Drug facts
Compounded tirzepatide facts: what the label says
Compounded tirzepatide has no label of its own. The label belongs to the approved products — Mounjaro and Zepbound, both from Eli Lilly — and everything below is drawn from it.
That distinction runs through every page here, because it is the most useful thing this section can tell you: what is established about tirzepatide was established about the approved product, and a compounded vial does not automatically inherit it.
- Pages in this corpus
- 45
- Sellers of the compounded version
- 383
- Approved products with a label
- 2
Taking it
- Dosage and titrationThe approved schedule: 2.5 mg to a maximum of 15 mg, in 2.5 mg steps no closer than four weeks apart.
- Dosage in units: mg to units chartHow many units each label dose is on a U-100 syringe, by vial strength, and what mixing a powder vial with bacteriostatic water changes.
- Storage and beyond-use datingThe label's refrigeration range and its 21-day room-temperature window, and why a compounded vial has a different kind of expiry.
- Surgery, sedation and delayed stomach emptyingThe label reports rare aspiration under anesthesia in people who fasted as instructed — and says plainly that the data are insufficient to recommend what to do about it.
- Switching sellers, or switching moleculesNeither label publishes a conversion between semaglutide and tirzepatide — and moving between compounded sellers can change the mark on your syringe without changing your dose.
- A missed doseWhat the label says to do, and the four-day rule that decides it.
- Where to inject: stomach, thigh or armThe three sites the label permits, why none works better than another, and what a red or itchy site means.
- Microdosing, and is there a chart?Not in the label at any dose below 2.5 mg, and not studied. What that absence does and does not mean.
- How long it takes to workThe drug acts within days; weight follows over months. The 2.5 mg starting month, and when SURMOUNT-1's results appeared.
- How to inject itLilly's approved steps for the Zepbound vial, and why its 0.5 mL line is not a dose on a compounded vial.
- How long it stays in your systemThe label's 5-to-6-day half-life, the halving arithmetic after a last dose, and what the label says about pregnancy.
- What to eatThe label names no foods. What "reduced-calorie diet" meant in the trials: about 500 calories a day below need, for everyone.
Safety
- Side effects and how common they areThe reactions reported in 5% or more of trial participants, with the placebo rate beside each one.
- Constipation17% at 5 mg against 5% on placebo — and the one common reaction that gets less frequent as the dose rises, for a reason that is not reassuring.
- The boxed warningThe thyroid C-cell tumor warning, verbatim, and the contraindications that follow from it.
- Interactions with other medicinesOral drugs, contraceptives, and the hypoglycemia risk when combined with insulin or a sulfonylurea.
- Pregnancy and contraceptionWhy the label says to stop, and the four-week contraception window that reopens at every dose increase.
- BreastfeedingWhat section 8.2 of the label actually states.
- Is compounded tirzepatide safe?Two questions: what the drug carries, and what compounding adds. What FDA has named, and the 730-plus reports it has counted.
- Diarrhea19–23% against 8% on placebo, mostly during dose escalation, and the point where it becomes a kidney warning.
- Bone density and fracturesNo bone density in either label and none in the phase 3 trials — Lilly’s own authors say so. The fracture counts, and two big studies that disagree.
What people report
- Hair lossA listed adverse reaction — with the trial rate and the placebo rate beside it.
- FatigueReported in 5 to 7% of participants against 3% on placebo.
- The face, and “Ozempic face”The word “facial” appears zero times in the label, and no trial measured facial appearance. What is documented is fat leaving the face along with the rest of the body.
- Muscle lossWhat weight loss does to lean mass, and what the label does and does not say about it.
- Anxiety and moodWhat both labels say, and the suicidality warning FDA had removed.
- AlcoholWhat the label addresses, and where it is silent.
- Obstructive sleep apneaWhere tirzepatide has been studied beyond weight and diabetes.
- Not losing weightHow often tirzepatide fell short in SURMOUNT-1, how slow starters did, and what the plateau looks like.
- HeadacheNot a listed reaction on either label. The word appears only among the Medication Guide's low blood sugar signs.
- Heartburn, reflux and burpingDyspepsia, reflux and eructation, each with its placebo rate. "Sulfur burps" are not on the label.
What you are buying
- Is compounded tirzepatide the same as Zepbound?Same molecule, different product: approval, labeling, concentration, and what evidence exists for each.
- How tirzepatide worksA dual GIP and GLP-1 receptor agonist, and what that dual action actually means.
- Retatrutide vs tirzepatideOne is approved and hits two receptors; the other hits three and is still in trials, with no approved product anywhere. What the published trials actually measured.
- Is there an oral tirzepatide?No approved tirzepatide product is a tablet. What compounding sellers market as oral tirzepatide is something else — and Lilly's approved oral drug is a different molecule entirely.
- Mounjaro vs ZepboundSame molecule, two approvals. What actually differs.
- What compounded tirzepatide isPrepared by a pharmacy, not FDA-approved and not a generic — what is in the vial, and who may still make it now the shortage is over.
- Does it work?SURMOUNT-1 measured 20.9% at 15 mg. No trial has measured a compounded vial — and the usual reasons it seems not to work.
- B12, B6 and glycineNo approved tirzepatide product contains any of them. What an add-in is, and what FDA says it does and does not change.
- Compounded tirzepatide vs MounjaroTirzepatide approved for type 2 diabetes, in adults and children 10 and older. What a compounded vial shares with it, and what it does not carry.
- Foundayo (orforglipron) vs tirzepatideFoundayo is orforglipron, not tirzepatide. Each label's figures side by side, clearly marked as coming from separate trials.
- Liraglutide (Saxenda) vs tirzepatideNo head-to-head trial exists. Daily Saxenda and weekly Zepbound, label by label, with every side-by-side marked cross-trial.
- “Research use only” vialsWhat FDA has written to sellers of “research use only” tirzepatide — and why this page gives no mixing volumes.
- What it is approved forFour approved uses across two labels — and the blood pressure, lipid and hsCRP figures the labels report but do not approve.
- Which pharmacy compounds it?The compounding pharmacies sellers name on their own sites, how many sellers name each one, and what to ask before you pay.
Informational only. Nothing here is medical advice, and none of it replaces the judgment of a prescriber who knows your history.