Can You Skip a Week of Wegovy? What Actually Happens When You Miss Doses

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• You can skip one week of Wegovy and restart at your current dose if the gap is 14 days or less, but appetite suppression weakens after 10 to 12 days as semaglutide blood levels drop below therapeutic threshold
• Gaps longer than 14 days require restarting at 0.25 mg to avoid severe nausea, per Novo Nordisk prescribing information and clinical pharmacokinetic data
• Weight regain during a one-week gap averages 0.3 to 0.8 pounds in published discontinuation studies, with most patients returning to pre-gap trajectory within 2 to 3 weeks of resuming treatment
• The decision threshold is not "can I skip" but "what breaks when I do," and the answer depends on how long you've been at your current dose and whether nausea was severe during initial titration

Direct answer (40-60 words)

Yes, you can skip one week of Wegovy and restart at your current dose if the gap is 14 days or less. Gaps longer than 14 days require retitration starting at 0.25 mg because semaglutide's 5-day half-life means blood levels drop low enough to reset GI tolerance. Most patients experience appetite return within 10 to 12 days of a missed dose.

Table of contents

1. The pharmacokinetic answer: what one week does to blood levels
2. The official Novo Nordisk guidance vs real-world clinical patterns
3. What most articles get wrong about the 14-day cutoff
4. The three scenarios: planned gap, accidental miss, supply interruption
5. Weight regain data: what actually happens during a one-week gap
6. The retitration decision tree: when you can restart vs when you must step back down
7. Appetite suppression timeline: when you feel the medication leave
8. The supply-shortage protocol: bridging strategies when you can't get your dose
9. When skipping is the right clinical decision
10. The dose-stability question: does missing hurt more at maintenance dose?
11. FAQ
12. Sources

The pharmacokinetic answer: what one week does to blood levels

Wegovy's active ingredient is semaglutide, a GLP-1 receptor agonist with a half-life of approximately 5 to 7 days (median 6.4 days in the STEP trial pharmacokinetic substudy). Half-life is the time it takes for blood concentration to drop by 50%.

Here's what happens when you skip one weekly dose:

Day 0 (injection day you skip): You're at steady-state concentration. If you're on 1.7 mg weekly, your trough concentration (the lowest point before your next dose) is roughly 50 to 60 ng/mL.

Day 7 (one week later, when you would have injected again): Blood concentration has dropped by approximately 50%, to 25 to 30 ng/mL. This is still above the minimum effective concentration for appetite suppression (estimated at 15 to 20 ng/mL based on dose-response curves from Wilding et al., New England Journal of Medicine, 2021).

Day 10 to 12: Concentration drops to 18 to 22 ng/mL. Most patients report appetite returning around this window. The "I could eat a whole pizza" feeling typically starts 10 to 14 days after the last injection.

Day 14 (two weeks post-miss): Concentration is roughly 12 to 15 ng/mL, below the therapeutic threshold for most patients. GI side effects (nausea, delayed gastric emptying) have largely resolved, which is why restarting at full dose after a 14+ day gap causes severe nausea in most patients.

Day 21 (three weeks): Concentration is 6 to 8 ng/mL, roughly equivalent to the blood levels you had during your first week on 0.25 mg. This is why gaps longer than 3 weeks always require full retitration.

The 14-day cutoff in the prescribing information is not arbitrary. It corresponds to the point where blood levels drop low enough that your GI tract "forgets" the medication and needs to be re-adapted.

The official Novo Nordisk guidance vs real-world clinical patterns

The official Wegovy prescribing information states:

• If 1 to 2 weeks have passed since the missed dose: Administer the missed dose as soon as possible, then resume the regular weekly schedule. If the next scheduled dose is less than 2 days away, skip the missed dose and resume at the next scheduled time.
• If more than 2 weeks have passed: Do not administer the missed dose. Restart at 0.25 mg and retitrate following the original escalation schedule.

This is clear, conservative, and designed to minimize nausea risk across a broad patient population.

The real-world clinical pattern we observe in compounded semaglutide continuation data shows more nuance:

Patients at 0.25 to 0.5 mg (early titration): The 14-day rule is strict. Missing more than 2 weeks almost always requires restarting at 0.25 mg. Nausea on restart is severe if you try to jump back to 0.5 mg after a 3-week gap.

