GLP-1 medication errors rise as online weight-loss prescribing grows
KFF Health News found reports of GLP-1 medication errors climbed sharply, raising concerns about telehealth prescribing and compounded drugs.
By Tom Brennan · Health & Medicine Correspondent
4 min read
Reports of medication errors involving popular GLP-1 weight-loss drugs have risen sharply as more Americans seek prescriptions online, according to a KFF Health News review of federal data. The increase has brought new scrutiny to telehealth companies that prescribe and sell the drugs, including compounded versions that are not reviewed by the Food and Drug Administration for safety.
KFF Health News reported that Karleigh McClain, a 31-year-old compliance consultant in Hendersonville, Tennessee, was hospitalized within a day of injecting semaglutide she said she obtained after a telehealth visit. McClain said the instructions told her to inject 2.21 milligrams once a week, a starting dose KFF Health News reported was nearly nine times the usual first dose.
McClain said she questioned the amount and contacted the company, where a care-team representative confirmed the directions. She said she later received an overdose diagnosis and continued to have symptoms weeks afterward, including a high heart rate and vision problems she believed were connected to the medication.
Data show a rapid rise in errors
A KFF Health News analysis of the FDA’s Adverse Event Monitoring System found medication-error reports tied to semaglutide, tirzepatide, dulaglutide and liraglutide rose from just over 2,000 in 2020 to more than 25,000 in 2025. The reports frequently cited wrong or extra doses, communication problems involving products and prescribing errors, according to KFF Health News.
America’s Poison Centers has reported a nearly 1,500% increase since 2019 in calls involving overdoses or side effects from injectable weight-loss drugs. KFF Health News noted that the poison-center data does not show whether the cases followed telehealth or in-person prescribing.
The data are incomplete because adverse events are not always reported, KFF Health News reported. In a March 5 warning letter, the FDA accused Novo Nordisk, maker of Wegovy and Ozempic, of failing to report some adverse events, including suicidal ideation and death.
Telehealth model draws concern
Most people who have used GLP-1 drugs received prescriptions through primary care doctors or specialists, KFF polling data show. But telehealth use expanded after many states eased rules during the Covid pandemic, and online companies have since grown into a major channel for weight-loss care, KFF Health News reported.
Some telehealth companies require a live virtual visit before prescribing. Others may use asynchronous reviews, in which patients submit forms and medical-history questionnaires. Ro spokesperson Nicholas Samonas told KFF Health News the company requires a real-time conversation when state law requires it, or when a patient or clinician asks for one.
Marc-Andre Cornier, an endocrinologist at the Medical University of South Carolina and immediate past president of The Obesity Society, told KFF Health News that some online programs may not adequately evaluate patients before prescribing. He said there is no government or medical-society standard that clearly separates appropriate from inappropriate telehealth prescribing.
Elizabeth Krupinski, an Emory University experimental psychologist who studies telehealth, told KFF Health News that telemedicine can help many patients, especially when it is tied to a broader health system. She criticized some companies for marketing GLP-1s as easy weight-loss tools while giving too little attention to diet, exercise and follow-up care.
Compounded drugs and dosing confusion
Many online companies offer compounded GLP-1 drugs through mail-order pharmacies, KFF Health News reported. The Department of Health and Human Services told KFF Health News that compounded drugs should be used only when a patient’s needs cannot be met by an FDA-approved product and urged consumers to know where their medicine comes from.
Leslie Gammon, 54, of Wendell, North Carolina, told KFF Health News she received a compounded semaglutide refill through Amble Health with instructions that differed from her earlier dose. She said she became severely ill after injecting less than the listed amount and was later hospitalized in Raleigh, leaving her with a bill of more than $9,000. KFF Health News said Amble Health did not respond to questions.
America’s Poison Centers has warned that some patients have reported taking 10 times the recommended dose because syringe measurement units were confusing. Arthur Caplan, a bioethics professor at NYU Grossman School of Medicine, told KFF Health News some telehealth companies are not doing enough to confirm patients understand the risks and injection process.
Drugmakers and regulators are also challenging online GLP-1 marketing. KFF Health News reported that Eli Lilly has sued multiple telehealth companies over compounded tirzepatide, while Novo Nordisk said it has filed 130 lawsuits against entities it says unlawfully market and sell knockoff semaglutide drugs. The FDA has sent warning letters to several online companies, saying some claims about compounded weight-loss drugs were false or misleading.
This story draws on original reporting from NBC News.