I was taking a quick look at the survey results so far and it got me curious about the perception vs the reality... if you had to guess what do you think the majority is doing? Tracking food or not?
I’m sure you’ve heard this repeated often that a 10% difference in dosage strength of a compounded drug makes it not an essential copy of the commercial product. But that’s not what the FDA said.
The 10% figure is just what the FDA said it would automatically consider a similar strength as part of the essential copy analysis.
It does not mean that an 11% strength difference is safe. In fact they go on to say that a compounded product would still be an essential copy if it can be easily substituted by a commercially available drug.
“Fractional or multiple doses” to me are the keywords.
In other words, if the compounded dose can easily be achieved by taking more or less of the commercial product then the compounded product can be considered an essential copy. A compounder cannot just say it’s more than 10% different so it’s not a copy!
And with Zepbound vials, where the dose can be easily adjusted by drawing more or less liquid, the fact that a compounded product is more than 10% different does not save it from FDA scrutiny.
But I’m so curious why this 10% myth is even repeated? It’s not like telehealths/pharmacies are even following this! 😂
I’ve had an Rx for 15mg with and without additives.
And the last weird dose I got was 13.5mg which I guess they’re trying to say is 10% different than 15mg but it’s only 8% different from 12.5mg so it fails anyway! 🤦♂️
But again it doesn’t matter because the 10% thing doesn’t end the analysis.
Tirzepatide Compound Summer 2026 Survey
We're back to the more comprehensive survey with some updates and new questions.
You will need to sign in to your google account before being able to answer but your email is not shared with me.
Survey closes July 15th, results likely July 25th.
For anyone curious about what their vials looked like. Label has a slight iridescence to it 🫧✨
Phenol lovers rejoice, a new pharmacy with phenol has entered the villa.
Rush Pharmacy's inactive ingredients are the same as Southend's:
Sodium phosphate, propylene glycol, phenol, and pH adjusters Hydrochloric Acid/Sodium Hydroxide.
But with BPI's higher concentration of B6 at 10mg/mL
So now there are 5 pharmacies with phenol.
There's a troll going around telling people that compounded tirz is degraded and useless because no available pharmacy has pH buffers to stabilize it like Zepbound.
Don't feed the trolls obviously, but I thought this needed to be said...
Currently available pharmacies that use pH buffers:
Pharmacies that don't:
And even with these it's not like it suddenly turns to water or poison past the BUD. It degrades slowly and keeping it cold and protecting it from light helps it degrade even slower.
Just reposting this study because I saw some people still didn’t know about it.
Read the study but here’s the summary I have included in the guide:
“And a recent preclinical study published in JCI Insight found that stopping and restarting GLP-1 receptor agonist treatment in mice made the medication less effective leading to less weight loss and increased body fat compared with continuous treatment.
This still needs to be confirmed in humans, but it does line up with what many people report experiencing after restarting following an extended break.”
According to recently published SURMOUNT-MAINTAIN clinical trial:
Rounded numbers above, real percentages in chart below.
So that's interesting.
(Important caveat from the chart: note that the chart says "among those who reached a bodyweight plateau" They defined a plateau as less than 5% loss in the last 12 weeks of the initial 60 week weight loss period. So this isn't talking about people who are continuing to lose a lot when they reach goal weight and need to titrate down to stop them from losing)
This trial also confirmed the SURMOUNT-4 clinical trial data that showed that most people who stopped regained at least half the weight back.
In the SURMOUNT-4 trial 57% of people who stopped regained at least half the weight back, and in this SURMOUNT-MAINTAIN trial 67% of those who stopped regained at least half.
I'm updating the pinned post after seeing that Fifty410 is out of BPI, but I haven't kept up with the others, are the others still taking BPI orders?
Just went through the form to test out possible codes and looks like Ezra50 works.
And BPI Labs was inspected on April 17th and shortly after announced they were stopping…
Looks like the FDA is serious about 503Bs stopping tirz production.
