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Evidence & access

GLP-1 for sleep apnea: what is actually approved

One GLP-1 has an FDA approval for obstructive sleep apnea, and it is not the one most people are prescribed. Here is the evidence, the distinction that matters, and where the drug is sold.

Approved drug
Tirzepatide (Zepbound) — brand only
Indication
Moderate-to-severe OSA with obesity
Approved
December 2024, FDA
Trial
SURMOUNT-OSA (NEJM, 2024)

What the trial showed

SURMOUNT-OSA tested tirzepatide in adults with obesity and moderate-to-severe obstructive sleep apnea. It substantially reduced the apnea-hypopnea index — the count of breathing interruptions per hour — in both participants using CPAP and those who were not. On the strength of it, the FDA approved Zepbound for moderate-to-severe OSA in adults with obesity in December 2024, the first drug ever approved for the condition.

Two things that result does not mean. It is not a cure, and it is not a replacement for CPAP on anyone's say-so but your clinician's — a large share of trial participants still had residual apnea afterwards. And the effect is tied to weight loss in people with obesity; it is not evidence that a GLP-1 helps sleep apnea in someone without it.

The distinction that decides whether any of this applies

The OSA approval belongs to brand Zepbound. Every provider listed below sells compounded tirzepatide — a different product, not FDA-approved, and carrying no OSA indication. Compounded tirzepatide has not been tested for sleep apnea. If your reason for wanting it is apnea specifically, the approval you just read about is an argument for the brand drug through a prescriber, not for the cheaper compounded route — and we would rather say so than let the two blur while we earn a commission on the blur.

Where compounded tirzepatide is sold

These are affiliate partners of ours, listed because they are the ones we have relationships with — not because they were selected on the evidence above, which none of them are approved under. Prices are company-stated and change often. Our disclosure explains how we are paid.

  • Direct Meds

    Compounded-only GLP-1 telehealth (launched 2024) offering both oral/sublingual and injectable options with no separate membership fee.

    Pricing: Company-stated: semaglutide ~$179 sublingual / ~$297 injectable; tirzepatide ~$224 / ~$399. All-inclusive pricing.

    Caveats: Compounded only (not FDA-approved). Pricing is company-stated and unverified, and the operator runs under multiple domains.

    Visit Direct Meds ↗

  • Gala Health

    Newer operator covering all 50 states with both a compounded path and a brand-name option, so readers who want brand Ozempic have a route.

    Pricing: Compounded tirzepatide $179/mo (microdose $149, 3-month $199); brand Ozempic listed at ~$1,299.

    Caveats: Compounded GLP-1 is not FDA-approved. No oral/sublingual option yet, and it is a relatively new operator with a shorter track record.

    Visit Gala Health ↗

  • Trimi

    Compounded semaglutide and tirzepatide GLP-1 telehealth with low entry pricing, available in all 50 states.

    Pricing: Low entry pricing on compounded semaglutide and tirzepatide.

    Caveats: Compounded only (not FDA-approved) and injectable only. The compounding pharmacy is not publicly named.

    Visit Trimi ↗

  • Enhance MD

    Compounded GLP-1 telehealth covering semaglutide and tirzepatide, with an optional NAD+ add-on. Ongoing care includes lab testing every six months.

    Pricing: Company-stated: semaglutide $212/mo (first month $112), tirzepatide $280, microdose $169, combo $322. NAD+ available as an add-on.

    Caveats: Compounded only (not FDA-approved). No brand-name or oral option, a higher entry price than some peers, and the states served are not published.

    Visit Enhance MD ↗

  • HealthRX

    LegitScript-certified (#50087439), physician-supervised telehealth for medical weight loss, offering compounded semaglutide and tirzepatide plus an oral GLP tablet. Transparent pricing with no insurance required.

    Pricing: Company-stated: ~$189/mo injectable, ~$239/mo oral GLP tablet, ~$349/mo GLP + GIP combination.

    Caveats: Compounded products are not FDA-approved. Some tiers are company-stated and the site is thin in places, and the number of states served is not published.

