GLP-1 Medications
A Patient Guide to Pricing & FAQs
This guide explains what GLP-1 medications are, how much they cost through cash-pay programs, what to expect on treatment, and how to get started with Berry Street. Your care team is always the best resource for personal questions, but this document can help you feel informed and prepared.
How to get started1 item
What happens when I start?
Starting with Berry Street is simple. You'll answer a short health questionnaire, schedule your first video visit with a prescriber, and once any required labs are reviewed your prescription will be sent directly to the pharmacy that makes the most sense for your cost and convenience. Your licensed dietitian joins you from day one to guide nutrition, side-effect management, and long-term success.
About GLP-1 Medications7 items
What is a GLP-1 medication?
GLP-1 (glucagon-like peptide-1) is a hormone your gut naturally produces to help regulate blood sugar, appetite, and digestion. GLP-1 medications mimic that hormone: they help your body release insulin after meals, slow how quickly your stomach empties so you feel full longer, and gently reduce appetite. Originally developed for Type 2 diabetes, they are now widely used for weight management as well.
What's the difference between semaglutide and tirzepatide?
Semaglutide (Wegovy, Ozempic) targets one gut hormone pathway: GLP-1. Tirzepatide (Zepbound, Mounjaro) targets two pathways: GLP-1 and GIP. By working on both, tirzepatide tends to produce greater average weight loss and, in recent research, a somewhat gentler digestive side-effect profile. Both are typically given as a once-weekly injection, and your prescriber will help choose the right fit based on your health history, goals, and coverage.
What's the difference between Wegovy and Ozempic?
Both contain semaglutide. Wegovy is FDA-approved for weight management and cardiovascular risk reduction (up to 2.4 mg weekly). Ozempic is FDA-approved for Type 2 diabetes (up to 2 mg weekly). Both are available cash-pay through NovoCare at the same price points.
What's the difference between Zepbound and Mounjaro?
Both contain tirzepatide. Zepbound is FDA-approved for weight management and obstructive sleep apnea. Mounjaro is FDA-approved for Type 2 diabetes. For cash-pay weight management, Zepbound via LillyDirect is significantly more affordable than Mounjaro at retail.
Who qualifies for a GLP-1 prescription?
A licensed prescriber makes the final decision based on your clinical evaluation. In general, patients with a BMI of 30 or higher qualify on BMI alone. Patients with a BMI of 27–29.9 may qualify if they also have a weight-related condition such as high blood pressure, Type 2 diabetes, high cholesterol, obstructive sleep apnea, or cardiovascular disease.
Who should NOT take GLP-1 medications?
- A personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 (MEN2)
- Active pancreatitis
- Severe GI disease (including gastroparesis)
- Active eating disorder
- End-stage kidney or liver disease
- Pregnancy or breastfeeding
Your prescriber will complete a full screening before starting therapy.
Is Berry Street's telehealth program right for my situation?
Berry Street's platform is built for uncomplicated metabolic care. Some people are better served by in-person care, and we would rather tell you that up front.
- General health: documented healthy kidney and liver function from recent labs.
- Low complexity: no conditions that need frequent dose changes to other high-risk medications.
If any of the following apply, your care is usually best managed by your primary care clinician or a specialist. These are not always a no for the medication itself, but they need a level of monitoring we cannot provide virtually.
- Insulin use: needs real-time dose adjustments to prevent dangerous drops in blood sugar.
- Diabetic retinopathy: needs close coordination with an ophthalmologist.
- Complex medical history: including moderate organ impairment or a recent major cardiac event.
Not sure where you fall? Answer the questionnaire and a prescriber will review your history with you before anything is prescribed.
Starting Therapy5 items
Do I need labs before starting?
In most cases, yes.
- HbA1c
- Metabolic panel (kidney and liver function)
- Lipid panel
- Thyroid panel (TSH)
Labs completed within the past 12 months may be accepted. All results are reviewed by your prescriber before a prescription is written and can increase the likelihood of insurance coverage.
