The usage of GLP-1 and GIP receptor agonists has grown worldwide. This class of medication includes several different injectable medications, Semaglutide, (Ozempic®, Wegovy®) and Tirzepatide (Mounjaro®, Zepbound™) as well as an orally delivered drug (Rybelsus®). High demand has pushed these medications onto the FDA’s Drug Shortage List. As a result, the FDA has issued guidance for compounding pharmacies to help address the shortage by making essential copies of the patented drugs, for as long as the drugs remain on the FDA’s Shortage List.
Compounded Semaglutide and Tirzepatide are available at Potter’s House Apothecary in both injectable and sublingual forms. Many patients and their healthcare providers would prefer to avoid injections if possible due to the challenges associated with giving/receiving an injection, the complex storage conditions requiring freezing/refrigeration and the short expiration dating per USP guidelines. Patients also report suffering from side effects like intense nausea and headaches. This feedback has led us to explore alternatives to the injectable medications we compound here at Potter’s House Apothecary.
HOW DO THESE MEDICATIONS WORK?
GLP-1 and GIP receptor agonists work by increasing the amount of insulin that the pancreas releases in response to food, while decreasing the amount of sugar the liver releases into the blood and slows food leaving the stomach after eating. In turn, this helps control blood glucose levels and prompts the feeling of fullness, resulting in weight loss overtime. These medications are intended to work in conjunction with diet and exercise to improve blood sugar (glucose) levels in adults with type 2 diabetes mellitus. These medications are not for use in patients with type 1 diabetes.
WHAT IS THE DIFFERENCE BETWEEN SEMAGLUTIDE AND TIRZEPATIDE?
Semaglutide (the active ingredient in Ozempic®, Wegovy® and Rybelsus®) solely targets the GLP-1 (Glucagon-like Peptide-1) receptor.
Tirzepatide (the active ingredient in Mounjaro® and Zepbound™) — is a dual receptor agonist, that works on the GLP-1 receptor and the GIP (Glucose Dependent Insulinotropic Polypeptide, also known as Gastric Inhibiting Polypeptide) receptor. *Activation of both types of receptors enhances the glucose-lowering effects which may provide additional benefits in terms of weight loss and blood sugar control.
HOW DOES SUBLINGUAL SEMAGLUTIDE AND TIRZEPATIDE MEDICATION WORK?
The oral route of administration for Semaglutide and Tirzepatide does pose challenges due to the drug’s high molecular weight, extremely low absorption with the commercially available oral tablets (less than 1% per the labeling for Rybelsus®) and the drug’s sensitivity to the heat required to compound it into a lozenge. As compounders, we specialize in the sublingual delivery of medications for hormone replacement therapy and pediatrics. We are now pleased to provide patent-pending compounded formulations of both Semaglutide and Tirzepatide for sublingual administration.
The sublingual suspension (liquid) is made using both commercially available and bulk ingredients, and SubMagna™ HMW anhydrous base. SubMagna™ is an anhydrous, self-emulsifying drug delivery system that is specifically designed to deliver drugs with a high molecular weight and has beneficial mucoadherant properties to increase contact time with the sublingual space. The medication is absorbed into the blood stream through the mucosa underneath the tongue. Some of the medication may also be absorbed in the GI tract and stomach after swallowing.
HOW DO I TAKE THIS MEDICATION?
The sublingual suspension is dispensed in a bottle with an oral syringe for accurate dosing. You simply use the syringe to draw the premeasured amount of the medication out of the bottle. Place and hold the medication under your tongue for 60 seconds, then swallow the remaining liquid. This is done once a day, you should avoid food, drink, or other medications/supplements for at least 30 minutes before and after administration. The medication does not require refrigeration or freezing and is good for up to 90 days.
- Semaglutide 1mg/ml Sublingual Suspension
- Semaglutide 0.75mg/ml
- Tirzepatide 0.25mg/ml Sublingual Suspension
HOW CAN I GET COMPOUNDED SEMAGLUTIDE OR TIRZEPATIDE?
Compounded Semaglutide and Tirzepatide requires a prescription from your healthcare provider. Please download an example of our weight loss form to give to your provider here. They can call in, fax, or send your prescription electronically. From there, we will contact you with pricing and options to pick up or have your medication shipped for an additional fee. If you need a referral for a weight loss provider, please download our list of weight loss providers here.
WHY POTTER’S HOUSE APOTHECARY?
Trust is key when you are working with a compounding pharmacy to provide your medication. In addition to our voluntary PCAB Accreditation, our pharmacy is USP 795, 797, and 800 compliant. We use high quality FDA approved ingredients and leverage state-of-the-art technology to produce medications that meet your healthcare provider’s exact specifications. You will have peace of mind knowing that your medication has been compounded by a trusted pharmacy professional and is not only safe, but effective.