My telehealth provider shut down or stopped serving my state: how to continue GLP-1 care

First: don't make medication changes on your own

When a service suddenly ends, it is tempting to stretch your remaining supply, restart at your old dose later, or buy a replacement from somewhere new. Talk to a licensed clinician before you:

• stop your medication
• skip or space out doses
• double up on doses
• switch products

Here's why that matters:

• Don't combine products. The Wegovy, Zepbound and Foundayo labels all say not to use them with other GLP-1 receptor agonists. Wegovy and Zepbound also warn against other products containing the same ingredient.
• Missed doses have their own instructions. Each label has a section on missed doses. A clinician who knows your history can apply it to your situation.
• Compounded products carry dosing risks. FDA has received adverse event reports linked to dosing errors with compounded semaglutide, some requiring hospitalization. Some errors came from patients measuring doses themselves, and some from health professionals miscalculating. If you are moving between a compounded product and a brand-name one, or between two compounded products, a clinician should make that plan.

If you have severe stomach pain, signs of an allergic reaction or other serious symptoms, get medical care right away. Don't wait for a new provider.

Get your records and prescription history now

Download what you can before a patient portal shuts off. Under HIPAA, you have the right to see and get a copy of your medical and billing records from health care providers and health plans covered by the law.

• A provider cannot refuse because you owe money.
• It can charge a reasonable fee for copies, but not for searching for or retrieving your records.
• Your doctor normally has up to 30 days to respond, and many respond sooner.

Also ask the pharmacy that filled your prescriptions for your fill history. Pharmacies are among the health care providers covered by HIPAA when they conduct certain standard electronic transactions.

Try to collect:

• the exact medication name, whether brand-name or compounded, with the strength and concentration printed on the label
• your current dose, the date you started it, and the date of your last dose
• the prescriber's name and the state where they are licensed
• the dispensing pharmacy's name, address and phone number
• lab results, visit notes, and any record of side effects
• a photo of your current medication label

If you have compounded medication left

FDA's consumer guidance includes a few points that apply here:

• Discard a multiple-dose vial within 28 days after first use, even if medicine remains and even if the compounder's instructions say otherwise.
• Use a new, sterile needle and syringe every time.
• Don't use injectable GLP-1s that arrive warm or without enough refrigeration.

Check that the pharmacy on your label is real and licensed. FDA knows of fraudulent labels naming pharmacies that do not exist. See how to check a compounding pharmacy's license.

Finding a new prescriber

Any new clinician, in person or online, must be licensed or legally permitted to practice in the state where you are located. That is also why a telehealth company may be unable to keep treating you after it leaves your state, or after you move.

Options include:

• your primary care clinician
• a local obesity medicine, endocrinology or weight-management clinic
• another telehealth service that is licensed where you live

You can find a clinic near you that offers GLP-1 or weight-management care.

A new prescriber will usually want to evaluate you before continuing any prescription. They may not keep the exact plan you had. For example, they may prefer a different product, want new lab work, or adjust the timeline. That is a normal part of taking over care responsibly.

What to ask a new clinic

• Do you take patients who are already on a GLP-1 medication, including compounded ones?
• Can you review my records before or at my first visit?
• How soon can I be seen, given when my last dose was?
• Do you prescribe FDA-approved products, compounded products, or both, and how do you decide?
• Which pharmacy would fill my prescription, and is it licensed in my state?
• Will you handle insurance prior authorization, or am I paying cash?
• How do follow-up visits work, and who do I contact about side effects between visits?
• What does care cost: per visit, membership, or a package that includes medication?

If something goes wrong

• Report side effects or quality problems with a medication to FDA's MedWatch program, which FDA links from its GLP-1 guidance page.
• If a provider refuses to give you your records, you can file a complaint with the HHS Office for Civil Rights.