Availability is set programme by programme and changes without notice — including after you have enrolled.
Programme service maps continue to change without announcement. A handful of states appear on exclusion lists repeatedly, driven by stricter rules on non-resident pharmacies, telehealth prescribing or compounded preparations rather than by clinical judgement.
Two licences have to line up for any shipment: the prescriber must hold one in your state, and the pharmacy must be registered to ship into it. A gap in either closes the route.
The practical consequence is that any published state list, including ours, is a starting point. The binding answer appears at checkout, and it can change at renewal.
If you live in a state that appears on exclusion lists, ask about continuity specifically: what happens to your prescription if the programme's map changes mid-course.
Sources
- Programme service maps and state board licensure records, 2026
Dated 2026-03-20. If this item is out of date or wrong, tell us through contact and the change is logged in corrections.
Primary sources
Clinical, dosing and regulatory statements on this page rest on the documents below. Links go to the publisher, not to a summary of it. Prices are not sourced here — they carry a verification date instead, and the reason is set out in the source ledger.
- ZEPBOUND (tirzepatide) full prescribing information — DailyMed, US National Library of Medicine. Dose ladder, contraindications, warnings, storage.
- FDA’s concerns with unapproved GLP-1 drugs used for weight loss — US Food and Drug Administration. Compounded GLP-1 risks, API import alert, cold-chain complaints.
- FD&C Act provisions that apply to human drug compounding — US Food and Drug Administration. Why a compounded preparation is lawful without being FDA-approved.
- Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) — N Engl J Med 2022;387:205-216. Registration NCT04184622. The weight-reduction and adverse-event figures used across this site.
- The full source ledger — every primary source, what it supports, the date we read it, and the claims we deliberately do not source.