Dr.SurgeonPGH said:

Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

This is where I part company with the consensus forming above. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

Worth separating that from compounded supply, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

One concrete data point for the thread. Two things anyone can check: a state licence number for a 503A, and an FDA outsourcing-facility registration for a 503B. Both are publicly searchable, and a pharmacy unwilling to give you either has answered the question.

Worth separating that from compounded supply, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Ask again with the specifics and you will get a better answer than this one.

Dr.KarenChen said:

The "tirzepatide is simply better" summary irritates me.

Adding the part of the answer the thread has not reached. Resolution therefore closed the doors unevenly, and the asymmetry follows from the bulks lists. For 503B the shortage clause was the only route to these molecules, so that route shut completely. A 503A pharmacy can still argue a doorway via "component of an approved drug" — but only for the substance in the form present in the approved product, which is exactly where the base-versus-salt argument lives, and it does nothing about the copy restriction, which came back into force on resolution.

Worth separating that from compounded supply, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

One thing that is still open after Dr.EndoEP’s answer:

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

Reporting back.

Reporting back after another eight months at the same dose. Still losing slowly, no new side effects, and no reason I can find to climb further.