Ozempic Shortage: Current Status, Alternatives, and Solutions

Since 2021-2022, GLP-1 receptor agonists including Ozempic have experienced intermittent shortages driven by explosive demand far exceeding manufacturing capacity. This comprehensive guide explores the causes of these shortages, current availability status, which doses are most affected, practical strategies for obtaining medication when facing shortages, and alternatives including compounded semaglutide, other GLP-1 options, and telehealth resources.

Understanding the Root Causes of GLP-1 Shortages

The GLP-1 shortage resulted from a dramatic collision between supply constraints and demand explosion, creating one of the most significant pharmaceutical supply crises in recent years.

Semaglutide (Ozempic, Wegovy) was FDA-approved for diabetes in 2017. For its first several years, demand was modest and stable—diabetes treatment drove use. Manufacturing capacity was sized appropriately for this demand level. The market operated in balance.

Beginning in 2021-2022, semaglutide's use for weight loss exploded. A combination of factors drove this: celebrities and public figures (Elon Musk, Oprah Winfrey, others) publicly credited semaglutide with weight loss, generating massive media attention; social media amplified demand through viral posts and influencer endorsements; off-label prescribing for weight loss became widespread; telehealth services began offering semaglutide for weight loss; the weight loss results (15% body weight reduction) proved dramatically effective in practice.

The demand surge was sudden and staggering. Novo Nordisk, the manufacturer, reported demand increased 10-15 fold within 18-24 months. This explosion immediately exceeded existing manufacturing capacity. Unlike other industries, pharmaceutical manufacturing capacity takes years to expand. Building new facilities, installing equipment, achieving FDA regulatory approval, training personnel—the process requires 3-5 years minimum. Novo Nordisk couldn't instantaneously scale production.

Supply chain complications exacerbated the shortage. COVID-related manufacturing disruptions persisted into 2022-2023. Ingredient sourcing faced delays. Transportation and logistics faced bottlenecks. These temporary disruptions compounded capacity limitations. The combination of constrained capacity plus temporary supply chain issues created severe shortages in 2022-2023.

Additionally, insurance coverage and formulary issues affected distribution. Many insurers restricted semaglutide coverage for weight loss, preferring diabetes-indication Ozempic. This created apparent shortages in certain channels (weight-loss-focused supply) while other channels (diabetes-focused) had better availability. Different distribution networks experienced different shortage severity.

Novo Nordisk began aggressive expansion. The company invested billions in new manufacturing facilities. New capacity came online in 2023-2024, dramatically improving availability. However, demand continues exceeding supply for certain formulations and doses. Shortages improved from severe (2022-2023) to intermittent and dose-specific (2024-2025), but aren't completely resolved.

Current Ozempic and GLP-1 Shortage Status in 2024-2025

The shortage situation has evolved substantially from its 2022-2023 peak, with current status characterized by intermittent shortages and dose-specific availability issues rather than complete unavailability.

As of 2024-2025, Novo Nordisk reports improved semaglutide availability. New manufacturing facilities are operational, capacity has increased, and supply is closer to matching demand. However, completely stable supply hasn't been achieved. Certain doses remain intermittently short while others are readily available. Geographic variation persists; some regions have better access than others.

Wegovy (semaglutide for weight loss) faced tighter shortages than Ozempic (semaglutide for diabetes) during peak shortage periods due to higher demand concentration. Current availability has improved but remains variable. Online sources and telehealth services sometimes have better Wegovy availability than traditional pharmacies.

Mounjaro (tirzepatide from Eli Lilly) experienced its own shortage period starting later than semaglutide (2023-2024) as demand shifted to alternatives. Mounjaro availability has generally improved faster than semaglutide, with more stable supply by 2024-2025. Tirzepatide shortages are less severe than semaglutide shortages currently.

Saxenda (liraglutide) remained more consistently available due to lower demand. The older, less potent GLP-1 maintained sufficient supply throughout shortage periods.

Compounded semaglutide and tirzepatide have better supply than brand-name versions because compounding pharmacies can produce products more flexibly. When brand-name medications are short, compounded versions often remain available.

The realistic current picture is that most patients can access some form of GLP-1 medication, but accessing a specific preferred medication may require alternatives. Ozempic availability has improved but isn't guaranteed. Alternatives are usually available even when specific first-choice medications are short.

Which Ozempic and Semaglutide Doses Are Most Affected by Shortages

Shortages haven't affected all doses equally; understanding which doses face supply challenges helps guide alternatives.

