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The FDA could view the wide-scale manufacturing of custom medications as taking advantage of loopholes that ought to be closed: “I suspect the FDA never contemplated that [its guidance] would be applied the way it's being applied, given the scale of the compounded GLP-1 phenomenon,” he says

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Key considerations when switching: Allow a washout period based on tirzepatide half-life Start retatrutide at the standard 1mg initiation dose regardless of previous tirzepatide dose Expect renewed GI side effects as the glucagon receptor is a new stimulus Monitor heart rate more carefully during the initial escalation period When tirzepatide is the better choice Tirzepatide remains the superior option in several specific situations