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Lancet 368(9548):16961705 Muskiet MHA, Tonneijck L, Smits MM, Van Baar MJB, Kramer MHH, Hoorn EJ et al (2017) GLP-1 and the kidney: From physiology to pharmacology and outcomes in diabetes

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Since then, many sellers have pivoted to personalized formulations that add ingredients such as vitamin B-12 and argue the result is not essentially a copy. But FDA said on April 1, 2026 that a compounded product combining semaglutide and another active ingredient such as vitamin B12 may still be essentially a copy unless a prescriber documents a patient-specific significant difference. In March 2026, Eli Lilly has warned against the practice of compounding tirzepatide with vitamin B-12

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