Do I need a video visit with a prescriber?
Berry Street requires a live video visit to establish care before a GLP-1 can be prescribed. This follows state telehealth prescribing rules and is the standard for safe prescribing. Later follow-ups may be done asynchronously, depending on your state and clinical needs.
What's the starting dose, and how does it change over time?
Every GLP-1 begins at the lowest available dose and increases gradually over time to minimize digestive side effects. Typical starting doses are 0.25 mg weekly for Wegovy and Ozempic, and 2.5 mg weekly for Zepbound and Mounjaro. Dose increases usually happen every four weeks, based on how well you are tolerating the medication and how you are responding.
What should I do if I miss a dose?
- Semaglutide (Wegovy, Ozempic): if fewer than 5 days have passed, take it as soon as you remember. If more than 5 days have passed, skip that dose and resume your usual weekly schedule.
- Tirzepatide (Zepbound, Mounjaro): if fewer than 4 days have passed, take it as soon as you remember. If more than 4 days have passed, skip that dose and resume your usual weekly schedule.
Take the missed dose on the same day you remember, then continue your normal schedule.
What if I stop or pause my medication?
If you stop or pause for any reason, you'll need to restart at a low dose and titrate back up. Do not resume at your previous dose. Restarting gradually helps avoid severe side effects.
Side Effects & Safety6 items
What are the most common side effects?
The most common side effects are digestive and are usually worst in the first few weeks or just after a dose increase. They typically improve as your body adjusts.
- Nausea (about 28–44% of people)
- Diarrhea (23–30%)
- Vomiting (13–24%)
- Constipation (11–24%)
- Abdominal pain or bloating (10–20%)
Most symptoms are mild to moderate. Fewer than 10% of clinical trial patients stopped treatment because of side effects.
Full prescribing and safety information for every medication Berry Street clinicians prescribe is on the medication disclaimers page.
How can I manage the digestive side effects?
Eat small meals every 3–4 hours, eat slowly and stop when full, avoid high-fat, greasy, or spicy foods (especially after dose increases), limit carbonated drinks and alcohol, and try ginger or peppermint tea. Don't skip meals, because going too long without eating can make nausea worse.
Drink 2–3 liters (8–12 cups) of water daily, gradually increase fiber from fruits, vegetables, and whole grains, stay active, and consider over-the-counter options like psyllium (Metamucil), docusate (Colace), or polyethylene glycol (MiraLAX).
Stay hydrated with water and electrolyte fluids, temporarily avoid high-fat and very high-fiber foods, and contact your care team if symptoms are severe or persistent.
Eat smaller portions, don't lie down for 2–3 hours after eating, and limit irritating spices and high-fat foods. Your clinician may suggest an antacid or acid-reducing medication.
Your Berry Street dietitian is your primary resource for managing side effects through food and lifestyle changes. If symptoms are significantly affecting daily life, ask your primary care physician about a short-term anti-nausea prescription.
When should I seek urgent care?
- Severe abdominal pain that doesn't go away (could signal pancreatitis or gallbladder problems)
- Persistent nausea or vomiting that prevents you from keeping down fluids
- Signs of an allergic reaction (rash, swelling, trouble breathing)
- Sudden vision changes
- Severe dizziness or fainting
In an emergency, call 911 or go to your nearest emergency room.
To report a suspected side effect, contact the FDA at 1-800-FDA-1088 or fda.gov/medwatch.
Do GLP-1s interact with other medications?
They can. If you take insulin or sulfonylureas for diabetes, your risk of low blood sugar goes up, so your prescriber may adjust those doses before you start. Because GLP-1s slow stomach emptying, they can also affect how oral medications absorb. This matters most for birth control pills if you're on tirzepatide (see below). Your prescriber will do a full interaction review as part of your evaluation.
Will I need to change my birth control on tirzepatide?
