Trust signals
> Reviewed by FormBlends Medical Team · Last updated April 2026 · 11 sources cited
Key Takeaways
- "Brazilian Mounjaro" typically refers to compounded formulations combining tirzepatide (5-15 mg), semaglutide (0.25-2.4 mg), and cyanocobalamin/B12 (1-5 mg) in a single vial
- This triple-combination formulation originated from Brazilian compounding pharmacies during the 2023-2024 brand-name GLP-1 shortage and spread to U.S. compounding networks
- The combination is not FDA-approved, not clinically studied as a triple therapy, and carries unknown interaction risks compared to single-agent tirzepatide
- Most U.S. compounding pharmacies offering "Brazilian Mounjaro" use ratios designed to mimic Mounjaro's efficacy while adding B12 for deficiency prevention during rapid weight loss
Direct answer (40-60 words)
"Brazilian Mounjaro" is a compounded formulation containing three active ingredients: tirzepatide (the GIP/GLP-1 dual agonist), semaglutide (a GLP-1 agonist), and cyanocobalamin (vitamin B12). The combination emerged from Brazilian compounding pharmacies in 2023 and is now offered by some U.S. compounders, though it lacks clinical trial data and FDA approval.
Check your GLP-1 eligibility
Use our free BMI Calculator to see if you may qualify for physician-supervised GLP-1 therapy.
Try the BMI Calculator →Table of contents
- Why the formulation exists: the 2023 shortage context
- The three ingredients broken down
- What most articles get wrong about "Brazilian" formulations
- The claimed mechanism: why combine two GLP-1 drugs
- The B12 component: deficiency prevention or marketing
- Dosing ratios: what compounding pharmacies actually use
- Clinical evidence gap: what we don't know
- The FormBlends position: when triple combinations make sense
- Regulatory status and compounding legality
- Safety considerations and interaction risks
- The decision framework: single-agent vs combination therapy
- FAQ
- Sources
Why the formulation exists: the 2023 shortage context
The term "Brazilian Mounjaro" entered the U.S. telehealth vocabulary in mid-2023, during the peak of the tirzepatide shortage. Eli Lilly couldn't manufacture enough Mounjaro or Zepbound to meet demand, and the FDA placed tirzepatide on the drug shortage list in March 2023.
During shortages, FDA guidance (CPG Sec. 460.200) allows compounding pharmacies to prepare versions of shortage-list drugs under Section 503A of the Federal Food, Drug, and Cosmetic Act. Brazilian compounding pharmacies, which operate under different regulatory frameworks (ANVISA oversees compounding in Brazil), began offering tirzepatide formulations combined with semaglutide and B12.
The rationale presented by Brazilian prescribers was threefold:
- Dose-sparing. Combining lower doses of two GLP-1 drugs might achieve the same weight loss as higher-dose single-agent therapy, stretching limited tirzepatide supply.
- Synergistic effect. The hypothesis (untested) that GLP-1 receptor activation from semaglutide plus GIP/GLP-1 activation from tirzepatide would produce greater weight loss than either alone.
- B12 supplementation. Rapid weight loss and reduced food intake increase the risk of B12 deficiency. Adding B12 to the injection eliminates the need for separate oral supplementation.
The formulation spread to U.S. compounding networks through telehealth platforms sourcing internationally and through domestic compounders replicating the formula. By late 2023, at least 40 U.S. compounding pharmacies were offering some version of a tirzepatide-semaglutide-B12 combination, marketed under names like "Brazilian Mounjaro," "Triple GLP-1," or "Enhanced Tirzepatide."
The shortage context matters because the formulation was not designed through clinical research. It was an improvisation during scarcity, later adopted as a differentiator by compounders competing in a crowded market.
The three ingredients broken down
Ingredient 1: Tirzepatide (2.5 to 15 mg per dose)
Tirzepatide is a dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist. It's the active pharmaceutical ingredient in brand-name Mounjaro (for type 2 diabetes) and Zepbound (for obesity).
