The Most Common GLP-1 Medications: A Timeline of How We Got Here
GLP-1 medications seem to have appeared overnight, but the class has been in use for about twenty years. Knowing the sequence of events explains a good deal: why semaglutide and tirzepatide are the names you hear most, why compounded versions became widespread, and why the rules around them keep changing. This timeline covers the main milestones and what they mean for someone considering treatment today. It is educational and does not replace medical advice.
Before the medications: the hormone
Researchers identified GLP-1 as a gut hormone in the 1980s. It is released after eating, signals fullness, slows stomach emptying, and takes part in blood sugar control. The natural hormone lasts only minutes in the body, so the challenge was to create a version that would last long enough to be used as a medicine.
2005: The first approval
The FDA approved the first GLP-1 receptor agonist for adults with type 2 diabetes. It required two injections a day. For its first decade, the class was used almost entirely in diabetes care.
2014: The first approval for weight management
The FDA approved a GLP-1 medication for chronic weight management for the first time. It was a once-daily injection. This marked the point at which the class moved beyond diabetes.
2017: Once-weekly semaglutide
Semaglutide was approved for type 2 diabetes as a once-weekly injection. A weekly schedule made treatment far easier to follow than daily or twice-daily dosing. A tablet form followed two years later.
2021: Semaglutide for weight management
The FDA approved a semaglutide product for chronic weight management. Public awareness rose sharply from this point, and demand grew faster than supply.
2022: Tirzepatide and the shortages
Tirzepatide, which acts on both the GIP and GLP-1 pathways, was approved for type 2 diabetes. In the same period, the FDA placed semaglutide and tirzepatide products on its drug shortage list.
That listing mattered. Under federal law, when an approved drug is in shortage, compounding pharmacies have more room to prepare versions of it. This is the origin of the large market for compounded GLP-1 medications.
2023: Tirzepatide for weight management
The FDA approved a tirzepatide product for chronic weight management. With that, semaglutide and tirzepatide became the two most commonly discussed medications in the class.
Late 2024 to early 2025: The shortages end
The FDA declared the tirzepatide shortage resolved in December 2024 and the semaglutide shortage resolved in early 2025. Because the shortage was the basis for much of the compounding that had been taking place, pharmacies were given limited time to wind down that activity. Compounding for individual patients with a specific medical need remained possible under narrower conditions.
2025: FDA safety communications
During this period, the FDA published concerns about unapproved GLP-1 products. These included reports of dosing errors with compounded injectable versions, the use of ingredient forms different from those in approved drugs, counterfeit products, and vials sold online as "research use only."
2026: Proposed limits on compounding
In April 2026, the FDA proposed leaving semaglutide, tirzepatide, and a third medication in the class off the list of substances that large outsourcing facilities may use for compounding. The comment period closed in July 2026. Anyone using a compounded GLP-1 medication should ask their provider about the current status.
What is most common today
Semaglutide and tirzepatide are the two medications most often prescribed in this class. Each exists in three broad forms:
- FDA-approved brand-name products, reviewed by the FDA for specific uses
- Compounded versions, prepared by state-licensed pharmacies for individual prescriptions and not FDA-approved
- Unapproved products sold online without a prescription, which should be avoided
Nu Image prescribes compounded semaglutide and compounded tirzepatide, each as a weekly injection or a daily rapid-dissolve tablet. These are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
What the timeline means for you
Approvals belong to specific products. Each milestone above refers to an FDA-approved brand-name product for a stated use. An approval does not extend to compounded versions of the same ingredient.
"Common" is not the same as "right for me." How widely a medication is used says nothing about whether it suits your health history.
The rules are still moving. Availability of compounded options may change, and it can differ from state to state.
The source matters. A licensed provider, a prescription, and an identifiable licensed pharmacy are the minimum.
Questions to ask a provider
- Is the medication you are recommending FDA-approved or compounded?
- Has anything changed recently that affects its availability?
- If it becomes unavailable, what are my alternatives?
- Which pharmacy will prepare it?
- Is it appropriate given my history and other medications?
Getting an evaluation
Nu Image offers online evaluations with licensed providers, who review your health history and decide whether a prescription is appropriate. A provider can explain your options and what currently applies in your state.
This content is for educational purposes only and is not medical advice, diagnosis, or treatment. Compounded medications are prepared by state-licensed compounding pharmacies and are not reviewed or approved by the FDA for safety, efficacy, or quality. Prescription products require an online consultation with a licensed healthcare provider, who will determine whether a prescription is appropriate.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your physician about the risks and benefits of any treatment. Nu Image Medical may not offer the medications or services mentioned in this article.
