The FDA's adverse event database documented more than 990 reports linked to compounded semaglutide and more than 730 linked to compounded tirzepatide as of May 31, 2026, per publicly available FDA safety communications
Patients should be advised to maintain consistent timing of levothyroxine administration and to report any symptoms suggestive of thyroid dysfunction, such as palpitations, tremor, anxiety (suggesting hyperthyroidism), or worsening fatigue and weight gain (suggesting hypothyroidism)
The agency also barred Evan Asher Field from importing any drug into the United States for a period of five years
Branded FDA-approved alternatives are available
They work through different mechanisms in the bodyone on GLP-1 receptors and the other on histamine H2 receptors in the stomach
Once reconstituted, compounded tirzepatide typically lasts 28 to 30 days in the refrigerator