Get Apothecary while you can I guess. 🤷♂️
For informational purposes only. This is not medical advice. Tirzepatide is prescription only and should be used under the supervision of a licensed healthcare provider.
Table of Contents:
Tirzepatide is a dual GIP and GLP-1 receptor agonist that reduces appetite, increases satiety, slows gastric emptying, and improves blood glucose control. In clinical trials, it demonstrated substantial and sustained weight loss along with significant reductions in A1C.
Compounded tirzepatide is not FDA approved, but it is prescribed by licensed healthcare providers and is made by 503A compounding pharmacies or 503B outsourcing facilities.
503A compounding pharmacies are primarily regulated, inspected, and licensed by state boards of pharmacy. They generally comply with United States Pharmacopeia (USP) standards for sterile compounding.
503B outsourcing facilities are registered with and inspected by the FDA. They must follow Current Good Manufacturing Practice (CGMP) regulations, which are federal drug manufacturing standards designed to help ensure consistent quality, strength, and purity. 503Bs commonly have longer Beyond Use Dates.
Manufactured tirzepatide is the FDA approved, commercially available version of tirzepatide made by Eli Lilly under the brand names Mounjaro and Zepbound. Mounjaro is FDA approved for type 2 diabetes, while Zepbound is FDA approved for chronic weight management and obstructive sleep apnea. These products are made through large scale, standardized, CGMP compliant manufacturing. Future FDA approved generic versions would also fall under this category once Lilly’s patent protections expire.
28 Day Rule:
A safety guideline that says multi-dose vials should be discarded 28 days after first puncture to reduce infection risk.
Beyond Use Date (BUD):
The date after which potency and sterility can no longer be assured based on regulation and stability data.
Many users report going beyond these limits. This is an observation, not a recommendation. Please base any medical decisions on your provider’s guidance, your risk tolerance, and your medical history, not on other people’s choices.
Common side effects as reported by respondents in a recent survey
Seek medical attention if you experience:
Tips to reduce side effects:
For providers and plans check out this post:
Where to Buy: Telehealth Providers
Before choosing a telehealth provider, review the plan details, search this subreddit for any recent issues, and join the telehealth’s subreddit, if available, for further updates and support.
Please do your research before signing up. Choose a provider and plan that works best for you. Different formulations may affect people differently. If you're sensitive to meds, consider trying one month before committing to a multi-month plan.
Once you've chosen a telehealth provider:
Your Tirzepatide Package Arrived Warm? Read This Before You Panic!
Why this happens:
| Additive | May help with |
|---|---|
| B3 / Niacinamide | NAD production, cellular energy and repair, antioxidant activity, skin health, inflammation |
| B6 | Nausea relief, nutrient metabolism, nervous system function, immune function, red blood cell formation |
| B12 | Fatigue relief, energy metabolism, nerve health, red blood cell formation, DNA synthesis, repair, and methylation |
| Glycine | Collagen, connective tissue, glutathione, sleep quality, nervous system function, and metabolic health |
Your vial may not be filled to the top. This is normal. Your tirzepatide may come in a larger vial than necessary, so it may only be half full or less.
You need very little liquid for your shots, the syringe just makes it look like more. For perspective, 10 units is only about 2 drops of liquid. Even a completely full 1 mL syringe (100 units) is only about 20 drops of liquid, or about 1/5 of a teaspoon.
Insulin syringes come in different sizes: 0.3 mL (30 units), 0.5 mL (50 units), and 1 mL (100 units). All are U-100, meaning 100 units = 1 mL. The syringe size only affects how much it can hold. On any U-100 insulin syringe, each unit is the same amount of liquid.