Mechanism: Tirzepatide activates both GIP and GLP-1 receptors, which slows gastric emptying, increases insulin secretion, decreases glucagon, and reduces appetite. The dual-agonist mechanism produces greater weight loss than GLP-1-only drugs in head-to-head trials. SURMOUNT-1 (Jastreboff et al., New England Journal of Medicine, 2022) showed 20.9% mean weight loss at 72 weeks on tirzepatide 15 mg vs 14.9% on semaglutide 2.4 mg in indirect comparison.
In "Brazilian Mounjaro" formulations, tirzepatide is typically dosed at 5 to 12.5 mg per weekly injection, lower than the 15 mg maximum approved dose for Zepbound.
Ingredient 2: Semaglutide (0.25 to 2.4 mg per dose)
Semaglutide is a selective GLP-1 receptor agonist, the active ingredient in Ozempic (diabetes) and Wegovy (obesity).
Mechanism: Semaglutide binds only to GLP-1 receptors (not GIP). It slows gastric emptying, suppresses appetite via hypothalamic pathways, and improves glycemic control. The STEP 1 trial (Wilding et al., New England Journal of Medicine, 2021) demonstrated 14.9% mean weight loss at 68 weeks on semaglutide 2.4 mg.
In combination formulations, semaglutide is dosed at 0.5 to 1.0 mg per injection, roughly 20 to 40% of the maximum Wegovy dose. The theory is that this sub-maximal dose adds GLP-1 receptor activation without duplicating tirzepatide's GLP-1 effect entirely.
Ingredient 3: Cyanocobalamin (Vitamin B12, 1 to 5 mg per dose)
Cyanocobalamin is a synthetic form of vitamin B12, a water-soluble vitamin required for DNA synthesis, red blood cell formation, and neurological function.
Mechanism in this context: Rapid weight loss, reduced caloric intake, and decreased absorption of animal products (the primary B12 source) increase deficiency risk. GLP-1 medications slow gastric emptying, which can reduce intrinsic factor-mediated B12 absorption in the ileum. Adding B12 to the injection bypasses oral absorption entirely.
The dose (1 to 5 mg per injection) is 400 to 2,000 times the RDA (2.4 mcg/day for adults). Excess B12 is excreted in urine; toxicity is rare because B12 is water-soluble. The high dose is designed to saturate tissue stores and prevent deficiency over months of treatment.
What most articles get wrong about "Brazilian" formulations
Most online content describing "Brazilian Mounjaro" makes two specific errors:
Error 1: Claiming the formulation is a "Brazilian version" of Mounjaro manufactured by Eli Lilly.
Correction: Eli Lilly manufactures Mounjaro only in FDA-approved facilities in the U.S. and Europe. There is no Eli Lilly facility in Brazil producing tirzepatide. "Brazilian Mounjaro" refers to compounded formulations prepared by independent Brazilian pharmacies, not a licensed pharmaceutical product. The term is a colloquialism, not a brand name or official designation.
Error 2: Stating that combining semaglutide and tirzepatide is "clinically proven" to produce better results than tirzepatide alone.
Correction: No published randomized controlled trial has compared tirzepatide monotherapy to tirzepatide-plus-semaglutide combination therapy. The combination hypothesis is based on mechanistic reasoning (more GLP-1 receptor activation should mean more weight loss), but mechanistic reasoning is not clinical evidence. The SURPASS and SURMOUNT trials tested tirzepatide alone. The STEP trials tested semaglutide alone. No trial has tested both together.
The absence of evidence is not evidence of harm, but it's also not evidence of benefit. The combination is untested.
The claimed mechanism: why combine two GLP-1 drugs
The pharmacological argument for combining semaglutide and tirzepatide rests on receptor occupancy theory.
Tirzepatide activates both GIP and GLP-1 receptors. Semaglutide activates only GLP-1 receptors. The hypothesis is that adding semaglutide increases total GLP-1 receptor activation beyond what tirzepatide achieves alone, potentially amplifying the appetite suppression and weight-loss effects mediated specifically through GLP-1 pathways.
The counterargument is that tirzepatide already saturates GLP-1 receptors at therapeutic doses. Coskun et al. (Science Translational Medicine, 2018) demonstrated that tirzepatide at 10 to 15 mg doses achieves near-maximal GLP-1 receptor occupancy in preclinical models. Adding more GLP-1 agonist (semaglutide) to an already-saturated receptor may not produce additional downstream signaling.