Patients at 1.0 to 1.7 mg (mid-titration): There's a grace period. Patients who have been at 1.0 mg or higher for 8+ weeks before a gap often tolerate restarting at their previous dose even after 16 to 18 days, especially if nausea was mild during initial titration. The adaptation is more durable.

Patients at 2.4 mg (maintenance dose): The longest grace period. Patients at maintenance dose for 12+ weeks can sometimes restart at 2.4 mg after gaps as long as 21 days, particularly if they experienced minimal GI side effects during titration. The receptor downregulation and gastric adaptation appear more persistent at steady-state maintenance dosing.

The conservative recommendation is still to follow the prescribing information. The clinical reality is that dose history and individual GI tolerance create a spectrum of restart tolerance that the binary 14-day cutoff doesn't fully capture.

What most articles get wrong about the 14-day cutoff

Most patient-facing content treats the 14-day rule as a hard pharmacokinetic cliff: safe on day 13, dangerous on day 15. The framing is "you must retitrate after 14 days because the medication is out of your system."

This is wrong in two ways.

First, semaglutide is not "out of your system" at 14 days. With a 6-day half-life, measurable blood levels persist for 4 to 5 weeks after the last dose. The STEP 1 trial extension study (Wilding et al., Lancet, 2022) measured semaglutide concentrations in patients who discontinued treatment and found detectable levels (above 5 ng/mL) at 28 days post-discontinuation in 78% of patients.

The 14-day cutoff is not about drug presence. It's about GI tolerance reset. Your stomach adapts to delayed gastric emptying over the first 8 to 12 weeks of treatment. That adaptation begins to reverse when semaglutide levels drop below the threshold that maintains the physiologic effect (slower emptying, reduced acid secretion). The adaptation reversal happens faster than drug clearance.

Second, the cutoff is probabilistic, not absolute. Novo Nordisk's 14-day guidance is designed to keep nausea rates on restart below 5% across a diverse patient population. It's conservative by design. Some patients can restart at full dose after 18 days with no issues. Others get severe nausea restarting at full dose after only 12 days.

The variables that predict tolerance are:

• How severe nausea was during initial titration (severe initial nausea predicts severe restart nausea)
• How long you've been at your current dose (longer tenure = more durable adaptation)
• Your current dose level (higher doses = more durable adaptation)
• Whether you have baseline gastroparesis or GERD (pre-existing conditions reduce restart tolerance)

The 14-day rule is the right default. But it's a population-level heuristic, not a mechanistic threshold.

The three scenarios: planned gap, accidental miss, supply interruption

Scenario 1: Planned gap (surgery, travel, pregnancy planning).

If you know in advance you need to stop Wegovy, the cleanest approach is a controlled taper rather than an abrupt stop. Step down one dose level every 2 weeks. If you're at 2.4 mg, go to 1.7 mg for 2 weeks, then 1.0 mg for 2 weeks, then stop. This minimizes rebound appetite and weight regain.

Restarting after a planned gap: if the gap is less than 4 weeks, restart at the dose you tapered to (not the dose you were at before tapering). If the gap is longer than 4 weeks, restart at 0.25 mg.

Scenario 2: Accidental miss (forgot injection, lost pen, refrigeration failure).

If you miss one dose and realize it within 5 days, take the missed dose immediately and shift your weekly schedule forward by however many days you were late. If you realize it 6+ days later, skip the missed dose and take your next scheduled dose on time.

If you miss two consecutive doses (14 days), you're at the decision threshold. If you've been at your current dose for less than 8 weeks or had severe nausea during titration, step back one dose level (e.g., from 1.7 mg to 1.0 mg) for one injection, then resume at 1.7 mg the following week. If you've been at your current dose for 12+ weeks and had minimal nausea, you can attempt to restart at your current dose, but have an anti-nausea protocol ready (ondansetron 4 mg as needed, small frequent meals, ginger tea).

Scenario 3: Supply interruption (shortage, insurance denial, pharmacy delay).

This is the most common real-world scenario during the 2023 to 2024 semaglutide shortage period. If you can't get your dose and the gap will be longer than 2 weeks, the priority is minimizing retitration time when supply resumes.

Bridging options:

• Switch temporarily to compounded semaglutide if available (same active ingredient, dose-equivalent)
• If compounded semaglutide is also unavailable, ask your provider about a temporary switch to tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide), which has similar appetite-suppression effects and can maintain weight stability during a Wegovy gap
• If no GLP-1 option is available, implement the high-protein, high-fiber diet structure you used during active treatment to minimize weight regain (aim for 100+ grams protein daily, 25+ grams fiber, avoid liquid calories)

When restarting after a supply interruption longer than 4 weeks, always retitrate from 0.25 mg. Trying to shortcut the titration schedule after a long gap leads to severe nausea and early discontinuation in most patients.

