Wegovy then switched to a compounded formula of semaglutide

Hi, @bhb30602 - I moved your post into its own discussion so that members could talk about specifically what you mentioned, going from brand name semaglutide (Wegovy) to a compounded version.

I took brand name semaglutide (Wegovy) personally. I lost over 50 pounds, but I was plagued by pretty severe gastrointestinal issues. So I switched to tirzepatide (Zepbound). I'm having fewer gastrointestinal issues, but still issues. I've only lost about a pound and am still going up in dosage. Trying to remain patient, especially as a friend told my husband he did not think these shots were working at all till he got to the highest dose.

How has your time on the semaglutide samples gone? Are you planning to proceed with the compounded formula?

Thanks for moving my post, Lisa. I wasn't sure I had posted in the right location.
I've lost 5 pounds thus far (3 weeks in at .25mg). A consistent message I see on reviews is that the .25mg dose is to get your body ready for the higher dose and to be patient. Once on a higher dose such as .50 or higher, then noticeable changes will begin.
At this time, I plan on proceeding with the compounded formula and will see how it goes. Hopefully it will work and and I won't experience any major side effects.
I wish you success in your journey!

Congratulations on your weight loss, @bhb30602. Good luck on your journey, as well.

Tagging a few members who might have some thoughts on switching from semaglutide (Wegovy) to a compounded version @projfan @quinceykk @blynn9030 @dfcox3 @roch @joysmiley64 @ecmoandrrt @surftohealth88 @paulinegreen79.

Thank you for the tag! Mostly, I think the patient has agency and control, and if this is a direction you want to head, it really doesn't matter if it would or would not be my choice.

In general, I'm cautious about compounding -- for me, it's too unregulated, wild, wild west, especially for a drug with these kinds of potential impacts (https://www.nature.com/articles/s41591-024-03412-w.epdf). I think compounding pharmacies serve a very useful purpose, especially when drugs otherwise come in a form that is incompatible with the needs of a patient, but compounding for something like this makes me nervous. I have no idea how the patient determines what the compounded drug is actually made of, the train of custody/condition of those ingredients, and the ways in which it may be different from the branded product.

Having said that, I suppose I might feel differently if I had a history of trust with a particular compounding pharmacy, and a solid medical team who also trusts the pharmacy and is prepared to address whatever happens in regard to (perhaps unusual?) side effects.

My choice has been to manage the cost and availability of the drug through click-counting/microdosing using a branded multi-pen product. But again, that's just me.

I was on the same and nearly died. Extreme nausea and vomiting depleting potassium and magnesium in my body. Hospitalized for a week. I would NOT do this again. I now walk five days a week.

Hi, @bhb30602 - wanted to see how you are doing and how the compounded version of semaglutide is working for you?

Thanks for checking in Lisa.
I've lost about 5-6 lbs total since beginning. I started out on 25mg sample of Wegovy from my PC, then moved to the compound the next month to the .50, then 1.0 the following month. This past week I started my 1.7mg dose and fortunately, still have not experienced any major side effects.
My PCP said this (1.7) dose but for sure the next dose (I believe will be 2.4 or 2.5 mg) will begin more weight loss. I'm walking 3 miles 3x p/week at a pretty good pace and drinking LOTS of water so I'm being patient. I've also noticed some consensus around the notion that the lower doses up to 2.5 are helping calibrate and prepare my body for the higher dose, and that they (lower doses) usually don't yield the best results.
Thanks again for reaching out - any thoughts to share are welcomed and appreciated.

Hello,

I tried wegovy last year and it didnt work like I hoped, since I am not diabetic my weight loss was slow and only like 15 to 20 lbs. I did lose mostly muscle and even fell and damaged my meniscus. After a year my weight loss was only like 20 lbs, which I gained back. I was thinking of trying a different one, it is called Zepbound (tirzepatide). any thoughts? this time I will be excersisng and doing yoga. I am hoping to lose aprox 30 lbs by december.

Welcome to Mayo Clinic Connect, @loresull.

I personally was prescribed semaglutide (Wegovy) and lost 53 pounds. However, I had really challenging gastrointestinal side effects and finally asked my doctor about switching to tirzepatide (Zepbound). My husband, meanwhile, started the semaglutide (Wegovy) as well. He had no GI side effects and lost around 30 pounds on it before hitting his insurance cap for coverage of weight loss shots. He's since gained back 20 pounds.

In retrospect, switching weight loss shots was a mistake for me, mostly due to running into an insurance cap for weight loss medications and losing time. I hit this cap right about the time I got to the highest tirzepatide dose, as I had to start at the bottom dose and work up to the highest one. The tirzepatide did not suppress my appetite like the semaglutide did, which was crystal clear. I also had not lost more than 1 pound on it before I got to the insurance cap. This seemed odd, as I'd understood tirzepatide to be more effective than semaglutide. But it didn't turn out that way in my case.

In order to test to see if the semaglutide was causing my GI distress, I had to be off all weight loss shots for a month. Then, as I mentioned, I had to start all over with the tirzepatide. All this led to my gaining back 24 pounds. Super frustrating.

All this is to say that one's response to these weight loss shots appears to be highly individual. I would consult with your doctor and look at the best plan for you with any medical insurance caps you may have for weight loss shots very much in mind.

What does your doctor recommend you do at this point, loresull?

I have been on compounded tirzepatide-zepbound for 14 months and lost over 100#. I have 20-30# yet to go. I was unable to tolerate the starting dose, couldn’t hardly eat. Talked the endo into decreasing my dose instead of increasing it. I’ve been doing 1.5mg every for a whole year. I use a compound pharmacy where I live. My endocrinologist gives me a compound. I can eat now but still have no food noise or craving. I know I am not typical but I work very hard at dieting. I count my protein and calories daily. Making sure I get fiber and enough fluids. I am moving more using resistance bands for strength. I’m 68 years old. Off many meds. Blood work is normal. Yay!!
One thing I have noticed in my GLP-1 groups that all telehealth companies are not equal. I would suggest if you don’t feel your compound is working to find a reputable compounding pharmacy and try another. I may end up with telehealth when I get on maintenance because I have a concierge endo because I had to find one to take care of my post cancer and that would prescribe me compounds. If you can find a compounding pharmacy in your city or near you to get your meds that is affordable it’s easier and they are easier to deal with if you have questions. Also the tirzepatide works two ways and has less side effects than the semaglutide. I sure wish you well. It’s a job. People don’t understand that the weight doesn’t fall off and you have to work at it! Sounds like you know what you need to do! Good luck!!