Possibly. Tirzepatide can reduce the effectiveness of oral birth control because it slows stomach emptying. If you take the pill, you should either switch to a non-oral form (IUD, implant, or injection), or use a backup barrier method (like condoms) for 4 weeks after starting tirzepatide and for 4 weeks after each dose increase. This is specifically a tirzepatide concern and is less of an issue with semaglutide, but discuss it with your prescriber either way.
Do I need to stop the medication before surgery?
Tell both your surgeon and anesthesiologist that you are on a GLP-1. These medications slow stomach emptying, which can raise the risk of complications during anesthesia. Your surgical team will advise on when to pause the medication and when it's safe to resume.
Nutrition, Exercise & Daily Life3 items
What should I eat while taking a GLP-1?
Because these medications reduce your appetite, every bite matters. Your Berry Street dietitian will build a personalized plan for you, but in general you'll focus on fruits, vegetables, whole grains, lean proteins (chicken, fish, eggs, Greek yogurt, cottage cheese, beans), and healthy fats (olive oil, avocado, nuts). You'll want to limit refined carbohydrates, sugary beverages, processed and fried foods, and red or processed meats. Ask your Berry Street dietitian whether a daily multivitamin or specific supplements (like vitamin D, calcium, or B12) make sense for you while your appetite is reduced.
Should I exercise while on a GLP-1?
Yes. This is one of the most important things you can do. When you lose weight through any method, up to 25–40% of the loss can come from muscle rather than fat. Regular exercise, especially strength training, can substantially reduce that muscle loss and help preserve bone density.
- Start with movement. Aim for 150 minutes per week of moderate activity (brisk walking, cycling, swimming) or 75 minutes of vigorous activity.
- Add strength training. Shoot for 2–3 sessions per week: weights, resistance bands, bodyweight, or fitness classes all count.
- Keep it combined. The best long-term results come from 30–60 minutes of daily aerobic activity plus 2–3 strength sessions per week. Older adults should add balance and mobility work too.
Exercise also independently improves blood sugar, blood pressure, cholesterol, mood, and energy.
Can I drink alcohol?
There's no direct interaction between GLP-1 medications and alcohol, but alcohol can affect blood sugar and may make nausea worse. Talk with your care team about what level of consumption is right for you.
Cost & Access5 items
Why is the manufacturer price so much lower than retail?
Manufacturer direct-to-patient programs (NovoCare and LillyDirect) skip the traditional supply chain (wholesalers, pharmacy benefit managers, and retail pharmacies), so they can offer the same medication at a much lower price. Retail cash prices for branded GLP-1s usually exceed $1,000 per month.
Can I use insurance AND the cash-pay program?
No. NovoCare and LillyDirect cash-pay pricing is for self-pay patients only, so you can't submit these prescriptions to insurance for reimbursement. If your insurance covers the medication with a manageable copay, going through insurance is usually the better option.
My insurance doesn't cover GLP-1s. What are my options?
- Wegovy or Ozempic through NovoCare: $149–$349 per month
- Zepbound through LillyDirect: $299–$699 per month
- Retail pharmacy with GoodRx or similar discount programs (typically still $900 to $1,300 per month)
- Prior authorization appeal if your plan covers GLP-1s for diabetes but denied a weight management claim. Your care team can help
How does the Zepbound Journey Program work?
To keep the discounted price of $449 per month on doses 7.5–15 mg, you must refill within 45 days of receiving your previous order. Miss that window and pricing resets to the standard rate (up to $699 per month). Berry Street sends a refill reminder around day 30–35 to help you stay on schedule.
Are compounded GLP-1 medications safe?
We don't recommend them. Compounded GLP-1s are not FDA-approved and have been linked to dosing inconsistencies and serious adverse events. With the 2025 resolution of national drug shortages, FDA enforcement flexibility for compounded GLP-1s has ended. Berry Street prescribes only FDA-approved brand-name medications through licensed pharmacies.
If you are considering a compounded GLP-1 from another provider, talk to your Berry Street clinician first.
Ongoing Care & Long-Term Questions6 items
How will I know if the medication is working?
