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On April 30, 2026, the FDA proposed formally excluding semaglutide and tirzepatide from the 503B bulk drug substances list, a move that would close the last major large-scale compounding pathway for these medications if finalized

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Choosing Between Speed and Side Effects Tirzepatide's dual-agonist action delivers faster weight loss but also carries a slightly higher incidence of nausea, vomiting, and gastrointestinal upset during the dose-escalation phase