In 2022, citing shortages of the drugs, the FDA allowed compounding pharmacies to make them but with the shortages over, the FDA stopped allowing compounding pharmacies to make tirzepatide (Mounjaro and Zepbound) in March, and semaglutide (Ozempic and Wegovy) last week
Patients should contact their healthcare provider if they experience: Persistent vomiting lasting more than 24 hours or inability to keep down fluids, which raises concern for dehydration Signs of dehydration including decreased urination, dark urine, dizziness upon standing, extreme thirst, or dry mouth Severe abdominal pain , particularly if constant and radiating to the back, which may indicate pancreatitisa rare but serious adverse effect Hypoglycemia symptoms including sweating, tremor, palpitations, confusion, dizziness, or irritabilityespecially in patients taking concurrent insulin or sulfonylureas Right upper quadrant pain, fever, or jaundice which may indicate gallbladder disease, a reported adverse effect with tirzepatide [11] [12] Symptoms interfering with daily activities or causing significant distress despite conservative management Immediate emergency care is warranted for: Severe, unrelenting abdominal pain with vomiting Signs of acute pancreatitis (severe epigastric pain radiating to the back, fever, rapid pulse) Symptoms of severe dehydration or electrolyte imbalance (confusion, irregular heartbeat, muscle weakness) Suspected hypoglycemia with altered consciousness The FDA prescribing information specifically warns about the risk of acute kidney injury secondary to dehydration from gastrointestinal adverse effects
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