Medication · Weight management

Compounded tirzepatide

Not yet medically reviewed. Fact-checked against the sources listed below on 2026-10-07.

Compounded tirzepatide is a dual GIP and GLP-1 receptor agonistprepared by a licensed pharmacist for one named patient, on a licensed doctor's prescription. It is distinct from Mounjaro® and Zepbound®. At Obra, a PRC-licensed doctor reviews your free assessment first and decides whether it is appropriate for you.

Patient-specific prescription required

This page explains the medicine. It is not an offer to sell it. Trial results describe the medicines that were studied and should not be assumed for compounded preparations.

How it works

How tirzepatide works

How the molecule works, as described in the branded medicines' prescribing information.

Tirzepatide is a GIP receptor and GLP-1 receptor agonist. It selectively binds to and activates both the GIP and GLP-1 receptors, which are the targets of the body's own GIP and GLP-1 hormones.

GLP-1 is a physiological regulator of appetite and calorie intake. Nonclinical studies suggest GIP may add to the regulation of food intake. Both receptors are found in areas of the brain involved in appetite regulation.

It contains a C20 fatty diacid that enables albumin binding and prolongs its half-life.

Tirzepatide decreases calorie intake, and the label says the effects are likely mediated by affecting appetite.

Tirzepatide enhances first- and second-phase insulin secretion and reduces glucagon levels, both in a glucose-dependent manner.

Tirzepatide increases insulin sensitivity, as shown in a hyperinsulinemic euglycemic clamp study in patients with type 2 diabetes after 28 weeks of treatment.

ClassDual GIP and GLP-1 receptor agonist

Branded products (not the same as compounded)Mounjaro®, Zepbound®

PrescriptionPatient-specific, from a licensed doctor

Prepared byA licensed pharmacist

Philippine registrationregistered

What the research shows

Specific branded tirzepatide products are approved for specific uses in the places named below. Those approvals do not cover compounded tirzepatide. The trial below studied branded tirzepatide.

SURMOUNT-1 (Jastreboff et al., NEJM 2022;387:205-216)

Phase 3, double-blind, randomized, controlled trial in 2,539 adults with BMI of 30 or more, or 27 or more with at least one weight-related complication, excluding diabetes, over 72 weeks. "The mean percentage change in weight at week 72 was -15.0% (95% confidence interval [CI], -15.9 to -14.2) with 5-mg weekly doses of tirzepatide, -19.5% (95% CI, -20.4 to -18.5) with 10-mg doses, and -20.9% (95% CI, -21.8 to -19.9) with 15-mg doses and -3.1% (95% CI, -4.3 to -1.9) with placebo (P<0.001 for all comparisons with placebo)." Weight reduction of 5% or more occurred in 85%, 89% and 91% with 5 mg, 10 mg and 15 mg versus 35% with placebo. The most common adverse events were gastrointestinal, and most were mild to moderate and happened mainly during dose escalation. "Adverse events caused treatment discontinuation in 4.3%, 7.1%, 6.2%, and 2.6% of participants receiving 5-mg, 10-mg, and 15-mg tirzepatide doses and placebo, respectively."

SURMOUNT-1 three-year prediabetes analysis (Jastreboff et al., NEJM 2025;392:958-971)

Participants with obesity and prediabetes (1032 of 2539 in SURMOUNT-1) took tirzepatide 5, 10 or 15 mg or placebo once weekly for 176 weeks, then 17 weeks off treatment. "At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who received placebo (P<0.001 for all comparisons with placebo)." Type 2 diabetes was diagnosed in 1.3% on tirzepatide versus 13.3% on placebo (hazard ratio 0.07).

These results come from trials of the studied medicines. They should not be assumed for compounded tirzepatide, and individual results vary.

What branded tirzepatide is approved for

Regulators approve specific branded products for specific uses. These approvals do not cover compounded preparations.

