Desperate for Ozempic and Mounjaro, Some People Are Turning to DIY Versions

 

Some people have resorted to a possibly hazardous method in their desperate search for an affordable source of the new generation of powerful anti-obesity medications: combining their own semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro) at home.

Without a prescription, DIYers buy the raw materials—active medicinal components of unidentified origin and safety—online. The fact that these materials have warning labels like "for research only" or "not allowed for use in humans" hasn't deterred individuals like Carlos Alvarez, 58. He oversees a discussion board on the internet where people discuss where to find tirzepatide, the main component of the popular medication Mounjaro. Alvarez prepares a solution in his Phoenix, Arizona home using sterile water and freeze-dried tirzepatide powder, which he then administers intravenously.

Prediabetic Alvarez was upset because Mounjaro, the medication he concluded would be the best treatment for his high blood sugar levels, wouldn't be covered by his insurance company. He calls the price "astronomical." wishing to stay away from "the mercy of a medical system that I believe has abandoned me without support... I completely DIYed everything. I'm prone to doing it anyway.

However, experts warn that Alvarez and others' actions carry a number of dangers.

"Making it in your kitchen isn't safe. Simply put, it's not safe at all, claims pharmacist Stephanie Young Moss. Dr. Young Moss is an experienced healthcare consultant and pharmacist. She admitted that "people are desperate" for the revolutionary anti-obesity medications, but she expressed mistrust for any vendor who would sell them. Prediabetic Alvarez was upset because Mounjaro, the medication he concluded would be the best treatment for his high blood sugar levels, wouldn't be covered by his insurance company. He calls the price "astronomical." wishing to stay away from "the mercy of a medical system that I believe has abandoned me without support... I completely DIYed everything. I'm prone to doing it anyway.

However, experts warn that Alvarez and others' actions carry a number of dangers.

"Making it in your kitchen isn't safe. Simply put, it's not safe at all, claims pharmacist Stephanie Young Moss. Dr. Young Moss is an experienced healthcare consultant and pharmacist. She admitted that "people are desperate" for the revolutionary anti-obesity medications, but she expressed mistrust for any vendor who would sell them.

Peptides advertised as being "sold for research use" "pose significant risks to patients because they have not been reviewed by the FDA before they are marketed to ensure safety, effectiveness or quality, and they are obtained without a prescription or prescriber oversight," the FDA said in a statement.

Reconstituting such medications at home is a risky concept, according to Scott Brunner, CEO of the Alliance for Pharmacy Compounding. The apparent recommendation is to avoid buying research-grade semaglutide (or something claiming to be semaglutide; how do they know?) online and administering it on one's own.

How Do People Make Their Own ‘Ozempic’?

The demand for semaglutide and tirzepatide has surged due to intense social media buzz, leading to shortages despite very high costs. A Mounjaro prescription cost over $1,000 a month at most pharmacies at the time this article was published, and finding insurance coverage for the medication can be challenging, particularly for people without diabetes. Some users have previously purchased their prescription from a number of sources, including online compounding pharmacies, which are legally permitted to combine off-brand versions of the widely used drugs, due to the high cost and irregular access. The U.S. FDA issued a warning to customers in late May about compounded semaglutide, which it does not assess for effectiveness or safety.

DIYers are going a step further and taking matters into their own hands by synthesizing drugs on their own.

Semaglutide or tirzepatide, the powdered form of the active pharmaceutical ingredient (API) used in Ozempic or Mounjaro, is the first step in the do-it-yourself procedure. It is lyophilized (freeze-dried). Do-it-yourself 'pharmacists' combine the powdered active component with bacteriostatic water, which was created to stop the formation of bacteria, using insulin syringes and sterilized glass bottles. The medication can then be injected under the skin after being reconstituted into a liquid solution that is allegedly the same as the brand-name medication. On YouTube, TikTok, and other websites, you may find directions for making these homemade injections.

As the practice has expanded, new online forums have appeared where people may share their stories of discovering these "peptides," which are powdered medication ingredients. Some members of the community worry that providers are selling peptides with questionable safety or potency or are engaging in open fraud. Others fear that a reliable source's excessive popularity would cause shortages or legal issues. Some claim that the most trustworthy peptide merchants don't even have websites; instead, they only have email addresses that are shared from user to user.

It's challenging to estimate the scope of DIY reconstituting, although semaglutide and tirzepatide peptide-focused Facebook groups and Reddit subreddits can have hundreds of members, and considerable debate can be found in larger forums more widely devoted to the use of peptides or of compounded weight loss drugs.

Alvarez, who moderates one such forum, also creates YouTube videos to demonstrate the reconstitution procedure. Alvarez has no pharmacological training — he’s just an enthusiastic amateur: “You might say that I’ve jumped into this topic like a skydiver without a parachute.”

