October 20, 2026Updated October 21, 2026, 10:13 a.m. ET
Cheaper versions of popular weight loss drugs Wegovy and Zepbound are still marketed to consumers.
The booming market for “compounded” GLP-1 drugs persists despite warnings from federal drug regulators, a recall announced by one company and inspections that found contaminants such as mold and insects at overseas factories.
Recent actions by the Food and Drug Administration and Apothecary Pharma LLC’s recall of the compound tierzepatide, the active ingredient in Zepbound and Mounjaro, have raised safety concerns regarding these drugs.
Drug safety experts have emphasized that compounded drugs used for appropriate reasons are generally safe. However, consumers should be aware of potential risks when choosing counterfeit GLP-1 medications sold by telehealth companies and medical spas, rather than FDA-approved versions.
“It’s really important to understand why: why do you need a compound version? said Erin Fox, senior director of pharmacy at University of Utah Health and an expert in drug supply chains. “If it’s right on the money, then definitely buyer beware because you get what you pay for.”
Why do people use compounded weight loss drugs?
Compounding pharmacies are allowed to mix drug ingredients to tailor medications for patients who might benefit from a personalized version of a medication. These dispensaries differ from mainstream pharmacies such as CVS and Walgreens, which provide FDA-approved versions of medications at different dosages among specific patient populations.
During drug shortages, compounding pharmacies are authorized to manufacture and distribute copies of FDA-approved medications.
Consumers flocked to compounded versions of the popular GLP-1 drugs earlier this decade, when pharmaceutical companies Novo and Eli Lilly were struggling to keep pace with demand for their weight-loss drugs. The FDA allowed telehealth companies and medical spas to sell massive quantities of semaglutide and tirzepatide until the FDA declared shortages of these drugs to have ended in late 2024 and 2025.
Yet some marketers continue to sell compounded versions of these drugs, prompting FDA warnings and lawsuits from Lilly and Novo.
Consumers told USA TODAY they seek out compounded versions of popular weight-loss drugs because they are generally less expensive. Wegovy and Zepbound are generally more expensive, and less than half of large employer health insurance plans cover medications prescribed for weight loss.
Why did a company recall its medications?
Apothecary Pharma LLC issued a voluntary recall of tirzepatide injections, the active ingredient in Zepbound and Mounjaro weight-loss injections, on September 24 for “lack of assurance of sterility,” according to an FDA advisory. The federal agency updated the recall on Oct. 10 to classify it as a “Class II” recall, meaning use of the drug could result in “temporary or medically reversible adverse health consequences.” However, the risk of serious harm is low.
In December 2025, Apothecary Pharma received a warning letter from the FDA listing several violations, including “serious deficiencies in your production practices for drug products intended or intended to be sterile, which put patients at risk.”
It is unclear which marketers sold Apothecary Pharma’s tirzepatide injections. (See a list of the company’s recalled products here.)
The Outsourcing Facilities Association represents large national manufacturers. OFA President and General Counsel Lee Rosebush said U.S. compounding manufacturers follow good manufacturing practices “for high quality and consistency – the same standards used by U.S. pharmaceutical manufacturers.”
What did FDA inspectors find at two factories in China?
FDA inspectors found contaminants at factories in China that make ingredients for compounded versions of GLP-1 drugs, according to FDA inspection reports first reported by Bloomberg.
At a plant operated by Chengdu Shengnuo Biopharm, FDA inspectors found black mold in pipes and ceilings with “significant insect activity,” according to an August 2026 inspection report obtained by USA TODAY.
The Chengdu inspection report noted a complaint filed on May 5 by a customer who observed dark foreign particles inside a batch of active pharmaceutical ingredients. The inspection report, partially redacted, did not identify the customer or the drug ingredient.
When FDA inspectors arrived at the plant, they observed the plant’s quality control officers “throwing numerous solution samples down the drain in a coordinated effort” despite a policy that requires them to store the samples.
Following the inspection, the FDA issued an “import alert” on September 19 ordering agency staff to detain more than a dozen human and animal pharmaceutical products or ingredients shipped from the Chengdu plant.
Chengdu officials did not immediately respond to emailed questions from USA TODAY
What does the FDA say about the safety of compound GLP-1?
In an Oct. 1 advisory, the FDA warned that compounded versions of GLP-1 could be risky because the agency had not verified the safety, effectiveness and quality of these custom-made drugs.
The agency said compounded drugs are intended for people “whose medical needs cannot be met by an FDA-approved drug” but urged consumers to be careful.
Among the red flags cited by the FDA:
- Marketers who claim compounded medications are the same as the FDA-approved version.
- Compound versions sold at deep discounts or at prices that seem too good to be true
- Medicine that looks different from that supplied by your pharmacy or whose packaging is broken, damaged or without instructions.
Novo Nordisk officials said the company has filed more than 130 lawsuits in 40 states against compounding pharmacies, telehealth entities and others “illegally marketing and selling unapproved counterfeit drugs.”
“Given the public health considerations at play, we support FDA’s plans to take further decisive action against the illegal mass preparation of GLP-1 products,” Novo spokeswoman Liz Skrbkova said in an emailed statement. “Protecting patients and preserving the integrity of the drug approval framework remain priorities for Novo Nordisk. »
Contributor: USA TODAY reporter Mary Walrath-Holdridge
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