Philippines (FDA Philippines Verification Portal, searched 2026-10-07): Mounjaro KwikPen (tirzepatide) solution for subcutaneous injection is registered as a prescription drug (Rx) under DR-XY49504 (2.5 mg/0.6 mL), DR-XY49503 (5 mg/0.6 mL), DR-XY49501 (7.5 mg/0.6 mL), DR-XY49531 (10 mg/0.6 mL), DR-XY49505 (12.5 mg/0.6 mL) and DR-XY49502 (15 mg/0.6 mL). Importer and distributor: Zuellig Pharma Corporation; manufacturer Eli Lilly Italia S.p.A. DR-XY49501 to DR-XY49505 were issued on 9 September 2025 and are valid until 9 September 2030; DR-XY49531 was issued on 1 October 2025 and is valid until 1 October 2030.
Philippines (FDA Philippines Verification Portal, searched 2026-10-07): Mounjaro (tirzepatide) solution for subcutaneous injection is registered as a prescription drug (Rx) under DR-XY49611 (2.5 mg/0.5 mL), DR-XY49612 (5 mg/0.5 mL), DR-XY49613 (7.5 mg/0.5 mL) and DR-XY49610 (10 mg/0.5 mL), manufacturer BSP Pharmaceuticals S.p.A., issued on 26 to 27 January 2026 and valid until 26 to 27 January 2031; and DR-XY49616 (12.5 mg/0.5 mL) and DR-XY49617 (15 mg/0.5 mL), manufacturer Eli Lilly Italia S.p.A., issued on 24 March 2026 and valid until 24 March 2031. Importer and distributor: Zuellig Pharma Corporation. The records do not say whether these 0.5 mL products are pens or vials.
Zepbound (US): with a reduced-calorie diet and increased physical activity, to reduce excess body weight and maintain weight reduction long term in adults with obesity, or in adults with overweight and at least one weight-related comorbid condition. Also to treat moderate to severe obstructive sleep apnea in adults with obesity.
Zepbound BMI thresholds at US approval: adults with obesity (BMI of 30 kg/m2 or more) or overweight (BMI of 27 kg/m2 or more) with at least one weight-related condition. It should not be used with Mounjaro or a GLP-1 receptor agonist.
Mounjaro (US): as an adjunct to diet and exercise to improve glycemic control in adults and in children aged 10 and older with type 2 diabetes. Also to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who are at high risk for these events.
Mounjaro (EU, first authorised 15 September 2022; current EU indications): for insufficiently controlled type 2 diabetes in adults, adolescents and children aged 10 and older. Also for weight management, including weight loss and weight maintenance, in adults with a BMI of 30 kg/m2 or more, or a BMI of 27 to under 30 kg/m2 with at least one weight-related comorbid condition.
The Zepbound US prescribing information (revised 08/2026) lists two indications, both in combination with a reduced-calorie diet and increased physical activity: weight reduction and long-term maintenance in adults with obesity, or overweight with at least one weight-related comorbid condition; and moderate to severe obstructive sleep apnea in adults with obesity. It does not list a heart failure indication, although SUMMIT reported outcomes in heart failure with preserved ejection fraction.
Philippine label (Mounjaro KwikPen package insert linked from the FDA Philippines Verification Portal for DR-XY49504; the identical file is linked for DR-XY49505; date of revision of package insert 10 Oct 2024, "EUSPC 01 Sep 2024"; opened 2026-10-07). Type 2 diabetes: "Tirzepatide (Mounjaro) is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise • as monotherapy when metformin is considered inappropriate due to intolerance or contraindications • in addition to other medicinal products for the treatment of diabetes." Weight management: "Tirzepatide (Mounjaro) is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with an initial Body Mass Index (BMI) of • ≥ 30 kg/m2 (obesity) or • ≥ 27 kg/m2 to < 30 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, prediabetes, or type 2 diabetes mellitus)." The insert lists no indication for adolescents or children and no cardiovascular risk reduction or sleep apnea indication.

Risks and side effects

What the prescribing information for the branded medicines says. These are not instructions: your doctor reviews your history against them and decides.

