How to Switch from Compounded to Brand GLP-1s (Without Losing Progress)

The math has changed.

When compounded semaglutide cost $150/month and brand Wegovy cost $1,000+, the choice was obvious for most cash-pay patients. But now? Wegovy pill starts at $149. LillyDirect offers tirzepatide vials at $299. And the regulatory future of compounded GLP-1s remains uncertain.

If you're thinking about switching from compounded to brand-name, you're not alone. Here's how to do it right—without starting over, without brutal side effects, and without losing the progress you've worked so hard to achieve.

Why People Are Switching

Several factors are driving compounded-to-brand transitions:

Price parity: Brand-name options are now price-competitive with many compounders
Regulatory uncertainty: Post-shortage enforcement could disrupt compounded supply
Convenience: Wegovy pill = no injections, no refrigeration
Insurance coverage: New indications (MASH, sleep apnea, CV risk) may enable coverage
Quality assurance: FDA-approved products offer standardized quality
Peace of mind: Some patients simply prefer the certainty of brand-name

Switching Within the Same Molecule

The easiest transitions are within the same active ingredient—compounded semaglutide to brand semaglutide, or compounded tirzepatide to brand tirzepatide.

Compounded Semaglutide → Wegovy/Ozempic

Step 1: Know Your Current Dose

Compounded semaglutide doses are typically measured in milligrams (mg) per week. Common maintenance doses are 1.0mg, 1.7mg, 2.0mg, or 2.4mg weekly.

Step 2: Find the Equivalent Brand Dose

Compounded Dose	Wegovy Equivalent	Notes
0.25-0.5mg/week	Wegovy 0.25mg or 0.5mg	Starting doses
1.0mg/week	Wegovy 1.0mg	Direct match
1.7mg/week	Wegovy 1.7mg	Direct match
2.0-2.4mg/week	Wegovy 2.4mg	Maintenance dose

Step 3: Timing the Switch

Take your last compounded injection, then start brand Wegovy one week later (on your normal injection day). You don't need to re-titrate if you're already at maintenance dose.

Switching to Wegovy Pill

If you're on injectable semaglutide (compounded or brand) and want to switch to Wegovy pill:

• Stop injection
• Wait one week (when your next injection would be due)
• Start Wegovy pill 25mg daily (if you were at maintenance dose)
• If you were on lower doses, you may need to titrate up

Compounded Tirzepatide → Zepbound/Mounjaro

Compounded Dose	Zepbound Equivalent	Notes
2.5mg/week	Zepbound 2.5mg	Starting dose
5mg/week	Zepbound 5mg	Direct match
7.5mg/week	Zepbound 7.5mg	Direct match
10mg/week	Zepbound 10mg	Direct match
12.5-15mg/week	Zepbound 12.5mg or 15mg	Higher maintenance

Same process: last compounded dose, wait one week, start brand at equivalent dose.

Switching Between Molecules

Want to switch from semaglutide to tirzepatide (or vice versa)? This is more complex because they're different drugs with different mechanisms.

Semaglutide → Tirzepatide

Why switch: Tirzepatide typically produces ~5-6% more weight loss than semaglutide. Some patients plateau on semaglutide and want the boost.

How to do it:

Finish your current week of semaglutide
Wait one week (washout period)
Start tirzepatide at a lower dose (typically 2.5mg or 5mg, even if you were on high-dose semaglutide)
Titrate up as tolerated—your body needs to adjust to the new medication

Expect some adjustment: Even though you're GLP-1-experienced, tirzepatide adds GIP agonism. Some patients experience renewed GI side effects during the transition.

Tirzepatide → Semaglutide

Why switch: Price (Wegovy pill is cheaper), convenience (oral option), or insurance coverage.

How to do it:

Finish your current week of tirzepatide
Wait one week
Start semaglutide at maintenance dose (you don't need to start low)

Important note: You may see slightly less weight loss or appetite suppression on semaglutide vs tirzepatide. This is normal—semaglutide is effective, just slightly less so than tirzepatide for most patients.

Common Mistakes to Avoid

❌ Starting Brand at Too Low a Dose

If you're already at 2.4mg semaglutide, don't let a new provider start you at 0.25mg "because that's protocol." You'll spend months re-titrating unnecessarily. Advocate for starting at your equivalent dose.

❌ Overlapping Doses

Don't take compounded on Monday and start brand on Wednesday. These drugs have long half-lives. Overlapping can cause severe GI side effects.

❌ Ignoring Dosing Differences

If your compounder was inconsistent with potency (a known issue), your "2mg" might have actually been delivering less. Be prepared for an adjustment period as you dial in your actual effective dose.

❌ Switching During a Plateau

If you've plateaued, switching brands of the same molecule won't necessarily help. The plateau is usually about dose, lifestyle, or natural adaptation—not the source of the medication.

What to Tell Your New Provider

When transitioning to a new telehealth company or pharmacy for brand-name:

Your current medication: Compounded semaglutide or tirzepatide
Your current dose: Exact mg per week
How long you've been at this dose: This shows stability
Your starting weight and current weight: Documents your progress
Any side effects you've experienced: Helps guide dosing decisions
Why you're switching: Regulatory concerns, price, convenience, etc.

Most providers will understand that you're an experienced GLP-1 user and don't need the standard titration schedule. If a provider insists on starting you at the lowest dose despite documented history, consider finding one who listens.

Your Brand Options (January 2026)

Product	Form	Price (Cash-Pay)	Best For
Wegovy Pill	Daily oral	$149-299/mo	No injection preference
Wegovy Injection	Weekly injection	$199-499/mo	Proven track record
Zepbound Vials	Weekly injection	$299-449/mo	Max weight loss
Ozempic	Weekly injection	~$499/mo	Diabetes indication

The Bottom Line

Switching from compounded to brand GLP-1s is straightforward if you do it right:

Know your current dose in mg/week
Find the equivalent brand dose
Take your last compounded dose
Wait one week
Start brand at equivalent dose (no re-titration needed for same molecule)

With brand prices now competitive and regulatory uncertainty around compounding, many patients are finding the switch makes sense. The key is maintaining dose continuity—there's no reason to start over from scratch when you've already done the hard work of titrating up.