Oral GLP-1 Alternatives: Pros and Cons of Injectable Diabetes and Weight Loss Drugs

Since their release, injectable GLP-1 drugs like Ozempic have gained popularity. They treat diabetes and obesity and have cardiovascular benefits. Some studies suggest they may help reduce addiction and protect against certain cancers, increasing their appeal. However, these drugs require a weekly injection, which is a drawback for people who dislike needles.

Recently, ads for oral alternatives to GLP-1 drugs have exploded on platforms like Instagram and Facebook. Following a shortage of brand-name GLP-1 drugs in 2022, many compounding pharmacies and telehealth clinics began offering their copies. These clinics provide oral versions of semaglutide and tirzepatide, available as lozenges, tablets, pills, gels, drops, and strips, claiming to have the same active ingredients without the need for injections.

This option is attractive, especially since these oral drugs are often much cheaper than the brand-name options and can be delivered quickly after completing a simple online questionnaire. For example, a month’s supply of semaglutide lozenges from the telehealth startup Strut costs $149, while Wegovy can exceed $1,000.

Melinda Lee, a pharmacist who runs a pharmaceutical database, acknowledges the excitement around oral semaglutide. It is easier to take than injections and does not require refrigeration, making it simpler to handle. However, Lee remains cautious. She points out that there is not enough evidence to confirm that these oral drugs work as effectively as the injectables.

Unlike Ozempic, Wegovy, Mounjaro, and Zepbound, compounded drugs have not undergone rigorous clinical testing and lack FDA approval. These oral medications must contain the same active ingredient as the originals, but they may not perform as well.

Maria Daniela Hurtado Andrade, an obesity specialist at the Mayo Clinic, does not recommend oral compounded GLP-1 medications. She does not prescribe or endorse them, highlighting the need for caution.