, MD Oct 3, 2025 5 min read Updated: Jan 21 Medically authored by Joshua Silva, MD | Evidence-Based Weight Loss at Potere Health MD As of 2026, compounded semaglutide and tirzepatide are no longer broadly permitted in the United States

Injection forms of these drugs need to be refrigerated, while oral tablet forms of these drugs can be stored at room temperature

Both use a gradual dose escalation to minimize GI side effects, sharing the same schedule through 1.0 mg before diverging

If you are in the middle of a dose increase, it may be worth evaluating how things settle over the next several weeks before making changes

Neither extreme is helpful