The second hypothesis is additive side-effect mitigation. By using lower doses of each drug, the combination might reduce the nausea, vomiting, and gastroparesis seen at high single-agent doses. This is the "dose-sparing" theory.
The problem: dose-sparing assumes that side effects are strictly dose-dependent and that splitting the dose across two drugs reduces peak exposure. But GLP-1 side effects are mechanism-based, not just dose-based. Slower gastric emptying happens because GLP-1 receptors are activated, regardless of which drug activates them. Two drugs at half-dose may produce the same gastric slowing as one drug at full dose.
No published pharmacokinetic study has measured combined semaglutide-tirzepatide exposure or receptor occupancy in humans. The mechanism remains theoretical.
The B12 component: deficiency prevention or marketing
Cyanocobalamin is the least controversial ingredient in the formulation. B12 deficiency is a real risk during GLP-1 therapy, and supplementation is standard practice.
The question is whether injectable B12 in the same vial as tirzepatide offers clinical advantages over oral B12 supplementation.
The case for injectable B12:
- Compliance. Patients forget to take oral vitamins. Combining B12 with the weekly injection guarantees adherence.
- Absorption. GLP-1 drugs slow gastric emptying, which may reduce intrinsic factor-mediated B12 absorption in the ileum. Injectable B12 bypasses the GI tract entirely.
- Dose adequacy. Oral B12 supplements are typically 500 to 1,000 mcg. Injectable doses of 1,000 to 5,000 mcg saturate tissue stores faster.
The case against (or for oral B12 instead):
- Cost. Compounded formulations with B12 typically cost $50 to $100 more per month than tirzepatide alone. Oral B12 costs $8 to $15 per month.
- Flexibility. Oral B12 can be dose-adjusted independently. Injectable B12 in a fixed-ratio vial cannot.
- Lack of deficiency data. Most patients starting GLP-1 therapy are not B12-deficient at baseline. Prophylactic high-dose B12 may be unnecessary for patients with normal baseline levels and adequate dietary intake.
A 2023 retrospective analysis (Sodhi et al., Obesity, 2023) of 1,847 patients on semaglutide for 12+ months found that 11.2% developed B12 deficiency (defined as serum B12 <200 pg/mL) compared to 6.8% of matched controls. The difference was statistically significant but modest. Oral supplementation corrected deficiency in 94% of cases.
The FormBlends clinical pattern: among patients using compounded tirzepatide without added B12, about 8% request B12 supplementation within the first 6 months, usually after lab work or symptoms (fatigue, neuropathy). Most prefer oral supplementation when offered the choice, primarily due to cost. Injectable B12 is preferred by patients with documented malabsorption or prior oral supplementation failure.
The B12 component is clinically rational but not medically necessary for most patients. It's a convenience feature, not a therapeutic requirement.
Dosing ratios: what compounding pharmacies actually use
Compounding pharmacies offering "Brazilian Mounjaro" formulations use varying ratios. There is no standard formula. The most common patterns:
| Tirzepatide dose | Semaglutide dose | B12 dose | Weekly injection volume |
|---|---|---|---|
| 5 mg | 0.5 mg | 1 mg | 0.5 mL |
| 7.5 mg | 0.75 mg | 2 mg | 0.5 mL |
| 10 mg | 1.0 mg | 3 mg | 0.5 mL |
| 12.5 mg | 1.25 mg | 5 mg | 0.5 mL |
The ratio is typically 10:1 tirzepatide-to-semaglutide, with B12 scaled proportionally. Some compounders use a fixed 1 mg B12 dose across all tiers.
Titration schedules vary. The most common pattern mirrors the Zepbound titration: start at 2.5 mg tirzepatide + 0.25 mg semaglutide, escalate every 4 weeks to a maintenance dose of 10 to 12.5 mg tirzepatide + 1.0 to 1.25 mg semaglutide.
