Safety and risk assessment of no-prescription online semaglutide purchases
Open accessAbstract
This qualitative study assesses the quality, amount of active ingredient, and characteristics associated with counterfeiting of semaglutide purchased from illegal online pharmacies without a prescription.
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A significant number of concerning reports regarding safety and efficacy of compounded incretin products have emerged, including use of unproven salt forms, untested additional ingredients, nonstandard concentrations and doses, and counterfeit products.
“A significant number of concerning reports regarding safety and efficacy of compounded incretin products have emerged, however, including using salt forms of the FDA-approved product's active ingredient that are not proven safe or effective for use in humans, incorporation of additional ingredients not clinically tested when mixed with incretin products (e.g., vitamin B12 and vitamin B6), products”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [206]
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Research works printed but not linked: 4
- [1]Suran M. As Ozempic’s popularity soars, here’s what to know about semaglutide and weight loss. JAMA. 2023; 329(19): 1627- 1629. doi: 10.1001/jama.2023.2438 37099334 · DOI
- [2]Mackey T, Jarmusch A, Xu Q,. Multifactor quality and safety analysis of antimicrobial drugs sold by online pharmacies that do not require a prescription: multiphase observational, content analysis, and product evaluation study. JMIR Public Health Surveill. 2022; 8(12): e41834. doi: 10.2196/41834 36563038 PMC9823576 · DOI
- [3]Schiavetti B, Wynendaele E, Melotte V, Van der Elst J, De Spiegeleer B, Ravinetto R. A simplified checklist for the visual inspection of finished pharmaceutical products: a way to empower frontline health workers in the fight against poor-quality medicines. J Pharm Policy Pract. 2020; 13: 9. doi: 10.1186/s40545-020-00211-9 32377348 PMC7193355 · DOI
- [4]FDA Center for Drug Evaluation and Research. Warning letter: www.semaspace.com—MARCS-CMS 665848. October 2, 2023. Accessed July 3, 2024. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/wwwsemaspacecom-665848-10022023
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9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Bajaj, M., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s009 · Cited by 728 · see citing works
Neumiller, J. J., Bajaj, M., Bannuru, R. R., McCoy, R. G., Pekas, E. J., Segal, A. R., & ElSayed, N. A. (2025) · Diabetes Care · doi:10.2337/dci24-0091 · Cited by 49 · see citing works
Weight Loss and Body Composition after Compounded Semaglutide Treatment in a Real World Setting
Chun, E., Siojo, A., Rivera, D., Reyna, K., Legere, H., Joseph, R., & Pojednic, R. (2025) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.16162 · Cited by 23 · see citing works
- Authors
- Ashraf, A. R., Mackey, T. K., Schmidt, J., Kulcsár, G., Vida, R. G., Li, J., & Fittler, A.
- Affiliations
- University of Pecs (HU)
- University of California San Diego (US)
- S-3 Research, San Diego, California
- Corresponding author
- Mackey, Tim K.
- ORCID
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2024-08-02
- Volume
- 7
- Issue
- 8
- Pages
- e2428280
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC11297364
- OpenAlex
- W4401250433
- Cited by
- 44
- References
- 0
- Citations by year
- 2026: 18 · 2025: 15 · 2024: 11
- FWCI
- 18.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
- Physical Sciences › Computer Science › Information Systems › Cybercrime and Law Enforcement Studies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Keywords
- semaglutide, online pharmacies, drug counterfeiting, unregulated drug sales, prescription drug access, drug safety, active ingredient content, risk assessment
- MeSH terms
- Semaglutide, Adult, Aged, Diabetes Mellitus, Type 2, Glucagon-Like Peptides, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Risk Assessment
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