On September 19, 2025, the FDA issued Import Alert 66-80, which authorizes field staff to detain without physical examination shipments of GLP-1 active pharmaceutical ingredients (APIs) from manufacturers not included on its newly established Green List.[1] This action follows FDAs September 5 th announcement of the Green List initiative to curb illegal imports of semaglutide, tirzepatide, and other corresponding APIs.[2] Together, the Green List and Import Alert form FDAs most aggressive enforcement measures to date against GLP-1 imports
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A recent meta-analysis including 6 trials and 4744 participants indicated that semaglutide reduced DBP by 2.5 mmHg in obese patients without DM [39]
Throughout the study, participants were advised to eat a healthy diet and exercise with the goal of weight loss
In many cases, the answer involves cutting corners somewhere in the quality chain: using lower-cost API from questionable sources, reducing testing, operating in substandard facilities, or skipping cold-chain shipping