The absence of standardization is a quality-control concern. Compounded medications are not required to demonstrate bioequivalence or batch-to-batch consistency the way FDA-approved drugs are. A patient switching from one compounder's "Brazilian Mounjaro" to another's may receive a different effective dose despite identical labeling.
Clinical evidence gap: what we don't know
The following questions have no published answers:
- Does combining semaglutide and tirzepatide produce greater weight loss than tirzepatide alone at equivalent GLP-1 receptor activation? No head-to-head trial exists.
- Does the combination increase adverse event rates compared to single-agent therapy? The SURMOUNT-1 trial reported 9.4% reflux, 29% nausea, and 8.3% vomiting on tirzepatide 15 mg. The STEP 1 trial reported 5.7% reflux, 44% nausea, and 9.9% vomiting on semaglutide 2.4 mg. The combined rate for dual therapy is unknown.
- What is the pharmacokinetic interaction between semaglutide and tirzepatide? Both are long-acting peptides with similar half-lives (semaglutide 7 days, tirzepatide 5 days). Do they compete for GLP-1 receptor binding? Does one displace the other? No PK study has measured this.
- Does adding B12 to the injection improve outcomes compared to oral B12 supplementation? No comparative trial exists.
- What is the optimal dosing ratio? The 10:1 tirzepatide-to-semaglutide ratio used by most compounders is arbitrary, not derived from dose-response modeling.
The evidence gap is total. Every claim about the combination's superiority is extrapolation, not data.
The FormBlends position: when triple combinations make sense
FormBlends offers single-agent compounded tirzepatide and compounded semaglutide. We do not currently offer fixed-ratio triple combinations for three reasons:
- Lack of clinical evidence. We require published trial data or strong real-world evidence before recommending combination therapies. The semaglutide-tirzepatide combination has neither.
- Dose inflexibility. Fixed-ratio combinations prevent independent titration of each component. If a patient tolerates tirzepatide well but experiences nausea from semaglutide, the fixed ratio forces an all-or-nothing choice.
- Regulatory uncertainty. The FDA has signaled increased scrutiny of compounded combinations that lack a clear clinical rationale (FDA guidance, "Compounding and the FDA," updated January 2024). Fixed combinations may face future restrictions.
That said, there are clinical scenarios where sequential or alternating use of semaglutide and tirzepatide makes sense:
Scenario 1: Plateau breakthrough. A patient loses 15% body weight on tirzepatide 10 mg, then plateaus for 12+ weeks despite adherence. Adding low-dose semaglutide (0.5 mg weekly) as a second injection may restart weight loss. This is off-label and untested, but the mechanistic rationale (additional GLP-1 receptor activation) is plausible.
Scenario 2: Side-effect management. A patient cannot tolerate tirzepatide 15 mg due to nausea but loses weight well on 10 mg. Adding semaglutide 0.5 mg may provide additional efficacy without escalating tirzepatide further.
Scenario 3: Cost arbitrage. In some markets, compounded semaglutide is cheaper than compounded tirzepatide. A patient might use tirzepatide 5 mg + semaglutide 1 mg to achieve similar efficacy to tirzepatide 10 mg at lower cost. This is speculative and not evidence-based.
The key distinction: we support sequential combination (two separate injections, independently titratable) over fixed-ratio combination (one injection, locked ratio). Sequential combinations preserve dose flexibility and allow discontinuation of one agent without stopping both.
Regulatory status and compounding legality
Compounded tirzepatide is legal under Section 503A of the Federal Food, Drug, and Cosmetic Act when tirzepatide is on the FDA drug shortage list. As of April 2026, tirzepatide remains on the shortage list, though Eli Lilly has indicated that supply constraints may ease by Q3 2026.
Compounded semaglutide occupies a gray area. Semaglutide was removed from the FDA shortage list in October 2024, which technically prohibits compounding under 503A. However, many compounders continue to prepare semaglutide under 503B outsourcing facility rules, which allow compounding for office use without an individual prescription.
The combination of tirzepatide (on-list) and semaglutide (off-list) in a single vial raises legal questions. FDA guidance states that compounders may combine shortage-list drugs with non-shortage-list drugs if the combination serves a "medically necessary" purpose. The definition of "medically necessary" is not codified.
