Pause when the offer skips a check.

• A prescription is missing

  As of September 26, 2026, US federal law requires a valid prescription before anyone supplies prescription medicine.

  Pause to check an offer if its checkout lets you skip the prescription.

• A custom medicine claims approval

  In compounding, a pharmacy or doctor makes medicine for a particular order.

  As of September 26, 2026, medicines made to order had not been approved by the Food and Drug Administration (FDA). A pharmacy’s licence does not make its custom medicines FDA-approved.

  As of September 26, 2026, seeing “FDA registered” in an offer does not show that the medicine has FDA approval. Registration puts a business or drug on an FDA list; it does not give approval.

• An offer says “for research use only”

  An offer may say “for research use only”. It may instead say “not for human consumption”. Those words say the product is for research, not treatment.

  In letters checked on September 26, 2026, the FDA said those words did not excuse specific sellers who were offering products for people to inject.

  A warning letter says the FDA believes that seller has broken the rules. It is not a court decision and does not prove whether an individual product is safe.

  Ask the clinician or pharmacist to check any offer that calls a research product a treatment.

• The ingredient name has an extra word

  Look for “sodium” or “acetate” after “semaglutide” on the offer or paperwork. These words name changed chemical versions of semaglutide, called salt forms.

  As of September 26, 2026, the FDA says these salt forms are different ingredients from the semaglutide used in approved medicines. It does not know whether they work the same way in the body.

  The FDA says it is not aware of any legal way to use these salt forms in made-to-order medicines. That is the agency’s stated position; it is not saying it has approved them.

• Payment is restricted to hard-to-recover methods

  The Federal Trade Commission warns about offers that allow payment only by bank transfer, wire transfer, a payment app, gift card or cryptocurrency, a kind of digital money.

No. As of September 26, 2026, US law allows medicines to be made to order when the legal conditions are met. One reason can be that the patient needs a medicine an approved product cannot provide.

As of September 26, 2026, US law limits a pharmacy or doctor making copies of medicines already sold on the market as a regular business or in large amounts.

For example, a medicine made without a dye may be needed if a person is allergic to that dye in the ready-made product. This is a general example of a medical need for compounding.

A prescriber may find that a changed medicine offers a meaningful medical difference for a named patient compared with the product already available. For that patient, the rule does not count the changed medicine as a copy. The price being lower does not, on its own, make a medical difference under this rule.

The prescriber and pharmacy still need to check all legal conditions for the medicine being offered.

A September 26, 2026 check found that neither tirzepatide injections nor semaglutide injections were on the FDA’s national shortage list.

One local pharmacy running out of a medicine does not add it to the national shortage list.

Ask: What does this custom medicine do for my medical need that the approved product cannot do? Ask the prescriber to explain the reason in writing and name the pharmacy that will make it.

Ask that pharmacist to explain why the law allows this medicine to be made for you. If the answer is unclear, ask your state pharmacy board to help check it.

These label cautions were checked on September 26, 2026.

• Stomach problems

  The labels for semaglutide (Wegovy), tirzepatide (Zepbound) and liraglutide (Saxenda) report nausea, vomiting, diarrhea and constipation.

  Severe stomach problems and fluid loss can harm kidneys; raise ongoing symptoms with the clinician.

• Thyroid history

  A boxed warning is the FDA’s strongest warning format. These medicine labels use it to flag thyroid tumors seen in rodents.

  Whether they cause these tumors in people is unknown.

  The labels rule these medicines out for someone with a history of medullary thyroid cancer, a rare cancer of the thyroid.

  They also rule out use if a relative has had that thyroid cancer, or if the patient has MEN 2, a rare tumor condition passed down in families. Written out, this name is multiple endocrine neoplasia type 2.

  Ask the clinician to check your records if you do not know whether you or your family has had MEN 2.

• Pregnancy plans, birth control and surgery

  Tell the prescriber about pregnancy plans, birth control pills and any planned surgery; these are part of the labels’ cautions.

  The tirzepatide label tells prescribers to discuss backup birth control for four weeks after treatment starts or its dose increases.