Your prescriber monitors progress monthly while your dose is still increasing, then at least quarterly. Signs the medication is working include losing at least 5% of your body weight within the first three months at full dose, reduced appetite or feeling full sooner, and improvements in blood sugar, blood pressure, or cholesterol. Because doses titrate slowly, it may take several months at full dose to know the complete picture.
How much weight can I expect to lose?
Weight loss varies from person to person.
- Wegovy (semaglutide): average of 14.9% body weight lost over 68 weeks; about 86% of patients lost at least 5% and 51% lost 15% or more.
- Zepbound (tirzepatide): average of 15.0–20.9% body weight lost over 72 weeks depending on dose; on higher doses, 89–91% lost at least 5% and 50–57% lost 20% or more.
Real-world results can be somewhat lower than trials. Weight loss is typically fastest in the first 6 months and plateaus around 12–18 months. Results are best when the medication is paired with healthy eating and regular activity.
What if the medication isn't working for me?
If you've lost less than 5% of your body weight after three months at the full dose, with no change in appetite, your prescriber will reassess. Options include reviewing technique, increasing the dose if you haven't reached the maximum, or switching to a different medication. Response varies, and not responding to one GLP-1 doesn't mean another won't work.
How long will I need to take a GLP-1?
GLP-1 therapy is a long-term treatment, similar to managing high blood pressure or cholesterol.
Because clinical studies show most patients regain one-half to two-thirds of their weight within a year of stopping, consistency is key. Your duration of treatment is a collaborative decision made with your prescriber based on your goals, tolerance, and results.
How often will I have follow-up visits?
- A first titration check at week 4
- Monthly visits while your dose is still increasing (usually months 2 to 6)
- Quarterly visits once you are on a stable dose
- Labs (HbA1c, metabolic panel) repeated every 6 to 12 months Your dietitian visits continue on Berry Street's regular schedule, integrated with your GLP-1 therapy goals.
Will I need prior authorization if I use insurance?
Most insurance plans require prior authorization for GLP-1s prescribed for weight management.
- Documented BMI
- Evidence of 3 to 6 months of supervised diet and exercise
- Recent labs
- Sometimes a prior trial of a different weight-loss medication
Your Berry Street dietitian's notes can help document the supervised lifestyle requirement, which is often the hardest piece for patients to evidence on their own.
This guide is for educational purposes and does not replace medical advice from your care team. Pricing was last reviewed in August 2026 and is subject to change.
Medication pricing at a glance5 items
Prices shown are cash-pay only, with no insurance, through each manufacturer's direct-to-patient program. All prices are for a 28-day supply. Confirm current pricing with your care team.
Zepbound® (tirzepatide)
FDA-approved for chronic weight management and obstructive sleep apnea. Available cash-pay through LillyDirect.
- Typically the most affordable tirzepatide option for weight management; ships to your home in cold-chain packaging.
- Two tiers: standard pricing, open to anyone, and the Self-Pay Journey Program, discounted for patients who refill on time.
| Dose | Format | Monthly cost |
|---|---|---|
| 2.5 mg | Vial | $299 / month |
| 5 mg | Vial | $399 / month |
| 7.5 mg and higher | Vial or KwikPen | $499 to $699 / month |
The Journey Program applies to 7.5 mg and higher doses. To qualify, refill within 45 days of receiving your previous order. Missing that window resets you to the standard rate on your next fill.
| Dose | Format | Monthly cost |
|---|---|---|
| 7.5 mg | Vial or KwikPen | $449 / month |
| 10 mg | Vial or KwikPen | $449 / month |
| 12.5 mg | Vial or KwikPen | $449 / month |
| 15 mg | Vial or KwikPen | $449 / month |
Wegovy® (semaglutide)
FDA-approved for chronic weight management and reducing cardiovascular risk. Available cash-pay through NovoCare Pharmacy, as either a weekly injectable pen or a daily pill.