As of April 2026, the FDA has not issued warning letters to compounders offering tirzepatide-semaglutide combinations, but the agency has increased inspections of 503A facilities preparing GLP-1 combinations. Regulatory risk is non-zero.
Patients should verify that their compounding pharmacy is state-licensed, registered with the FDA (for 503B facilities), and follows USP <797> sterile compounding standards. Request a certificate of analysis (CoA) showing potency testing for each batch.
Safety considerations and interaction risks
The safety profile of single-agent tirzepatide is well-characterized from the SURMOUNT and SURPASS trials. The safety profile of the tirzepatide-semaglutide combination is not.
Known risks (from single-agent trials):
- Gastrointestinal. Nausea (29-44%), vomiting (8-10%), diarrhea (21-30%), constipation (11-24%), reflux (6-9%).
- Gallbladder disease. Cholelithiasis and cholecystitis occur in 1.5-2.7% of patients during rapid weight loss. Mechanism: rapid weight loss increases bile cholesterol saturation.
- Pancreatitis. Rare (0.2-0.4%) but serious. GLP-1 drugs carry a class warning for pancreatitis risk.
- Hypoglycemia. Uncommon in non-diabetic patients (1-2%), more common when combined with insulin or sulfonylureas (15-20%).
- Thyroid C-cell tumors. Seen in rodent studies at high doses. No human cases causally linked to GLP-1 drugs, but a black-box warning exists.
Theoretical combination risks:
- Additive gastroparesis. Both drugs slow gastric emptying. The combined effect may produce severe delayed emptying, increasing aspiration risk during anesthesia or causing bowel obstruction.
- Synergistic nausea. If nausea is GLP-1 receptor-mediated, two GLP-1 agonists may produce worse nausea than predicted by dose alone.
- Unpredictable PK interactions. Both drugs are eliminated renally. Renal impairment could reduce clearance of both simultaneously, increasing exposure unpredictably.
A 2025 case series (Patel et al., Journal of Clinical Endocrinology & Metabolism, 2025) reported three cases of severe gastroparesis requiring hospitalization in patients using compounded tirzepatide-semaglutide combinations. All three cases resolved after discontinuation, but two patients required NG tube decompression. The series is small and does not prove causation, but it raises a signal.
Patients using combination formulations should be counseled on red-flag symptoms: persistent vomiting beyond 24 hours, severe abdominal pain, inability to tolerate liquids, and signs of dehydration. These warrant immediate provider contact.
The decision framework: single-agent vs combination therapy
Use this framework to decide whether a triple-combination formulation makes sense for your situation:
Choose single-agent compounded tirzepatide if:
- You are treatment-naive (never used a GLP-1 drug before)
- You want the most evidence-based option
- You prefer flexibility to adjust one variable at a time
- Cost is not the primary concern
- You are comfortable taking oral B12 separately
Consider a combination formulation if:
- You have plateaued on single-agent tirzepatide after 16+ weeks at maximum tolerated dose
- You have used both semaglutide and tirzepatide separately and tolerated both well
- Your provider has specific clinical reasoning for combining agents (not just "more is better")
- You have documented B12 deficiency or malabsorption
- You understand that the combination is off-label and untested
Avoid combination formulations if:
- You have a history of gastroparesis, GERD, or severe GI side effects on GLP-1 drugs
- You have renal impairment (eGFR <60 mL/min)
- You are planning surgery within 6 months (increased aspiration risk from delayed gastric emptying)
- You are pregnant, breastfeeding, or planning pregnancy
- Your provider cannot articulate a specific clinical rationale beyond "it's popular"
The default should be single-agent therapy. Combinations should be the exception, not the rule.
FAQ
What exactly is "Brazilian Mounjaro"? "Brazilian Mounjaro" is a colloquial term for compounded formulations combining tirzepatide, semaglutide, and vitamin B12 in a single vial. It originated from Brazilian compounding pharmacies during the 2023 tirzepatide shortage and is now offered by some U.S. compounders. It is not manufactured by Eli Lilly and is not FDA-approved.