Lower doses (0.25mg, 0.5mg) historically experienced more severe shortages than higher doses. The reason: most weight-loss demand concentrates on weight-loss-focused dosing which utilizes these lower doses in the titration protocol. Higher diabetes doses (1.0mg, 2.0mg) faced less pressure because diabetes patient population is smaller than weight-loss population. This dose-specific shortage pattern created situations where some strengths were unavailable while others were in stock.

By 2024-2025, dose-specific shortages persist but are less severe. Various doses remain intermittently short, but complete unavailability of all doses is less common. However, accessing your specific preferred dose can still be challenging at times.

Wegovy's dose progression protocol (0.25mg starter, 0.5mg maintenance, 1.0mg standard, 2.4mg maximum) created particular bottlenecks at starter and lower maintenance doses. Novo Nordisk prioritized higher doses for new-patient starts when shortages were severe, limiting patient ability to use the gradual titration protocol. This frustrated many patients wanting to start at appropriate doses and titrate up.

Ozempic's diabetes dosing (0.5mg, 1mg, 2mg for diabetes indication) faced less pressure than Wegovy weight-loss dosing, creating differences in availability between these formulations despite identical chemical content.

Availability continues fluctuating. A dose available this week might be short next week. Asking your pharmacist about expected availability timelines and alternative doses is valuable. Sometimes accepting a slightly different dose than ideal is necessary for accessing medication during shortages.

Practical Strategies for Finding Available Ozempic and GLP-1 Medications

When facing shortages, strategic approaches can locate available medication despite supply challenges.

Contact multiple pharmacies. Call several local pharmacies and ask about semaglutide availability in your specific dose. Ask about both Ozempic brand and Wegovy brand specifically. Different pharmacy chains have different supply relationships; CVS, Walgreens, Rite Aid, and independent pharmacies sometimes have different availability. Being willing to switch pharmacies might provide access. Chain pharmacies' regional distribution centers vary in available inventory.

Expand the search geographically. If local pharmacies lack stock, call pharmacies in nearby cities or towns. Some areas experience better supply than others. Transferring your prescription to a pharmacy with availability, even if less convenient, might be necessary. Some people have discovered that larger cities or medical hub areas maintain better GLP-1 supply.

Ask your prescriber's office for support. Physician offices dispensing prescriptions sometimes have information about pharmacy availability or relationships with specific pharmacies with better supply. Office staff may call pharmacies on patients' behalf to locate medication. Some office practices maintain sample stock to bridge short-term gaps.

Try online pharmacies and mail-order services. Pharmacy chains' mail-order services sometimes have better availability than retail locations. Online pharmacies with broader distribution networks may access supplies retail locations can't. This takes longer (mail takes 2-7 days) but might be worthwhile if other options are exhausted.

Consider telehealth GLP-1 services. Telehealth providers (Ro, Found, Calibrate, SemaGlutide.io, etc.) often have more reliable GLP-1 access than traditional pharmacies because they use multiple supply sources and compounding pharmacies. These services are designed for GLP-1 delivery and have built supply reliability into their models. This is a reasonable strategy during brand-name shortages.

Ask about substituting available alternatives. If your pharmacy lacks Ozempic, ask if Wegovy (same medication, different indication) is available. Ask about compounded semaglutide. Ask about different GLP-1s entirely (Mounjaro, Saxenda). Flexibility about which GLP-1 you use dramatically improves access during shortages.

Timing matters. Shortages fluctuate. If your prescription is due when supply is short, contacting pharmacies early for estimated availability can help plan ahead. Planning refills in advance rather than waiting until medication runs out provides flexibility.

Ask about partial fills or smaller quantities. If the pharmacy lacks full-quantity stock, asking for a partial fill tide you over until full stock is available. Getting 2 weeks' supply now plus 2 weeks in a few days is better than getting nothing.

Compounded Semaglutide as a Shortage Solution

Compounded semaglutide from licensed pharmacies represents a practical alternative when brand-name semaglutide is unavailable, with important quality considerations.

Pharmacy compounding involves preparing medications from bulk ingredients under pharmacy supervision. Compounding pharmacies obtain semaglutide bulk powder (from chemical suppliers) and create injectable solutions at prescribed doses. The process is regulated at state pharmacy board level, with standards and oversight. Products are prepared sterile, in appropriate doses, in proper containers.

Advantage: Compounding pharmacies often maintain better product availability during brand-name shortages. Since they produce products locally or through less-constrained supply chains than Novo Nordisk's global distribution, they often have stock when brand-name products don't. Cost is another advantage: compounded semaglutide typically costs $200-400 monthly compared to Ozempic's $1,200-1,500 monthly. This 60-75% cost savings is substantial.

