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Monitoring is especially important during treatment initiation and dose escalation
Hypoglycemia risk is generally low with Zepbound monotherapy in patients without diabetes, as the medication's insulinotropic effects are glucose-dependent
Semaglutide, a GLP-1 receptor agonist, has been used for over a decade, while tirzepatide, a newer dual GLP-1/GIP receptor agonist, entered the market more recently with a distinct mechanism
Both the semaglutide and tirzepatide shortages that made compounding legally available were declared resolved in 2024 and 2025, the compounding wind-down deadlines have passed, and in April 2026 the FDA proposed closing the remaining legal pathway entirely
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