Compounded Semaglutide: Where It Stands in the GLP-1 Litigation Right Now

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No Ozempic or other GLP-1 lawsuit has been settled, and no court or jury has found that these medications caused anyone's injury — the litigation is ongoing, with major expert-evidence rulings still ahead. Whether any individual has a claim depends on their own medical records and the law of their state.

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No Ozempic or other GLP-1 lawsuit has been settled, and no court or jury has found that these medications caused anyone's injury — the litigation is ongoing, with major expert-evidence rulings still ahead. Whether any individual has a claim depends on their own medical records and the law of their state. Do not stop, start, or change any prescribed medication because of anything on this page. Those decisions belong with your prescriber. Attorney Advertising.

Compounded semaglutide — the version sold through many med spas, wellness clinics, and telehealth services during the shortage years — does not currently meet the referral criteria for the GLP-1 stomach-injury track, which are written around brand-name Ozempic, Wegovy, and Rybelsus. That is a statement about today’s criteria, not about you or what happened to you, and a great many people are not certain which version they received. Tell us anyway; we will review it and give you a straight answer.

What “compounded” actually means

A compounded medication is prepared by a pharmacy or outsourcing facility rather than manufactured and packaged by the company holding the FDA approval. During the semaglutide and tirzepatide shortages, federal rules allowed large-scale compounding of these ingredients, and a market grew up around it: telehealth prescriptions, subscription programs, med-spa injections, vials rather than pens, and often a lower price.

Compounded products are not counterfeit and using one was not a mistake. They were legal, widely advertised, and for long stretches the only way many people could get the medication at all. Nothing here is a judgment about that.

The legal significance is narrower and more technical than it sounds. A product-liability claim in this litigation is built on what a specific manufacturer knew about a specific approved product, what it told regulators, and what it printed on that label. When the drug did not come from that manufacturer in that package, the chain of proof these cases run on does not connect the same way.

Where the criteria stand today

• Stomach-injury track (gastroparesis, gastric obstruction). Brand-name Ozempic, Wegovy, or Rybelsus only. Generic and compounded semaglutide do not meet these criteria, and neither do Mounjaro, Zepbound, or Trulicity.
• NAION vision-loss track. Brand-name Ozempic, Wegovy, Rybelsus, Trulicity, Mounjaro, or Zepbound. Compounded and generic products are likewise outside these criteria.
• What “does not meet the criteria” means. The referral pathway these criteria describe does not currently accept that fact pattern. It does not mean a court has ruled on compounded products, and it does not mean the criteria will read the same way a year from now. Intake criteria are revised as litigation develops, and they differ between firms.

The most common situation: not being sure

Far more people are uncertain than certain. Telehealth platforms and clinics do not always make the distinction obvious, some patients moved between brand and compounded as availability changed, and the word “semaglutide” appears on both. What usually settles it:

• Pharmacy records. A brand-name fill shows Ozempic, Wegovy, or Rybelsus by name, from a retail or mail-order pharmacy, usually with insurance applied.
• Packaging and the device. Brand-name semaglutide comes in a labeled manufacturer pen; compounded product is often a vial with a pharmacy-printed label and separate syringes.
• Invoices and emails. Telehealth and med-spa billing frequently uses the words “compounded” or “compounding pharmacy,” or names an outsourcing facility.
• Insurance records. Compounded products are typically paid out of pocket; brand-name fills usually generate an insurance record.

Keep whatever you still have: pens, vials, boxes, packaging, receipts, proof of purchase, letters, and emails from the prescriber or clinic. That is standard evidence-preservation advice in these cases and costs nothing to follow.

Why the compounded market existed — the regulatory timeline

FDA removed tirzepatide from the drug shortage list in October 2024 and declared the semaglutide shortage resolved in February 2025, narrowing the legal basis for large-scale compounding. On April 30, 2026, FDA proposed excluding semaglutide, tirzepatide, and liraglutide from the list of bulk drug substances outsourcing facilities may use for large-scale compounding, finding no clinical need now that the shortages had resolved; comments closed June 29, 2026. The proposal does not directly restrict smaller-scale pharmacy compounding.

The practical point: the compounded market was a product of a national shortage and is being wound down by regulators, not by patients.

What is happening in the brand-name litigation, for context

Federal stomach-injury cases sit in MDL 3094 in the Eastern District of Pennsylvania before Judge Karen S. Marston, created February 2, 2024, with 4,022 actions pending as of the JPML’s September 1, 2026 report. Federal NAION cases are in a separate proceeding, MDL 3163, created December 15, 2025 before the same judge, with 216 pending actions. New Jersey has designated two matching state-court multicounty litigations in Bergen County. There are no settlements, no verdicts, and no trial dates in any of them.

The most consequential ruling so far, on August 15, 2025, requires gastroparesis claims to be supported by properly performed objective gastric-emptying testing rather than symptoms alone. It applies to everyone in the stomach-injury track regardless of product, and it screens out many people who genuinely have the illness — because most patients diagnosed with gastroparesis were never sent for that test. It is a documentation rule imposed on the cases, not an opinion about whether you are sick.

Who may qualify — and what to do if you do not

• Stomach injuries: brand-name Ozempic, Wegovy, or Rybelsus; gastroparesis confirmed by a gastric emptying study or gastric obstruction confirmed by objective testing; diagnosed while taking the medication or within about 30 days of stopping; an emergency-room visit or hospital admission; diagnosis before December 31, 2024; age 75 or under at intake.
• NAION: brand-name Ozempic, Wegovy, Rybelsus, Trulicity, Mounjaro, or Zepbound; an actual NAION diagnosis during or after use; some degree of permanent vision impairment.
• Compounded product, or not sure: answer “I’m not sure” and keep going — that routes to a human review, not a dead end. If your records show a brand-name fill for part of the period, which happens often, that period may be what matters.
• If the answer is no, you will hear it in plain words, with the reason. Based on what is in your records today, a particular case may not move forward — records can change; a person cannot.
• Either way, this is not a claim against your doctor, clinic, or pharmacist. These cases are against drug manufacturers.

Common questions

Other GLP-1 medications: Wegovy, Rybelsus, Mounjaro, Zepbound, and Trulicity. The manufacturer: Novo Nordisk.