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Clinical considerations : -Noncirrhotic MASH: There may be risks to the mother and fetus related to MASH with advanced liver fibrosis (e.g., increased risks of gestational diabetes, hypertensive complications, preterm birth, postpartum hemorrhage)

FDA has raised specific concerns about compounded GLP-1 products: Reports of adverse events (including hospitalizations) tied to dosing errors with compounded injectable semaglutide Concerns about the use of semaglutide salt forms (sodium/acetate) rather than the base form used in FDA-approved products FDA has stated it is not aware of a lawful basis for compounding using these different salt forms Broader concerns about compounded GLP-1 dosing and titration beyond labeled dosing protocols Important distinction : Compounded medications prepared by state-licensed pharmacies operating under federal and state compounding frameworks are different from illegally marketed or counterfeit products sold online without valid prescriptions

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The Journal of the American Osteopathic Association 2011;111:eS1520 Shuey MM, Lee KM, Keaton J, Khankari NK, Breeyear JH, Walker VM, Miller DR, Heberer KR, Reaven PD, Clarke SL, Lee J, Lynch JA, Vujkovic M, Edwards TL