Alvarez has used several different sources for his powdered tirzepatide, including a Chinese vendor that offered a low price for a larger shipment. He reports that tirzepatide — he has alternated between official Mounjaro and self-mixed versions — has brought him “exceptional, life-changing, massive results,” including rapid weight loss, improved blood sugar levels, better sleep, and less desire for alcohol.

Semaglutide and tirzepatide, originally developed to treat hyperglycemia in type 2 diabetes, have widely been hailed as the most effective weight loss drugs ever approved. In one clinical trial of semaglutide, adults without diabetes lost an average of 14.9 percent of their body weight. In another, tirzepatide users without diabetes lost even more, an average of 20.9 percent of their body weight at the highest dose.

Though he acknowledges that there are risks inherent with injecting drugs from suspect sources, Alvarez argues that the alternative — stopping his use of anti-obesity medication, regaining weight, and watching his blood sugar climb back up — is the greater danger. “I believe that it’s reasonable to conclude that [my prediabetes] was much worse than the potential risk.”

‘Incredibly Dangerous’

There are, of course, many reasons why drug preparation and distribution are reserved for trained and certified professionals. Offering an example of the dangers of contaminated drugs, Young Moss referred to a 2018 incident in which a single compounding pharmacist ignored standard safety procedures and infected 793 patients with fungal meningitis; 64 died. 

Some of the infrastructure for the gray market sale of peptides was erected long before #ozempic went viral, largely for the distribution of a different type of pharmaceutical product: growth hormone peptides and other performance-enhancing drugs. Bodybuilders and athletes have been mixing and dosing their own solutions in the same manner, with insulin syringes and bacteriostatic water, for years. Others use peptides for skin care or sexual health, among other issues.

While the FDA declined to discuss the legality of the sale or use of weight loss peptides, in the past the organization has pursued legal action against suppliers. In 2016, for example, the owner of Precision Peptides was sentenced to house arrest and ordered to forfeit over $2 million for selling unapproved peptides to bodybuilders. A press release from the U.S. Attorney’s Office described how in “a ruse to avoid FDA scrutiny,” the peptides had been labeled “for research/laboratory use only.”

Brunner states that the use of such peptides, which come from unknown and possibly unregulated manufacturers, is risky: “For a patient to trust and inject that substance into their body is incredibly dangerous.” 

Even when the active ingredient is safe, DIYers open themselves up to other risks when reconstituting their medicine. The manufacturers of Ozempic and Mounjaro have created standards to make dosing as streamlined and easy as possible: one injection, once a week, with a pen designed to administer only a single dose. The math involved with reconstituting peptides is considerably more complicated, requiring facility with conversions between milligrams, milliliters, and insulin units. The risk of dosage error may be astronomically higher.

During his brief time championing DIY Ozempic and Mounjaro, Alvarez has seen some heinous and potentially very dangerous blunders on social media, including elementary math errors that have led users to self-administer gargantuan quantities of medicine. “I saw a lot of mistakes being made by a lot of people,” he says. He hopes that his comments and videos can help others use the drugs safely.

Though his behavior may seem reckless, Alvarez shares a concern with many experts that the inaccessibility of semaglutide and tirzepatide is only exacerbating healthcare disparities. These medications can have revolutionary health effects — “life-changing is an understatement,” contends Alvarez — but their high costs, combined with the reluctance of insurers to cover those costs, threatens to reserve the therapies for affluent Americans.

“I believe that these alternatives provide a free-market solution to the problem,” Alvarez states. “I think that consumer anarchy might force change in how we price these drugs.”

Staying Safe

It may seem simple for conscientious patients to avoid DIY weight loss drugs, but the lines between reputable and disreputable suppliers are getting blurred. Voracious demand for (and shortages of) Ozempic, Mounjaro, and Wegovy are inspiring more clinics and telehealth providers to offer the weight loss medicines, and it can be difficult to know which providers have their patients’ best interests at heart. 

In a statement to Everyday Health, Novo Nordisk said that it “does not supply semaglutide to companies selling research-use only products to patients,” a practice which it says “exposes patients to potentially unsafe products.”

The National Association of Boards of Pharmacy (NABP) publishes a “Not Recommended” list of thousands of websites that are suspected of selling “fraudulent and unsafe” medicine. The NABP verifies that pharmacies are fully licensed, comply with all relevant laws, and accept only valid prescriptions. In the event that there is any ambiguity about a supplier’s trustworthiness, it might be wise to check any online medicine supplier against the list, though it should not be considered exhaustive.

In a statement, Brunner and his organization advised the following:

“Don’t buy any substance purported to be semaglutide from an online entity if you do not have a legitimate prescription for it from a licensed prescriber, and you cannot verify that the seller is a licensed U.S. pharmacy.”