Verbatim response from Perplexity
Short answer: FDA-approved oral GLP-1s can work, but compounded “drops,” dissolvable tablets, and many other non-approved oral versions are not proven to work reliably. The best evidence supports approved oral semaglutide tablets and newer oral GLP-1 drugs under study, while compounded oral products have no good human evidence showing they produce consistent weight loss or blood-sugar benefits.[1][5][6][7]
What the evidence says:
- Approved oral GLP-1s do work, but usually not as strongly as injections for weight loss. Oral semaglutide has shown meaningful effects in trials and real-world studies, with weight loss and A1c improvements; however, injectable semaglutide still often produces greater weight loss overall.[2][3][9]
- Newer oral GLP-1s may be closer to injections. Eli Lilly’s oral drug orforglipron has shown about 14% average weight loss at the highest dose in trials, and a recent head-to-head trial found better A1c and weight results than oral semaglutide in people with type 2 diabetes.[1]
- Compounded oral “drops” and similar products are the weak point. Reports note that sublingual drops, orally disintegrating tablets, and nasal sprays marketed as compounded semaglutide have not been studied in humans for safety or efficacy, and absorption is not well understood.[5][7]
- The FDA does not review compounded GLP-1s for safety, effectiveness, or quality before sale. The agency says compounded drugs may be appropriate only when FDA-approved options can’t meet a medical need or aren’t available.[6]
If you’re deciding between options, the practical takeaway is:
- Best-supported oral choice: an FDA-approved oral GLP-1 tablet such as Rybelsus or an approved/late-stage oral agent under medical supervision.[1][2][7]
- Best weight-loss results overall: injections still have the strongest track record, especially for larger and more predictable weight loss.[3][9]
- Least reliable choice: compounded GLP-1 drops or tablets, because dosing, absorption, and clinical benefit are uncertain.[5][6][7]
If you want, I can also compare Rybelsus vs Wegovy/Ozempic vs compounded oral GLP-1s side by side, including expected weight loss and common side effects.