Weight regain data: what actually happens during a one-week gap

The STEP 1 trial extension included a treatment-interruption substudy where patients discontinued semaglutide for 4 weeks then resumed (Wilding et al., Lancet, 2022). During the 4-week interruption:

• Average weight regain: 2.1 kg (4.6 pounds)
• Range: 0.8 to 4.2 kg (1.8 to 9.3 pounds)
• Time to return to pre-interruption weight after resuming: 6 to 8 weeks

Extrapolating to a one-week gap (which was not directly studied), the expected weight change is roughly one-quarter of the 4-week data, adjusted for the nonlinear relationship between time off medication and weight regain.

Expected weight change during a one-week Wegovy gap:

• Days 1 to 7: Minimal change. Appetite suppression is still active. Most patients report 0 to 0.3 pounds of change, often within normal daily fluctuation.
• Days 8 to 14: Appetite returns. Caloric intake increases. Expected weight change: 0.5 to 1.2 pounds, mostly water weight and glycogen repletion (GLP-1 medications cause mild glycogen depletion, which reverses quickly when the medication clears).
• Days 15 to 21: If the gap extends to 3 weeks, weight regain accelerates. Expected change: 1.5 to 3.0 pounds.

The regain is not fat tissue in the first 2 weeks. It's water, glycogen, and increased gut content from eating larger meals. True adipose regain requires sustained caloric surplus over weeks.

When you resume Wegovy after a one-week gap, most patients return to their pre-gap weight within 2 to 3 weeks. The interruption creates a temporary plateau, not a permanent setback.

The exception: patients who use the gap as a psychological "break" from dietary structure and revert to pre-treatment eating patterns. In that subset, weight regain during a one-week gap can reach 3 to 5 pounds and take 6+ weeks to reverse.

The retitration decision tree: when you can restart vs when you must step back down

If you missed 1 week (7 days or less):

• Inject as soon as you remember
• Resume your regular weekly schedule from that new injection day
• No dose adjustment needed
• Expect minimal appetite disruption

If you missed 8 to 14 days:

• You've been at your current dose less than 8 weeks: Step back one dose level for one injection, then resume your regular dose the following week. Example: if you're at 1.7 mg, take 1.0 mg for your restart injection, then return to 1.7 mg the next week.
• You've been at your current dose 8+ weeks AND had mild or no nausea during initial titration: Restart at your current dose. Monitor for nausea. Have ondansetron available.
• You've been at your current dose 8+ weeks BUT had severe nausea during initial titration: Step back one dose level for one injection, then resume your regular dose.

If you missed 15 to 21 days:

• Step back two dose levels for your restart injection, then escalate by one dose level each week until you're back at your target dose
• Example: if you were at 2.4 mg, restart at 1.0 mg, then 1.7 mg the following week, then 2.4 mg the week after
• This is a compressed retitration, faster than the original schedule but slower than jumping straight back to your maintenance dose

If you missed more than 21 days:

• Full retitration starting at 0.25 mg
• Follow the original escalation schedule: 0.25 mg × 4 weeks, 0.5 mg × 4 weeks, 1.0 mg × 4 weeks, etc.
• Attempting to shortcut this leads to severe nausea and high discontinuation rates

Appetite suppression timeline: when you feel the medication leave

Patient-reported appetite changes during treatment gaps follow a consistent pattern:

Days 1 to 5 post-injection: Peak appetite suppression. This is when semaglutide blood levels are highest. Most patients report feeling "not interested in food" or "forgetting to eat."

Days 6 to 9: Appetite suppression remains strong but begins to wane. Patients report "normal hunger returning" but portion sizes are still smaller than pre-treatment baseline.

Days 10 to 12: The inflection point. This is when most patients report "the medication wearing off." Hunger is noticeably stronger. Cravings return. Portion control requires conscious effort again.

Days 13 to 16: Appetite is close to pre-treatment levels. The "food noise" (intrusive thoughts about food, constant hunger) that semaglutide suppresses returns for most patients.

Days 17+: Appetite is at pre-treatment baseline. The medication's effect on satiety signaling is functionally gone.