Disadvantage: Compounded products lack FDA finished-product approval and oversight. While individual ingredients and manufacturing processes are regulated, the final product is a pharmacy-prepared medication rather than an FDA-approved pharmaceutical. Quality standards vary between compounding pharmacies. Long-term safety data for compounded semaglutide specifically is limited; most data come from brand-name products. Switching to compounded carries unknown risks, though likely modest.

Quality assurance: When considering compounded semaglutide, request Certificate of Analysis (CoA) from third-party testing confirming purity, potency, and sterility. Reputable compounding pharmacies provide this documentation. Avoid pharmacies unwilling to provide CoA. Ask your prescriber for recommendations for quality compounding pharmacies; physicians often have reliable sources. PCAB certification (Pharmacy Compounding Accreditation Board) indicates higher standards.

Appropriateness: Compounded semaglutide is reasonable during shortage situations where brand-name is unavailable. If brand-name product can be accessed, it's generally preferable due to FDA oversight. However, for patients facing true inability to access brand-name product, compounded semaglutide from quality pharmacies offers practical solution with manageable risk.

Alternative GLP-1 Medications When Ozempic Is Unavailable

When facing Ozempic unavailability, alternative GLP-1 options often remain accessible, providing paths forward without reverting to compounded products.

Wegovy: Identical to Ozempic (same semaglutide molecule), Wegovy is marketed for weight loss while Ozempic is marketed for diabetes. These are interchangeable medications despite different brand names and indications. If Ozempic is unavailable but Wegovy is accessible, switching is seamless. Talk to your prescriber about changing the prescription to Wegovy. This is the simplest alternative—same medication, just different brand and marketing.

Mounjaro (tirzepatide): A different medication (GLP-1/GCG dual agonist) that's actually more potent than semaglutide. Tirzepatide achieves 22.5% weight loss versus semaglutide's 15%, providing superior efficacy. Downside: tirzepatide has different dosing (2.5mg-15mg weekly vs. semaglutide's 0.25mg-2.4mg), different side effect profile (similar but not identical), and requires dose adjustment. Some people tolerate tirzepatide better; others tolerate semaglutide better. Switching requires physician guidance but is often possible.

Saxenda (liraglutide): An older GLP-1 with lower efficacy (5-6% weight loss) and daily injections rather than weekly. Substantially less convenient and effective than semaglutide or tirzepatide. However, it's often more available during shortages due to lower demand. Considering Saxenda only if other options are truly unavailable; it's a weaker alternative but better than no treatment.

Rybelsus (oral semaglutide): An oral tablet form of semaglutide approved for diabetes (not weight loss). Oral bioavailability is lower than injections, so weight loss (10-13%) is less than injectable semaglutide. Administration is also less convenient (empty stomach, 30-minute wait before food). Primarily useful for people with extreme needle anxiety; otherwise less desirable than injectable semaglutide. Sometimes available when injectable is short.

Flexibility about which GLP-1 you use dramatically improves access during shortages. Most people tolerate different GLP-1s similarly. Accepting Mounjaro when semaglutide is unavailable, or Saxenda when preferred options are short, enables continued treatment. This is far preferable to stopping medication while waiting for preferred options to restock.

Telehealth Services and Online GLP-1 Providers During Shortages

Specialized telehealth services offering GLP-1 medications often maintain better supply reliability than traditional pharmacies, representing a valuable resource during shortages.

Telehealth GLP-1 services (examples include Ro, Found, Calibrate, SemaGlutide.io, Nurx, others) are designed specifically for GLP-1 delivery. They've built redundancy and supply reliability into their models. These services typically work with multiple supply sources and compounding pharmacies, creating flexibility traditional pharmacies lack. When brand-name supply is short, they can pivot to alternatives. This supply-chain advantage has made telehealth services increasingly popular during shortage periods.

Typical telehealth GLP-1 workflow: You complete a medical questionnaire, speak with a licensed physician (via video or message), receive a prescription, and medication is delivered to your home. Monthly membership costs typically run $200-500+ depending on service and medication dose. Some charge per prescription rather than membership; pricing varies. Medication arrives 2-7 days after prescription.

Advantages: Better medication availability, convenient home delivery, often lower costs than cash prices at traditional pharmacies, simplicity of the process. Many services handle logistics transparently, showing pricing and availability upfront.

Disadvantages: Telehealth consultations may be less thorough than in-person physician care. Insurance typically doesn't cover telehealth GLP-1 services, making out-of-pocket costs necessary. Some people prefer in-person physician relationships. Quality varies between services; some maintain higher standards than others. Verify the service is legitimate, has licensed physicians, uses quality pharmacies.

