GLP-1 peptides for weight loss
Compounded GLP-1 peptides (semaglutide and tirzepatide) are the most-studied prescription weight-loss medications available today. RxPepsDirect (rxpepsdirect.com) prescribes both molecules in two carrier formulations each: a B-12 variant (the default) and a glycine variant for patients with documented B-12 sensitivity. The active ingredient is identical to the branded products (Ozempic, Wegovy, Mounjaro, Zepbound). Optimal Balance Pharmacy compounds and dispenses every prescription.
- Tirzepatide produced 20.2 percent mean weight loss in SURMOUNT-5; semaglutide produced 13.7 percent at equivalent doses.
- Both molecules ship pre-reconstituted from Optimal Balance Pharmacy. No bacteriostatic water required.
- Glycine variants are reserved for B-12 sensitivity, methylation issues, or histamine reactions.
- Flat $39 medical visit fee covers the whole protocol; medication is billed separately at pharmacy wholesale.
Semaglutide/B12
From $25/1.2mgThe gold standard GLP-1 for weight management, paired with B12 for energy support.
Semaglutide/B6 + Glycine
From $175/10mgGlycine-buffered semaglutide for patients who don't tolerate the B12 cofactor.
Glycine carrier: reserved for patients with B-12 sensitivity, methylation issues, or histamine reactions. Higher carrier cost reflects formulation complexity, not the peptide itself.
Tirzepatide/B12
From $45/12mgDual GIP/GLP-1 receptor agonist for enhanced metabolic support with B12.
Tirzepatide/B6 + Glycine
From $225/60mgGlycine-buffered tirzepatide for patients who don't tolerate the B12 cofactor.
Glycine carrier: reserved for patients with B-12 sensitivity, methylation issues, or histamine reactions. Higher carrier cost reflects formulation complexity, not the peptide itself.
Ondansetron 4mg ODT
$37.50/30 tabletsAnti-nausea adjunct for GLP-1 patients. Generic Zofran orally disintegrating tablets.
AOD-9604
$80/6mgA modified fragment of human growth hormone that targets fat metabolism without growth effects.
AOD-9604 Troche
$2.50/trocheSublingual AOD-9604 troche. The growth hormone fragment that targets fat metabolism, in a no-needle daily form.
Lean Stack (AOD-9604/MOTs-C/Tesamorelin/Ipamorelin)
$125/36mgFour-peptide body composition stack: lipolysis, mitochondrial support, visceral fat targeting, and clean GH pulse in one vial.
5-Amino-1MQ
$80/25mgAn NNMT inhibitor that activates cellular energy pathways to boost metabolism.
Tesofensine
$2.25/capA triple monoamine reuptake inhibitor that suppresses appetite through central nervous system pathways.
Lipo-B (Cyanocobalamin/MIC)
From $30/10mlA lipotropic injection combining cyanocobalamin (B12) with methionine, inositol, and choline for fat metabolism.
Lipo-C (Cyanocobalamin/MIC/L-Carnitine)
From $35/10mlEnhanced lipotropic injection adding L-carnitine to cyanocobalamin and MIC for improved energy and fat transport.
Comparing semaglutide and tirzepatide formulations
Side-by-side at-a-glance comparison of every weight-loss peptide RxPepsDirect prescribes. Pricing is OBP wholesale passed through with no markup.
| Semaglutide/B12 | Semaglutide/Glycine | Tirzepatide/B12 | Tirzepatide/Glycine | AOD-9604 | |
|---|---|---|---|---|---|
| Mechanism | GLP-1 agonist | GLP-1 agonist | Dual GLP-1 / GIP | Dual GLP-1 / GIP | Lipolysis fragment |
| Carrier | B-12 | Glycine + B6 | B-12 | Glycine + B6 | None |
| Mean trial loss | ≈14.9% (STEP-1, 68 wk) | ≈14.9% (STEP-1, 68 wk) | 15-22% (SURMOUNT-1, 72 wk) | 15-22% (SURMOUNT-1, 72 wk) | Modest (mixed data) |
| Best for | Standard GLP-1 candidate | B-12 sensitive patient | Strongest weight loss | B-12 sensitive + maximum loss | Adjunct to GLP-1 or alone |
| Starting price | From $25 / 1.2 mg | From $175 / 10 mg | From $45 / 12 mg | From $225 / 60 mg | $80 / 6 mg |
| Visit fee | $39 | $39 | $39 | $39 | $39 |
What to expect on compounded GLP-1 therapy
Most patients start at 25 units (1.5 mg) of tirzepatide twice weekly or 25 units (0.15 mg) of semaglutide twice weekly. Titration is typically every 4 weeks if tolerated. Nausea is the most common side effect during titration and is mitigated by slow up-titration plus PRN ondansetron when needed. Hair shedding is reported in 3 to 5 percent of patients and is generally tied to rapid weight loss rather than the medication itself. Adequate protein intake (1 g per kg body weight or higher) reduces both lean-mass loss and shedding risk.