Starting doses come with introductory pricing for your first two months.
| Dose | Format | Monthly cost |
|---|---|---|
| 0.25 mg | Weekly pen | $199 first 2 months, then $349 |
| 0.5 mg | Weekly pen | $199 first 2 months, then $349 |
| 1 mg | Weekly pen | $349 / month |
| 1.7 mg | Weekly pen | $349 / month |
| 2.4 mg | Weekly pen | $349 / month |
| 1.5 mg | Daily pill | $149 / month |
| 4 mg | Daily pill | $199 / month |
| 9 mg | Daily pill | $299 / month |
| 25 mg | Daily pill | $299 / month |
Ozempic® (semaglutide)
FDA-approved for Type 2 diabetes, and the same active ingredient as Wegovy. Cash-pay pricing is available through NovoCare Pharmacy.
- Best option if you are being treated for Type 2 diabetes rather than weight management alone.
- Introductory pricing applies to the two starting doses; ask your care team to confirm.
| Dose | Format | Monthly cost |
|---|---|---|
| 0.25 mg | Weekly pen | $199 first 2 months, then $349 |
| 0.5 mg | Weekly pen | $199 first 2 months, then $349 |
| 1 mg | Weekly pen | $349 / month |
| 2 mg | Weekly pen | $349 / month |
Mounjaro® (tirzepatide)
FDA-approved for Type 2 diabetes, and the same active ingredient as Zepbound. Self-pay pricing is now available through LillyDirect; confirm current pricing with your care team.
If you are paying out of pocket and using tirzepatide for weight management, Zepbound through LillyDirect is typically a more affordable route.
| Dose | Format | Monthly cost |
|---|---|---|
| 2.5 mg to 15 mg | Weekly pen | $1,000 to $1,300 / month (retail) |
Foundayo® (orforglipron)
FDA-approved for chronic weight management, approved April 2026. A once-daily pill available cash-pay through LillyDirect.
Offered on the same LillyDirect platform as Zepbound, with standard and Journey loyalty pricing.
| Dose | Format | Monthly cost |
|---|---|---|
| 0.8 mg | Daily pill | $149 / month |
| 2.5 mg | Daily pill | $199 / month |
| 5.5 mg | Daily pill | $349 / month |
| 9 mg | Daily pill | $349 / month |
| 14.5 mg | Daily pill | $349 / month |
| 17.2 mg | Daily pill | $349 / month |
Manufacturer prices can change, and the tier you qualify for depends on your dose and refill timing. Your care team confirms current pricing before you order.
Please check the medication packaging for the full list of side effects, warnings and interactions.
To report a suspected side effect, contact the FDA at 1-800-FDA-1088 or fda.gov/medwatch
In an emergency, call 911 or go to your nearest emergency room.
Safety info: GLP-1 medications can have serious side effects, including possible thyroid tumors. Do not use if you or a family member has had a type of thyroid cancer called MTC, or if you have MEN 2. See more warnings and safety information
Prices shown are cash-pay only, through each manufacturer’s direct-to-patient program, and are not insurance coverage. Manufacturer pricing can change, and the tier you qualify for depends on your dose and refill timing. Insurance coverage and costs vary by plan, formulary, diagnosis, deductible, copay, prior authorization, pharmacy, and savings-program eligibility.
Berry Street is not affiliated with Novo Nordisk or Eli Lilly. Wegovy, Ozempic, Zepbound, Mounjaro and Foundayo are trademarks of their respective owners. This page is provided for informational purposes only and is not medical advice. Talk to your Berry Street clinician about whether a GLP-1 is right for you.
Explore GLP-1s with
Berry Street today
Excellent
Rated 4.9 / 5 based on 864 reviews on Trustpilot
Safety info: GLP-1 medications can have serious side effects, including possible thyroid tumors. Do not use if you or a family member has had a type of thyroid cancer called MTC, or if you have MEN 2. See more warnings and safety information
© Copyright 2026 Berry Street
© Copyright 2026 Berry Street
© Copyright 2026 Berry Street