For shortage navigation: Telehealth services represent a practical strategy for accessing GLP-1 when traditional sources are short. If your prescriber is unable to help locate medication, exploring telehealth services can provide access. Many telehealth platforms advertise current availability, helping you choose services with your desired medication in stock.

Medication Dosing Adjustments During Shortages

When preferred doses are unavailable, discussing dose modifications with your prescriber can sometimes enable treatment continuation.

Dose flexibility: If your ideal dose is unavailable, alternative doses might be possible. If 1.0mg semaglutide is unavailable but 0.5mg is in stock, using 0.5mg is better than no treatment. Results will be less dramatic; weight loss and appetite suppression will be modest with lower doses. However, maintaining some treatment is typically preferable to stopping entirely while waiting for preferred doses.

Dose timing: Sometimes a short supply just requires waiting. If your Ozempic is due for refill soon and current supply is short, your prescriber might adjust timing slightly (pushing refill back 1-2 weeks) if supply is expected to normalize soon. This requires communication with your provider about shortage timelines.

Extended intervals: Some people extend dosing intervals slightly (e.g., injecting weekly rather than every 5 days, or every 8 days rather than weekly) to stretch available supply. This is a desperation measure and not ideal; consistent dosing is preferable. However, extended intervals are better than missing doses entirely. Any interval modifications should be done with prescriber guidance.

Dose cycling: Some patients on regimens have temporarily cycled between available doses or medications (using what's available when, alternating between semaglutide and tirzepatide) to enable continued treatment. This isn't ideal but works as a temporary shortage bridge.

FDA Response and Government Actions on GLP-1 Shortages

The FDA and other government agencies have taken actions attempting to address GLP-1 shortages, though their effectiveness has been debated.

FDA actions have included: working with Novo Nordisk and other manufacturers to accelerate capacity expansion and production optimization; providing regulatory flexibility for manufacturing changes to increase production; monitoring shortages and maintaining public shortage status information; approving additional manufacturers and compounding pharmacies to produce GLP-1s; expediting regulatory review for competing products like tirzepatide.

State pharmacy boards have also acted, allowing expanded compounding and making semaglutide production easier for compounding pharmacies. This increased compounded semaglutide availability as brand-name products were short.

Insurance and payer level: Some health insurance companies modified prior authorization requirements during shortages, making it easier for patients to switch to available alternatives. Others improved coverage for compounded semaglutide when brand-name was unavailable.

Congressional attention: Congress inquired about shortage causes and pressured manufacturers and the FDA to address supply issues. Novo Nordisk provided testimony about expansion plans and committed to supply improvement.

Actual impact: These actions have contributed to supply improvements since 2023. However, shortages persisted into 2024-2025 despite government attention. Complete shortage resolution requires manufacturing capacity to match demand, a process taking years.

Future GLP-1 Supply Outlook: 2025 and Beyond

Understanding where GLP-1 supply is heading helps inform expectations and planning.

Novo Nordisk capacity: The company's expansion projects suggest semaglutide supply will continue improving. New facilities becoming operational in 2024-2025 will increase capacity. By 2025-2026, Novo Nordisk projects semaglutide supply meeting most demand. However, if demand continues accelerating (which is likely), supply-demand balance may remain tight.

Competitive products: Eli Lilly's tirzepatide faces its own supply constraints but is expanding capacity. By 2025-2026, tirzepatide supply should normalize more than semaglutide. As tirzepatide becomes more available and patients have choice between semaglutide and tirzepatide, demand concentration on any single product decreases, easing pressure on each.

Upcoming products: Oral GLP-1s from Eli Lilly (orforglipron), Roche (survodutide), and others are expected to reach market in 2026-2027. These new products will increase overall GLP-1 availability and provide alternatives when any single product faces supply issues. The era of single-product GLP-1 dependence is ending.

Compounding landscape: Compounding pharmacies will continue filling supply gaps when brand-name products are short. As competition in compounding develops, quality and price should improve. Compounded GLP-1s will likely become normalized parts of the supply landscape rather than shortage workarounds.

Long-term outlook: By 2026-2027, with multiple manufacturers, multiple formulations (injectable and oral), and robust compounding capacity, GLP-1 shortages should be substantially resolved. The acute shortage crisis will likely be viewed as a temporary mismatch between demand explosion and manufacturing capacity. However, periodic supply volatility for specific formulations or doses will likely persist as demand remains high.