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Compounded Weight Loss Drugs: A Growing Trend Among Doctors

Health care providers are increasingly turning to compounded versions of popular weight loss drugs like Wegovy and Zepbound as a viable alternative to address shortages and high costs. While some physicians have reservations about the ingredients used in these compounded medications, others are advocating for their use due to their accessibility and affordability.

The Rise of Compounded Weight Loss Drugs

In recent years, compounded weight loss drugs have been gaining traction among healthcare providers looking to offer effective treatments to their patients. Compounded versions of semaglutide (the active ingredient in Wegovy) and tirzepatide (the active ingredient in Zepbound) are becoming more widely prescribed as an alternative to the brand-name drugs that are often in short supply.

Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, notes that physicians are becoming more comfortable with prescribing compounded GLP-1 medications, including Wegovy and Zepbound. This shift in attitude towards compounded medications is driven by the need to provide patients with access to effective weight loss treatments at a more affordable cost.

At Duke Health’s Hillsborough Primary Care Center in North Carolina, providers have been actively prescribing compounded versions of weight loss drugs to their patients. Leanne Owens, a physician assistant at the practice, shared that she prescribed compounded weight loss medications to 10 of her patients after the state stopped covering the brand-name versions for state employees in April. Despite initial hesitations, Owens found reassurance in speaking with a compounding pharmacist at Duke, who helped address her concerns about the safety and efficacy of compounded medications.

Understanding Compounding and Its Benefits

Compounding pharmacies play a crucial role in providing patients with customized medications that meet their specific needs. Compounded versions of drugs can be tailored to address various patient requirements, such as converting tablets into liquid form or removing certain allergens like dyes. In the case of weight loss drugs, compounding offers a practical solution to drug shortages and high costs, allowing patients to access the medications they need at a more affordable price point.

The Food and Drug Administration (FDA) permits the use of compounded medications that are essentially replicas of commercially available drugs under specific circumstances, such as during drug shortages. Compounded pharmacies source their ingredients from FDA-registered facilities, ensuring that the active ingredients used in compounded medications meet quality standards. While the FDA does not directly test or verify compounded ingredients, pharmacists are responsible for ensuring the safety and efficacy of the medications they compound.

Ensuring Patient Safety and Quality Control

Providers and patients alike must exercise caution when considering compounded medications for weight loss. It is essential for doctors to prescribe compounded drugs from reputable compounding pharmacies that adhere to strict quality control measures. Patients should obtain prescriptions from licensed healthcare providers and fill them at state-licensed pharmacies to minimize the risk of receiving counterfeit or substandard medications.

Matthew Brown, the pharmacy manager at the Duke Compounding Facility, emphasizes the importance of using accredited pharmacies that have been vetted by reputable institutions like Duke. The facility prioritizes patient safety by only prescribing compounded weight loss medications during shortages, reverting to brand-name drugs once the supply chain stabilizes. By upholding stringent quality control standards, Duke ensures that patients receive safe and effective compounded medications for weight loss.

Patient Experiences with Compounded Weight Loss Drugs

Elizabeth Kenly, a resident of Graham, North Carolina, shares her positive experience with a compounded version of tirzepatide prescribed by a physician at the Hillsborough Primary Care Center. Despite initial reservations, Kenly found comfort in discussing the medication with her doctor and has since lost 25 pounds on the compounded drug. Her success story highlights the potential benefits of compounded weight loss medications in helping patients achieve their health goals.

While some patients have reported positive outcomes with compounded weight loss drugs, concerns remain about the lack of oversight and regulation in the compounding process. Novo Nordisk and Eli Lilly, the manufacturers of Wegovy and Zepbound, respectively, have expressed reservations about the use of compounded versions of their drugs, citing potential risks to patient safety.

Dr. Scott Isaacs, president-elect of the American Association of Clinical Endocrinology, acknowledges the challenges associated with compounded weight loss drugs, noting that there are inherent risks in using medications that have not undergone rigorous FDA testing and approval. Despite the growing acceptance of compounded medications among some healthcare providers, concerns persist about the consistency and quality of compounded weight loss drugs.

Exploring Alternatives in Weight Loss Treatment

Dr. Daniela Hurtado Andrade, an endocrinologist at the Mayo Clinic in Jacksonville, Florida, emphasizes the importance of considering alternative weight loss medications beyond injectable GLP-1 agonists. While drugs like Wegovy and Zepbound have garnered attention for their efficacy in promoting weight loss, there are other FDA-approved medications, such as phentermine-topiramate and naltrexone-bupropion, that offer viable options for patients seeking to manage their weight.

The availability of diverse weight loss medications underscores the importance of personalized treatment approaches tailored to each patient’s unique needs. By exploring a range of options, healthcare providers can offer comprehensive weight loss solutions that address individual health concerns and preferences. Patient education and shared decision-making play a crucial role in guiding treatment choices and ensuring optimal outcomes in weight management.

The Future of Compounded Weight Loss Drugs

As healthcare providers navigate the evolving landscape of weight loss treatment, the use of compounded medications is likely to remain a topic of debate and discussion within the medical community. While some physicians advocate for the benefits of compounded weight loss drugs in addressing treatment gaps and affordability issues, others raise valid concerns about quality control and patient safety.

Moving forward, ongoing research and collaboration between healthcare providers, compounding pharmacies, and regulatory agencies will be essential in establishing clear guidelines for the use of compounded medications in weight loss treatment. By prioritizing patient safety and quality assurance, providers can offer effective and reliable compounded medications that meet the needs of individuals seeking to achieve sustainable weight loss and improved overall health.