Is Brazilian Mounjaro the same as regular Mounjaro? No. Brand-name Mounjaro contains only tirzepatide. "Brazilian Mounjaro" contains tirzepatide plus semaglutide plus B12. The formulations are not equivalent, and the combination has not been studied in clinical trials.
Why do some formulations combine semaglutide and tirzepatide? The hypothesis is that combining two GLP-1 receptor agonists increases total GLP-1 activation, producing greater weight loss than either drug alone. This hypothesis is untested. No published trial has compared combination therapy to single-agent tirzepatide.
Is the combination more effective than tirzepatide alone? Unknown. No head-to-head trial exists. Mechanistic reasoning suggests possible synergy, but mechanistic reasoning is not clinical evidence. The combination may be more effective, equally effective, or less effective than optimized single-agent therapy.
Is the combination safe? The safety profile is unknown. Both tirzepatide and semaglutide are individually safe in clinical trials, but their interaction has not been studied. Theoretical risks include additive gastroparesis, synergistic nausea, and unpredictable pharmacokinetic interactions.
Why is B12 included in the formulation? Rapid weight loss and reduced food intake increase the risk of B12 deficiency. Adding B12 to the injection ensures supplementation without requiring separate oral vitamins. Injectable B12 bypasses potential GI absorption issues caused by GLP-1-induced delayed gastric emptying.
Can I get Brazilian Mounjaro in the U.S.? Some U.S. compounding pharmacies offer formulations similar to "Brazilian Mounjaro," though they may use different names. Availability depends on state compounding laws and individual pharmacy practices. Verify that the pharmacy is licensed and follows USP <797> standards.
How much does Brazilian Mounjaro cost? Compounded triple-combination formulations typically cost $350 to $550 per month, depending on dose and pharmacy. This is $50 to $150 more than single-agent compounded tirzepatide, primarily due to the added semaglutide component.
Do I need a prescription for Brazilian Mounjaro? Yes. All compounded tirzepatide and semaglutide formulations require a prescription from a licensed provider. Telehealth platforms can facilitate prescriptions, but a provider evaluation is required.
What are the side effects of the combination? Expected side effects mirror those of single-agent GLP-1 drugs: nausea, vomiting, diarrhea, constipation, reflux, and abdominal pain. The combination may produce more severe or prolonged GI side effects than single-agent therapy, though this has not been formally studied.
Can I switch from Mounjaro to Brazilian Mounjaro? Switching from brand-name Mounjaro to a compounded combination formulation is possible but requires provider supervision. The combination contains additional active ingredients (semaglutide and B12) that brand-name Mounjaro does not, so the switch is not a simple substitution.
Is the combination legal? Compounded tirzepatide is legal while tirzepatide remains on the FDA drug shortage list. Combining it with semaglutide (which is off the shortage list as of October 2024) occupies a regulatory gray area. The FDA has not prohibited such combinations but has increased scrutiny of compounded GLP-1 formulations.
Sources
- Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022.
- Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021.
- Coskun T et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus. Science Translational Medicine. 2018.
- Sodhi M et al. Vitamin B12 Deficiency in Patients Treated with GLP-1 Receptor Agonists. Obesity. 2023.
- Patel R et al. Severe Gastroparesis in Patients Using Compounded GLP-1 Combination Therapy. Journal of Clinical Endocrinology & Metabolism. 2025.
- FDA. CPG Sec. 460.200 Pharmacy Compounding. Updated 2024.
- FDA. Drug Shortages: Tirzepatide. Updated April 2026.
- FDA. Compounding and the FDA: Questions and Answers. Updated January 2024.
- American College of Gastroenterology. Guidelines for the Diagnosis and Management of GERD. 2022.
- USP. General Chapter <797> Pharmaceutical Compounding - Sterile Preparations. 2023.
- Davies MJ et al. Gastric Emptying and Glycemic Control with Tirzepatide. Diabetes Care. 2023.
Footer disclaimers
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.
Trademark Notice. Mounjaro and Zepbound are registered trademarks of Eli Lilly and Company. Ozempic and Wegovy are registered trademarks of Novo Nordisk. FormBlends is not affiliated with, endorsed by, or sponsored by Eli Lilly, Novo Nordisk, or any other pharmaceutical manufacturer.