Important Safety Information
- •Personal/family history of medullary thyroid carcinoma (MTC)
- •Multiple Endocrine Neoplasia syndrome type 2 (MEN2)
- •Active pancreatitis
- •Severe gastroparesis
- •Pregnancy or breastfeeding
- •Current use of insulin (flag for provider review)
- •Active eating disorder history
Frequently asked questions about weight loss & metabolic peptides
- Tirzepatide vs semaglutide: which loses more weight?
- Head-to-head trial data (SURMOUNT-5, 2025) showed tirzepatide produced 20.2 percent mean weight loss versus semaglutide's 13.7 percent at equivalent therapeutic doses over 72 weeks. Tirzepatide activates both GLP-1 and GIP receptors, while semaglutide is GLP-1-only. Tirzepatide also tends to produce stronger nausea during titration; patients with severe GI history sometimes prefer semaglutide.
- How fast does compounded tirzepatide work for weight loss?
- Most patients notice appetite suppression within 1 to 2 weeks of starting tirzepatide. Measurable weight loss appears around weeks 4 to 8 as the dose titrates up. Pivotal trial data shows 15 to 22 percent mean body weight loss over 72 weeks at therapeutic doses. RxPepsDirect prescribes a 1.5 mg twice-weekly starter protocol (3 mg per week total) to smooth the plasma peak and reduce nausea during titration.
- Is compounded tirzepatide as effective as Mounjaro or Zepbound?
- The active ingredient is identical: tirzepatide. The dose-response and weight-loss mechanism are the same because the molecule is the same. Compounded tirzepatide uses a different dosing schedule (1.5 mg twice weekly versus 2.5 mg once weekly for branded) to smooth the Cmax peak that drives nausea. Optimal Balance Pharmacy tests every batch for sterility (ScanRDI or Celsis) and bacterial endotoxin (USP <85>); the Certificate of Analysis is published on every product page.
- What is the cheapest compounded GLP-1 from RxPepsDirect?
- Semaglutide/B12 is the cheapest entry point at $25 for the 1.2 mg starter vial, plus the flat $39 medical visit fee. Tirzepatide/B12 starts at $45 for the 12 mg starter vial. Glycine variants of both peptides cost more because the alternate buffer system requires more complex compounding; they are reserved for patients with B-12 sensitivity rather than as a default.
- Why does RxPepsDirect offer two semaglutide formulations (B12 and Glycine)?
- The B-12 variant is the default formulation and supports energy metabolism during caloric restriction. Some patients have documented B-12 sensitivity, MTHFR methylation variants, or histamine reactions to cyanocobalamin. The Glycine variant uses glycine plus vitamin B6 as the carrier instead, with no B-12. The active ingredient (semaglutide) and weight-loss effect are identical across both formulations.
Protocol guides for weight loss & metabolic
Clinical guides covering the molecules in this category. Mechanism, dosing, evidence, and what the research does not yet support.
GLP-1 protocol guide
Microdose GLP-1: dosing math, evidence, and how to start safely in 2026
Microdosing semaglutide or tirzepatide means running them below the FDA-approved starter dose. The vial-duration math, the published evidence, and how to start with a provider.
Triple monoamine reuptake inhibitor (weight loss)
Tesofensine protocol guide: triple monoamine mechanism, Phase IIb data, and the cardiovascular signal
Not a peptide despite frequent miscategorization. 9.2 percent Phase IIb weight loss. Real cardiovascular signal. Monitoring is not optional.
NNMT inhibitor (metabolic weight-loss)
5-Amino-1MQ protocol guide: the NNMT inhibitor mechanism, the mouse data, and the missing human trial
A small-molecule NNMT inhibitor that raises cellular NAD+ to push fat cells toward burning energy. All weight evidence is preclinical mouse and cell-culture work. Honest that no human trial exists.
Growth hormone fragment fat-loss protocol
AOD-9604 (GH fragment 176-191) protocol guide: the lipolysis mechanism, the failed obesity trial, and the honest fat-loss picture
A growth hormone fragment built to burn fat without raising IGF-1. The rodent data is real, but the pivotal 534-subject obesity trial did not beat placebo and development stopped in 2007. Honest about the gap.
Lipotropic injection protocol
Lipotropic injections (Lipo-B / Lipo-C) protocol guide: what MIC, B12, and L-carnitine actually do, and the honest weight-loss evidence
MIC (methionine, inositol, choline) plus B12 or L-carnitine. The standalone fat-loss evidence is weak. These are adjuncts to diet and GLP-1 therapy, not primary weight-loss drugs.