Should You Microdose GLP-1 Medications?

If you take a GLP-1 agonist for weight loss or diabetes, there’s a good chance you may have heard about “microdosing” the medication.

But is taking a smaller dose really safe or effective?

Obesity medicine subspecialist W. Scott Butsch, MD, explains why it’s not a recommended practice.

What is microdosing GLP-1s?

Microdosing GLP-1s, like semaglutide (Wegovy®, Ozempic®) and tirzepatide (Zepbound®, Mounjaro®), is when you intentionally take a reduced amount of the medication. For example, someone may have a prescription for 15 milligrams of Mounjaro but only take a portion of it.

The idea of microdosing these drugs first gained traction due to obesity drug shortages shortly after their approval by the U.S. Food and Drug Administration (FDA) in 2021 and 2022. Now, attention has shifted to microdosing compounded versions of these medications.

Licensed pharmacists prepare compounded GLP-1s when an FDA-approved product can’t meet a person’s medical needs. Unlike FDA-approved medications, compounded drugs aren’t reviewed by the FDA for safety, effectiveness or quality before they’re marketed.

“I don’t recommend using compounded versions of these medications because they’re untested — both in their effectiveness and their safety,” warns Dr. Butsch.

Potential risks and side effects

Some common side effects of GLP-1s include diarrhea, nausea and bloating — but they often go away in the first day or two after taking the medication as prescribed. But if you’re microdosing Ozempic or any other GLP-1, these side effects can keep happening.

“If you take a reduced dose, you run the risk of the drug disappearing from your system faster than intended,” explains Dr. Butsch. “And when you take it again, you’re going to have that side effect again because there hasn’t been a steady amount of the medication in your system.”

Accidental overdosing is another potential risk of microdosing GLP-1s, especially if you’re using a compounded version.

If you’re measuring smaller doses on your own, you could make an error and take too much. Plus, compounded GLP-1s aren’t all concentrated the same way, and they’re not monitored or approved by the FDA. So, even small doses of compounded GLP-1s can result in taking far more medication than intended.

Studies have shown that Ozempic and other GLP-1s work best when they’re treated as long-term medications and taken at a full dose. But there’s not enough research to understand the effectiveness or safety of microdosing compounded GLP-1s.

Dr. Butsch also points out that there aren’t any official or standard guidelines for microdosing Ozempic and other GLP-1s, and microdosing isn’t endorsed by the American Diabetes Association.

Why do people microdose Ozempic and other GLP-1s?

The primary reason people microdose GLP-1s is to make their medication last longer and, therefore, save money.

Most insurance companies don’t cover the cost of a GLP-1. So, if you take one of the newer GLP-1 medications like semaglutide or tirzepatide, you may be paying out of pocket for it.

While prices initially varied, they’ve dropped to around $500 per month through manufacturers’ direct-to-consumer programs. Still, access and availability remain an issue.

Studies have also shown that people who stop taking GLP-1s may regain the weight they’ve lost. So, some might choose to microdose compounded GLP-1 drugs because they’re concerned this may happen to them.

Is microdosing safe?

There’s a lack of research on the safety of microdosing these weight loss drugs and any benefits to your health. If you have questions or concerns about dosage, affordability, side effects or how well the medication is working, talk with your healthcare provider.

“Like with any other medication, doctors can adjust GLP-1s based on their effectiveness, tolerability or side effects,” says Dr. Butsch. “That’s usually a conversation people have with their doctors, who know a lot about these medications and how they work.”

Even though it may seem like everyone on social media is talking about microdosing Ozempic, you shouldn’t do it or adjust your dosage without consulting your healthcare provider first.

“We can adjust the dose to the individual needs of each person,” affirms Dr. Butsch. “And that’s not microdosing — that’s just the art of practicing medicine.”