    Visit HealthRX ↗

  • RxSpan MD

    Physician-led telehealth founded by Dr. John Diaz, a board-certified plastic surgeon, and available in all 50 states. Broad menu spanning compounded semaglutide and tirzepatide — injectable and oral capsules — an advertised brand-name GLP-1 lane and microdosing, plus a longevity line (sermorelin, NAD+, glutathione) that overlaps this site's peptide focus. Includes 24/7 messaging, coaching and free expedited shipping.

    Pricing: From $194/mo. RxSpan publishes transparent, all-inclusive pricing on its own site: compounded semaglutide is $249/mo, dropping to $194/mo on the 12-month plan; tirzepatide is $329/mo; and semaglutide oral capsules are $249/mo. Each plan includes the consult, medication, supplies, shipping and support, and you can cancel or change plans anytime.

    Caveats: Compounded semaglutide/tirzepatide are not FDA-approved (not the same as Wegovy, Ozempic or Zepbound). Published pricing covers the compounded line, so brand-name pricing isn't itemized. A prescription isn't guaranteed — a provider reviews eligibility after checkout.

    Visit RxSpan MD ↗

  • yourEra

    Compounded GLP-1 telehealth ("A New Era of Personalized Health") carrying both semaglutide and tirzepatide as weekly injectables, alongside a broader menu of NAD+, microdosing protocols and an optional coaching/nutritionist/at-home-labs membership. Markets a 50-state licensed-clinician network; no insurance required, HSA/FSA accepted.

    Pricing: Publicly listed on the site: compounded semaglutide from $199/mo, tirzepatide from $299/mo (weekly injectable). NAD+ from $249/mo, microdosing from $179/mo, optional yourEra Optimum membership +$149/mo.

    Caveats: Compounded only (not FDA-approved) and injectable only — no brand-name or oral lane. Mid-market pricing sits above the cheapest compounders, and the 50-state and efficacy claims are self-reported with a thin independent-review footprint.

    Visit yourEra ↗

  • Sprout Health

    LegitScript-certified GLP-1 telehealth offering compounded semaglutide and tirzepatide alongside a real brand-name Wegovy and Zepbound path, with a low-friction start that often skips labs and the video visit.

    Pricing: Company-stated: compounded semaglutide from $149/mo, tirzepatide from $199/mo; brand-name Wegovy/Zepbound available at brand pricing.

    Caveats: Compounded products are not FDA-approved and injectable-only (no oral). No named medical director, and state availability is quiz-gated. "No labs, no visit" convenience also means lighter clinical oversight.

    Visit Sprout Health ↗

  • Shed

    A care-team GLP-1 program (physician, nurse, dietitian, coach) with one of the widest format menus — compounded semaglutide/tirzepatide injections plus GLP-1 drops, lozenges and a microdose option, alongside a brand-name Wegovy route.

    Pricing: Company-stated: compounded semaglutide as low as $159/mo, tirzepatide from $239/mo; Wegovy pill from $149. A 120-day weight-loss guarantee is advertised.

    Caveats: Compounded drops/lozenge/microdose formats are not FDA-evaluated in those delivery forms. No LegitScript badge, founding year or parent company is published, and prices step up with dose.

    Visit Shed ↗

  • Breeze Meds

    A transparent, all-50-state compounded GLP-1 telehealth with NPI-verifiable named physicians (Lion MD group) and named compounding pharmacies, offering weekly injectable semaglutide plus oral semaglutide and tirzepatide tablets.

    Pricing: Company-stated: injectable semaglutide from $199/mo; oral semaglutide ~$299/mo and oral tirzepatide ~$399/mo. FSA/HSA eligible.

    Caveats: Compounded medications are not FDA-approved. Oral tirzepatide is pricey and the $199 headline is the entry-dose injectable; it is a small, newer brand with a short public track record.

    Visit Breeze Meds ↗

If you came here from the peptide side

Sermorelin and the other growth-hormone secretagogues this site covers are a different intervention entirely, and none of them has an apnea indication or an apnea trial behind it. If you want the evidence on those, our sermorelin ranking is the honest place to start — including where the evidence for them runs thin.

Educational information, not medical advice. Obstructive sleep apnea is a diagnosis that requires a sleep study, and treatment decisions — including whether to change or stop CPAP — belong with the clinician managing it.