The label says: Gastrointestinal side effects were the most common adverse reactions in the weight reduction trials. Rates with tirzepatide 5, 10 and 15 mg versus placebo were: nausea 25-29% vs 8%, diarrhea 19-23% vs 8%, vomiting 8-13% vs 2%, constipation 11-17% vs 5%. Tirzepatide is not recommended in patients with severe gastroparesis.
The label says: Most common adverse reactions (reported in 5% or more of patients treated with Zepbound): nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, hypersensitivity reactions, eructation, hair loss, gastroesophageal reflux disease.
The label says: Most common adverse reactions (reported in 5% or more of patients treated with Mounjaro): nausea, diarrhea, decreased appetite, vomiting, constipation, dyspepsia, and abdominal pain.
The label says: Boxed warning: in rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether it causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. It is contraindicated in patients with a personal or family history of MTC or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
The label says: Treatment with tirzepatide and GLP-1 receptor agonists is associated with more cases of acute gallbladder disease.
The label says: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been seen in patients treated with GLP-1 receptor agonists or tirzepatide.
The label says: Patients taking tirzepatide together with an insulin secretagogue (for example a sulfonylurea) or insulin may have a higher risk of hypoglycemia, including severe hypoglycemia.
The label says: Acute kidney injury can result from volume depletion (dehydration). The label advises monitoring kidney function in patients whose side effects cause volume depletion, especially when starting treatment.
The label says: Tirzepatide may make oral hormonal contraceptives less effective. The label advises users to switch to a non-oral method, or add a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase.
The label says: Pregnancy: weight loss offers no benefit to a pregnant patient and may cause fetal harm. The label advises stopping tirzepatide when a pregnancy is recognized.
The label says: Serious hypersensitivity reactions (for example anaphylaxis and angioedema) have been reported after marketing. In patients with type 2 diabetes, temporary worsening of diabetic retinopathy has been reported with rapid improvement in glucose control. Rare reports of pulmonary aspiration have occurred in patients on GLP-1 receptor agonists undergoing elective surgery or procedures under general anesthesia or deep sedation.
BusinessWorld reported: The Philippine distributor Zuellig Pharma warns that illegally compounded tirzepatide poses significant health risks, including improper dosing that may lead to severe adverse effects and possible impurities and contamination due to the lack of regulatory oversight.
The label says: In the pooled weight trials (Studies 1 and 2), gastrointestinal adverse reactions occurred in 56% of patients on each Zepbound dose versus 30% on placebo. The label states: "The majority of nausea, vomiting, and/or diarrhea events occurred during dose escalation and decreased over time."
PubMed record (US National Library of Medicine) (PMID 39555826) reported: In SUMMIT (heart failure with preserved ejection fraction and obesity), adverse events (mainly gastrointestinal) led to stopping the trial drug in 6.3% of patients on tirzepatide versus 1.4% on placebo.
PubMed record (US National Library of Medicine) (PMID 41406444) reported: In SURPASS-CVOT (type 2 diabetes with atherosclerotic cardiovascular disease), adverse event incidence appeared similar to dulaglutide, although more gastrointestinal adverse events were observed with tirzepatide.
PubMed record (US National Library of Medicine) (PMID 37385275) reported: In SURMOUNT-2 (adults with obesity and type 2 diabetes), serious adverse events were reported by 68 (7%) participants overall. Two deaths occurred in the tirzepatide 10 mg group and were not considered related to study treatment by the investigator.

Tell your doctor about every medicine you take, including diabetes medicines and birth control, and if you are pregnant or planning a pregnancy.

If you have severe stomach pain, signs of an allergic reaction, or other severe symptoms, seek urgent medical care.

How Obra connects you

Assessment first. Prescription only if it is right for you.

You see your full total before you pay, and you may fill your prescription at any pharmacy you choose.

See compounded tirzepatide pricing by dose

Starting totalFrom ₱3,990 every 4 weeks

IncludesThe ₱500 Obra care fee

Changes withYour prescribed dose

The assessmentFree

01
Free assessment
Answer questions about your health, goals and current medicines.
02
Doctor review
A PRC-licensed doctor decides whether treatment is appropriate, or asks for more information.
03
Prepared for you
If prescribed, a licensed pharmacist prepares your medicine for you by name.

Common questions

Is compounded tirzepatide the same as Mounjaro® and Zepbound®?

No. Compounded tirzepatide is prepared for one patient by a licensed pharmacist. It is distinct from Mounjaro® and Zepbound®, and those brands' approvals and trial results do not transfer to it.

Do I need a prescription?

Yes. Every preparation starts with a prescription a licensed doctor writes for you after reviewing your health information.

What are the common side effects?

The branded medicine's label says: Gastrointestinal side effects were the most common adverse reactions in the weight reduction trials. Rates with tirzepatide 5, 10 and 15 mg versus placebo were: nausea 25-29% vs 8%, diarrhea 19-23% vs 8%, vomiting 8-13% vs 2%, constipation 11-17% vs 5%. Tirzepatide is not recommended in patients with severe gastroparesis. Your doctor talks you through side effects before you start.

Who should not take it?

The branded medicine's label says: Boxed warning: in rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether it causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. It is contraindicated in patients with a personal or family history of MTC or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Your doctor reviews your history before deciding.

Can I use a different pharmacy?

Yes. You may fill your prescription at any pharmacy you choose.

Sources

This content is for education only and is not medical advice. Talk to a licensed doctor before starting any treatment.

A doctor can say no. Ask anyway.

The assessment is free. If treatment is not right for you, that is the answer you will get.

Start my assessment See prescriptions and prices