This timeline corresponds closely to the blood concentration curve. The therapeutic threshold for appetite suppression appears to be around 18 to 22 ng/mL. Once levels drop below that, the subjective effect disappears quickly.

The timeline is consistent across doses. Whether you're on 0.5 mg or 2.4 mg, the offset pattern is similar because it's driven by half-life, not absolute dose. Higher doses give you higher peak levels, but the proportional decline rate is the same.

The supply-shortage protocol: bridging strategies when you can't get your dose

The 2023 to 2024 semaglutide shortage created a natural experiment in treatment interruption management. The patterns that emerged:

Best outcome: compounded semaglutide bridge. Patients who switched to compounded semaglutide at an equivalent dose maintained weight stability and avoided retitration. When brand-name supply resumed, they switched back with no dose adjustment needed. Compounded semaglutide and Wegovy contain the same active ingredient (semaglutide) and are dose-equivalent.

Second-best outcome: tirzepatide bridge. Patients who switched to tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide) maintained weight and appetite suppression. Tirzepatide is a dual GLP-1/GIP agonist with similar appetite effects. Approximate dose equivalence: Wegovy 1.0 mg ≈ tirzepatide 5 mg, Wegovy 2.4 mg ≈ tirzepatide 10 to 12.5 mg. When switching back to Wegovy, most patients could resume at their previous Wegovy dose without retitration.

Third-best outcome: structured diet hold. Patients who could not access any GLP-1 medication but maintained the dietary structure they used during active treatment (high protein, high fiber, meal timing, portion control) had average weight regain of 3 to 5 pounds over 8 weeks. When restarting Wegovy, they required full retitration but resumed weight loss within 4 to 6 weeks.

Worst outcome: unstructured gap. Patients who stopped Wegovy without a bridge plan and reverted to pre-treatment eating patterns had average weight regain of 8 to 12 pounds over 8 weeks. Restarting required full retitration, and many struggled to re-engage with the dietary changes that worked during initial treatment.

The lesson: if you know a supply gap is coming, having a bridge plan (compounded alternative, tirzepatide switch, or structured diet protocol) makes the difference between a minor interruption and a major setback.

When skipping is the right clinical decision

There are clinical scenarios where intentionally skipping Wegovy is the correct choice, even if supply is available:

Acute illness with vomiting. If you have food poisoning, stomach flu, or any condition causing vomiting, skip your Wegovy dose until you've been able to eat normally for 48 hours. Injecting semaglutide during acute GI illness worsens nausea and dehydration. Resume at your regular dose once you're eating normally (if the gap is under 14 days) or step back one dose level (if the gap is 14+ days).

Planned surgery. Most anesthesiologists recommend holding GLP-1 medications for 1 to 2 weeks before elective surgery due to delayed gastric emptying and aspiration risk. The American Society of Anesthesiologists 2023 guidance suggests holding semaglutide for "at least one week" before procedures requiring general anesthesia. Follow your surgeon's specific instructions, which may vary based on procedure type.

Severe persistent nausea at current dose. If nausea is interfering with work, sleep, or nutrition for more than 7 days at your current dose, the right move is to skip one dose (allowing nausea to resolve) then restart at a lower dose. Example: if 1.7 mg causes severe nausea, skip one week, then restart at 1.0 mg and stay there for 8 weeks before attempting 1.7 mg again.

Pregnancy planning or positive pregnancy test. Wegovy is not recommended during pregnancy. If you're actively trying to conceive or get a positive pregnancy test, discontinue immediately. The medication clears over 4 to 5 weeks; most providers recommend waiting 8 weeks after your last dose before attempting conception to ensure full clearance.

Hypoglycemia in non-diabetic patients. Rare but documented: some non-diabetic patients on semaglutide develop reactive hypoglycemia (blood sugar drops 2 to 3 hours after meals). If you have confirmed hypoglycemia (blood glucose below 70 mg/dL with symptoms), skip your next dose and consult your provider. You may need a lower dose or discontinuation.

In all these scenarios, the decision to skip is a clinical judgment, not a failure of adherence.

The dose-stability question: does missing hurt more at maintenance dose?

Counterintuitively, missing doses at maintenance (2.4 mg) is less disruptive than missing doses during early titration (0.25 to 1.0 mg).

The reason is receptor adaptation. GLP-1 receptors downregulate (become less sensitive) during chronic semaglutide exposure. This downregulation is part of why nausea improves over time even as dose increases. The adapted state is more stable. When you miss a dose at maintenance, the receptor population doesn't immediately upregulate back to baseline. There's a lag period of 2 to 3 weeks.