Store your vial in the refrigerator at 36°F to 46°F
Protect from light, keep vial in prescription bottle it came in
Some people prefer using a dedicated vial case
Getting a vial case? Here’s what you need to know
Before injecting:
How to use: Find your vial’s concentration in the left column and your desired dose across the top. Where they meet is how many units to draw.
| Concentration (mg/mL) | 2.5mg | 5mg | 7.5mg | 10mg | 12.5mg | 15mg |
|---|---|---|---|---|---|---|
| 8 | 31 | 63 | 94 | 125 | 156 | 188 |
| 9 | 28 | 56 | 83 | 111 | 139 | 167 |
| 10 | 25 | 50 | 75 | 100 | 125 | 150 |
| 12.5 | 20 | 40 | 60 | 80 | 100 | 120 |
| 15 | 17 | 33 | 50 | 67 | 83 | 100 |
| 17 | 15 | 29 | 44 | 59 | 74 | 88 |
| 17.65 | 14 | 28 | 42 | 57 | 71 | 85 |
| 18 | 14 | 28 | 42 | 56 | 69 | 83 |
| 20 | 13 | 25 | 38 | 50 | 63 | 75 |
| 22 | 11 | 23 | 34 | 45 | 57 | 68 |
| 25 | 10 | 20 | 30 | 40 | 50 | 60 |
| 30 | 8 | 17 | 25 | 33 | 42 | 50 |
| 33 | 8 | 15 | 23 | 30 | 38 | 45 |
Having trouble injecting? Consider getting an Autoject 2. It turns your syringe into an auto-injector pen. At the push of a button it inserts the needle and pushes the plunger down. The syringe and needle remain hidden as it's happening.
Tirzepatide affects everyone differently. Try not to compare yourself to others. Some people feel the therapeutic effects right away, while others may not notice much until several weeks in or until they reach higher doses. Some people do well on lower doses, while others need higher doses. Neither is better or worse.
Weight loss is not linear. Fluctuations and plateaus are normal. Some may experience rapid weight loss at the start, but this is not sustainable or healthy long term. A healthy weekly weight loss rate is about 0.5 to 1% of your body weight per week.
If you are tolerating your dose well but strong food noise returns or you have not lost weight in 4 weeks, it may be time to increase. If side effects are intolerable, you may need to decrease. Discuss any concerns you have about your dose with your provider
For many, tirzepatide may be part of their long term maintenance plan. In our recent survey 51% of respondents said they plan to use it for life, while another 23% said they plan to use it long term and stop only after maintaining the weight for a while. Only 3% said they would stop once they reached their goal weight.
The reason why may be explained by the SURMOUNT-4 clinical trial, which showed that within 1 year of stopping tirzepatide 82% regained at least 25% of the weight they had lost. 57% regained at least half the weight back.
Everyone's maintenance plan, like their weight loss journey, will look different. Many people decrease their dose once they reach their goal weight or increase the time between shots. Though some may need a weekly high dose to maintain.
Your maintenance dose, or whether you can maintain without tirzepatide, is not a reflection of your willpower or self-worth. Please remember to give yourself and others grace in this regard.
Apparently the formatting got a bit wonky for some people and it wasn’t showing them all the telehealths.
I’ve rewritten the list in the hopes it would fix the issue. Can y’all go check the pinned post to see that it matches this picture?
Lots of dissatisfaction and a bunch of newcomers. 😬
Anything y’all found interesting? 🤔
What percent must a telehealth reach to be considered for inclusion in the pinned list?
(I’ll make another poll with the top two if no choice gets above 50% in an hour)
What percent must a telehealth reach to be considered for inclusion in the pinned list?
https://www.reddit.com/r/tirzepatidecompound/comments/1t13kvu/short_telehealth_pharmacy_survey/
Fill out the survey if you haven't yet.
But I want to note that after a quick look through of the current numbers it seems people want the standard to be 20% usage rate and 90% recommended rate. I'm not sure if the question was misunderstood or if y'all overestimated something but as things stand now in this current survey there would only be two telehealths on the list...
Sorry but is that really what y'all want???????? 😂
I'm sure Casy from Trillium would be thrilled 🤣 but I'm not sure it would make for a good list lol
I'll wait to see what the final numbers are on this but I think when I get the final results I'll default to 5% usage and 70% recommended to be safe and maybe make a special note of the telehealths who reach the high threshold.
