Compounded vs. branded GLP-1 medications: what’s the difference?

Branded GLP-1 medications, such as Wegovy®, Zepbound®, Ozempic® and Mounjaro®, are made by their manufacturers and approved by the FDA. Compounded semaglutide and tirzepatide are prepared by a state-licensed pharmacy for one patient, on a prescription, and are not FDA-approved: the FDA does not review them for safety, effectiveness or quality before they reach patients. Compounded versions are not generics, and they are not the same products as the branded ones.

Tomorrow’s clinicians prescribe both. This guide explains what each label means, how the two differ in practice, and what to check before you start either one.

The differences at a glance

	Branded	Compounded
FDA approval	Approved by the FDA	Not FDA-approved
Who makes it	The manufacturer: Novo Nordisk or Eli Lilly	A state-licensed pharmacy, for one patient, on a prescription
Quality review	Reviewed by the FDA for safety, effectiveness and quality before approval	Not reviewed by the FDA; state boards of pharmacy oversee the pharmacy
Form	Prefilled pen, injected once weekly	A vial and syringes for a once-weekly injection, or drops held under the tongue
Dose	The schedule in the FDA-approved label	Set by the prescribing clinician; there is no FDA-approved dosing
Packaging	The manufacturer’s packaging, with the FDA-approved label and Medication Guide	The pharmacy’s label
Cost	Usually higher	Usually lower

What does “branded” mean?

A branded medication is made, packaged and labeled by the company that developed it, and approved by the FDA after it has reviewed the medication’s safety, effectiveness and quality. Tomorrow’s clinicians can prescribe four:

• Wegovy® (semaglutide, made by Novo Nordisk) and Zepbound® (tirzepatide, made by Eli Lilly) are approved for chronic weight management in adults with obesity, or with overweight and at least one weight-related condition, alongside a reduced-calorie diet and increased physical activity.
• Ozempic® (semaglutide) and Mounjaro® (tirzepatide) contain the same two molecules, but they are approved for adults with type 2 diabetes, not for weight management.

Each comes as a prefilled pen in the manufacturer’s own packaging and is injected once weekly, on the dose schedule in its FDA-approved label. A licensed U.S. pharmacy dispenses it on a prescription written after a clinician review. All four are on one page.

What does “compounded” mean?

Compounding is when a licensed pharmacist combines, mixes or alters ingredients to create a medication tailored to an individual patient. Federal law recognizes two kinds of compounder:

• 503A pharmacies are state-licensed pharmacies that compound for an individual patient, on a prescription. State boards of pharmacy oversee them day to day, and the FDA can also inspect them.
• 503B outsourcing facilities register with the FDA, must follow federal manufacturing quality rules (current good manufacturing practice) and are inspected by the FDA on a risk-based schedule.

Tomorrow does not compound medications. The compounded medications Tomorrow’s clinicians prescribe are prepared by licensed 503A pharmacies against a patient-specific prescription:

• Compounded semaglutide and compounded tirzepatide, injected once weekly from a vial.
• Microdose versions of each, at a lower dose, with vitamin B12. There is no FDA-approved dosing for microdose protocols.
• Sublingual drops of each, held under the tongue instead of injected. There is no FDA-approved sublingual form of either molecule.

Compounded semaglutide and tirzepatide are not affiliated with, endorsed or approved by, or intended to replace the FDA-approved products made by Novo Nordisk and Eli Lilly.

Is compounded semaglutide or tirzepatide FDA-approved?

No. Compounded drugs are not FDA-approved, which means the FDA does not review their safety, effectiveness or quality before they are marketed. That applies to every compounded medication, including the ones Tomorrow’s clinicians prescribe.

Is compounded semaglutide a generic Wegovy?

No. A generic drug is approved by the FDA, after showing that it is therapeutically equivalent to its brand-name drug. A compounded drug is not FDA-approved, so it is not a generic, and it is not the same product as Wegovy®, Zepbound®, Ozempic® or Mounjaro®. No generic semaglutide or tirzepatide exists.

Can pharmacies still compound semaglutide and tirzepatide?

Yes, within limits. While both medications were on the FDA’s drug shortage list, pharmacies could compound copies of them. The FDA declared the tirzepatide shortage resolved in December 2024 and the semaglutide shortage resolved in February 2025. As of the FDA’s April 2026 update, neither is on the shortage list.

A 503A pharmacy may still compound either one for an individual patient, on a prescription. What it may not do is regularly compound what the FDA calls “essentially copies” of a commercially available drug. Under FDA guidance, a compounded medication is not treated as a copy when the prescriber determines, and documents, that it contains a change that produces a significant difference for that patient.

How are they taken?

Branded medications come as prefilled pens. Compounded injectables usually come in a vial with separate syringes, so each dose is measured by the patient.

The FDA has received reports of adverse events, some requiring hospitalization, that may be related to dosing errors with compounded semaglutide injections: patients measuring the wrong amount, and in some cases doses being miscalculated. If you use a compounded injectable:

• measure and take each dose exactly as your clinician and the pharmacy’s instructions say;
• use a new, sterile needle and syringe for every dose;
• contact the pharmacy or your clinician if anything on the label or in the instructions is unclear.

How to tell a compounded prescription is legitimate

The FDA lists warning signs to look for in a telehealth company that offers compounded medications. A legitimate service:

• requires a screening and a prescription from a licensed clinician before any medication is sent;
• has a licensed clinician available to answer questions after your medication arrives;
• fills prescriptions through a state-licensed pharmacy, whose name and correct address are on the label;
• does not claim that a compounded drug is the same as an FDA-approved drug, or a generic version of one;
• does not offer prices that seem too good to be true.

At Tomorrow, a clinician licensed in your state reviews every intake before anything is prescribed, and you are not charged unless they approve treatment. The pharmacies that fill Tomorrow’s prescriptions are listed, with their addresses, on the Compliance page. How it works covers each step. For buying any prescription medicine online, the FDA’s BeSafeRx campaign has more.

Which one is right for you?

The FDA’s position is that compounded drugs should be used only by patients whose medical needs cannot be met by an FDA-approved drug. Whether a branded medication, a compounded one, or neither is appropriate for you is a clinical decision. A clinician weighs your health history, your current medications and what you tell them about how you want to start.

Questions worth asking at your consultation:

• Is an FDA-approved medication an option for me?
• If you prescribe a compounded medication, why that one, and which pharmacy prepares it?
• How do I measure and take each dose?
• Which side effects should I watch for, and who do I contact if I have one?

Every Tomorrow plan starts with the same intake, whichever medication a clinician recommends. Compare the healthy-weight options.