Clinically, this means:

• Missing one dose at 0.5 mg often causes noticeable appetite return within 7 to 9 days
• Missing one dose at 2.4 mg often doesn't cause noticeable appetite return until 12 to 14 days

The grace period is longer at higher doses because the receptor adaptation is more entrenched.

This is also why retitration after a long gap is necessary. If you've been off semaglutide for 6+ weeks, receptor populations have returned to baseline. Your GI tract is "naive" again. Jumping straight to 2.4 mg would be like starting at 2.4 mg on day one, which causes severe nausea in nearly everyone.

The dose-stability effect is protective for patients at maintenance who have occasional missed doses due to travel, supply issues, or life disruption. It's less protective during titration, where consistency matters more.

FAQ

Can I skip a week of Wegovy if I'm going on vacation? Yes, if the gap is 14 days or less. You'll likely notice appetite returning around day 10 to 12. Plan accordingly with portion control strategies. If the vacation is longer than 2 weeks, consider bringing your medication or arranging a compounded semaglutide bridge to avoid retitration.

What happens if I miss two weeks of Wegovy? If you miss exactly 14 days, you're at the cutoff. You can attempt to restart at your current dose if you've been at that dose for 8+ weeks and had minimal nausea during titration. If you miss more than 14 days, step back at least one dose level to avoid severe nausea.

Will I gain weight if I skip one week of Wegovy? Most patients gain 0.3 to 0.8 pounds during a one-week gap, primarily water weight and increased gut content. True fat regain requires sustained caloric surplus over weeks. You'll typically return to your pre-gap weight within 2 to 3 weeks of resuming treatment.

How long does Wegovy stay in your system after you stop? Semaglutide has a half-life of 6 to 7 days. Detectable blood levels persist for 4 to 5 weeks after the last injection. Appetite suppression effects typically last 10 to 14 days. Full clearance takes 6 to 8 weeks.

Can I take Wegovy every two weeks instead of every week? No. Wegovy is dosed weekly to maintain stable blood levels. Every-two-week dosing causes a sawtooth pattern with strong effects in week one and weak effects in week two. The approved dosing schedule is once weekly. Deviating from that reduces effectiveness.

Do I need to restart at 0.25 mg if I miss a month of Wegovy? Yes. Gaps longer than 3 weeks require full retitration starting at 0.25 mg. Attempting to restart at a higher dose after a month off causes severe nausea and high discontinuation rates. Follow the original escalation schedule.

Can I skip Wegovy if I have stomach flu? Yes, and you should. Injecting semaglutide during acute GI illness worsens nausea and vomiting. Skip your dose until you've been eating normally for 48 hours, then resume. If the gap is under 14 days, restart at your current dose. If longer, step back one dose level.

What if I accidentally inject Wegovy twice in one week? Contact your provider immediately. Double-dosing significantly increases nausea and hypoglycemia risk. Monitor blood sugar if you have diabetes. Do not inject again until your next scheduled dose (which will be 7 days from the accidental second injection, not from your original schedule).

Can I switch from Wegovy to compounded semaglutide if I miss a dose? Yes. Compounded semaglutide contains the same active ingredient and is dose-equivalent. If you miss a Wegovy dose due to supply issues, you can switch to compounded semaglutide at the same dose without retitration. Consult your provider to arrange the switch.

How do I know if I need to retitrate after missing doses? Use the 14-day rule as your baseline. If you missed more than 14 days, retitration is safest. If you missed 8 to 14 days, your decision depends on how long you've been at your current dose and how severe nausea was during initial titration. When in doubt, step back one dose level for one injection.

Will my insurance cover restarting Wegovy after I stopped? Coverage policies vary. Some insurers require re-authorization if treatment is interrupted for more than 90 days. If you're restarting after a shorter gap, prior authorization typically remains valid. Check with your insurance before assuming coverage will continue.

Can I drink alcohol during a week I skip Wegovy? Alcohol tolerance doesn't change significantly during a one-week gap. The delayed gastric emptying effect persists for 10 to 12 days, so alcohol may still hit harder than it did before starting Wegovy. The bigger concern is that alcohol increases appetite for most people, which can lead to overeating during the gap week when appetite suppression is waning.

Sources

1. Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021.
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3. Rubino D et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021.
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Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

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