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In January of this year, the FDA noted that it had "received adverse event reports after patients used compounded semaglutide" and that "patients should not use a compounded drug if an approved drug is available to treat a patient." In July, the agency followed up with a notice that it had "received reports of adverse events, some requiring hospitalization, that may be related to overdoses due to dosing errors associated with compounded semaglutide injectable products." And in August, Eli Lilly, the maker of Zepbound and Mounjaro, sent a series of cease-and-desist letters to providers urging them to stop prescribing compounded versions of those drugs

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In clinical trials, all four of these drugs have been shown to reduce HbA 1c by 0.6-0.7% when used either as monotherapy or in combination with metformin, sulphonylureas or a combination of both

Emerging competitors also deserve attention