Washington, DC

Yes. Compounded semaglutide prescribed by a DC-licensed provider and dispensed by a licensed compounding pharmacy is legal when prepared for an individual patient with a documented clinical need. Pallas works only with U.S. state-licensed 503A and 503B compounding pharmacies.

DC Medicaid covers GLP-1s for type 2 diabetes with prior authorization. Coverage for weight-management indications is limited. Compounded GLP-1s are not covered. Pallas is a cash-pay service, so Medicaid rules do not apply to our prescriptions.

Yes — through a live video visit. Under District of Columbia Board of Medicine telemedicine rules, a DC-licensed provider establishes the provider-patient relationship through a real-time encounter when there has been no prior in-person visit, but you never have to travel to a physical office. Your video consultation is with a provider licensed in the District of Columbia.

Most DC patients receive their medication within 2–3 business days of the pharmacy filling the prescription. Delivery times are consistent across the District — Georgetown, Capitol Hill, Columbia Heights, and every other neighborhood typically see the same fast shipping.

Pallas is a cash-pay telehealth service — there is no insurance to bill. Your Pallas Membership covers your clinician's review, ongoing check-ins, and care-team messaging; the medication is billed separately and ships free to your DC address, only when a clinician prescribes it. You see your full price during intake before you pay anything — no surprise renewal markups. The price is the same whether you are in Georgetown, Columbia Heights, or anywhere else in the District.

Eligibility is always decided by a DC-licensed clinician after your intake and video visit, never by an automated quiz. In general, GLP-1 medications for weight management are considered for adults with a BMI of 30 or higher, or a BMI of 27 or higher together with a weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol, or obstructive sleep apnea. Your clinician also reviews your medical history and current medications to confirm a GLP-1 is appropriate and safe for you, and will tell you if it is not.

Brand-name medications — Wegovy^® and Ozempic^® (semaglutide) and Zepbound^® and Mounjaro^® (tirzepatide) — are FDA-approved products from their manufacturers, offered cash-pay. Compounded semaglutide and tirzepatide are prepared on a per-patient basis by US-licensed compounding pharmacies, regulated under federal law (FDCA §503A) and by state boards of pharmacy, when a clinician documents a patient-specific clinical need. While these pharmacies are highly regulated, the compounded medications themselves are not FDA-approved, are not generic versions of brand-name drugs, and have not been evaluated by the FDA for safety, efficacy, or quality. Which option fits you is a clinical decision you make with your DC-licensed provider.

Yes, many patients transfer their care to Pallas. During your video visit you tell your clinician which medication and dose you take now and how you have tolerated it. Your DC-licensed provider reviews that history and, if appropriate, continues you at a comparable dose or adjusts your titration plan. Do not stop or change a prescription on your own — let your clinician guide any transition.

Often, yes. During intake you list every prescription, over-the-counter medication, and supplement you currently take, and your DC-licensed clinician reviews that list for interactions before prescribing. Common medications like metformin, blood pressure medication, and hormonal birth control don't automatically rule you out — your clinician weighs your full history and tells you directly if a GLP-1 isn't appropriate alongside something you're taking.

Most patients use a once-weekly injection with a very fine needle, but a compounded oral semaglutide tablet is available for people who would rather not inject. Both are prescribed only after a clinician confirms they are appropriate for you, and your provider can help you weigh which form fits your routine and goals.

The most common side effects are gastrointestinal — nausea, constipation, diarrhea, or reflux — and they are usually mildest when the dose is raised slowly, which is why clinicians titrate up gradually. GLP-1s are not right for everyone; they are avoided in people with a personal or family history of medullary thyroid carcinoma or MEN2, and during pregnancy. Your Pallas clinician screens for these before prescribing and stays available to help you manage any side effects.

You complete a detailed online intake sharing your health history, goals, and current medications, then meet with a clinician licensed by the District of Columbia Board of Medicine over live video — the District requires this real-time visit to establish your provider relationship. After that first visit, most ongoing care, including check-ins, dose adjustments, and refill questions, can be handled asynchronously by secure message. If a GLP-1 is appropriate, your prescription goes to a licensed pharmacy that ships to any address in the District, usually within 2–3 business days.

After your DC-licensed clinician approves your prescription, your first shipment ships to your address and most patients start on a low dose that's titrated up gradually to help minimize side effects like nausea. Your care team checks in by secure message during the first few weeks to see how you're tolerating the medication, and your clinician can adjust your dose directly in the app if needed — a separate visit usually isn't required. You can message your care team with questions at any point.

Pallas care is ongoing, not a one-time script. Your plan renews on a regular cadence so your medication arrives before you run out, and your clinician schedules check-ins to monitor your response, adjust your dose, and manage side effects. You can message your care team, change your plan, or cancel anytime from your patient portal — no phone calls or retention hoops.

Compounded semaglutide injection through Pallas is $139 for your first month, then $597 every 12 weeks ($199/mo average). Cancel anytime. That one plan price includes your US-licensed provider, ongoing check-ins, dose adjustments, and unlimited care-team messaging — no separate membership fee. Medication ships free to any Washington, DC address, only if a clinician prescribes it, and you are refunded in full if a clinician decides treatment isn't right for you.

Compounded tirzepatide injection through Pallas is $179 for your first month, then $897 every 12 weeks ($299/mo average). Cancel anytime. That one plan price includes your US-licensed provider, ongoing check-ins, dose adjustments, and unlimited care-team messaging — no separate membership fee. Medication ships free to any Washington, DC address, only if a clinician prescribes it, and you are refunded in full if a clinician decides treatment isn't right for you.

Yes. FDA-approved Wegovy^® and Zepbound^® for chronic weight management — plus Ozempic^® and Mounjaro^® for type 2 diabetes — are available to Washington, DC patients cash-pay from $1069/mo; insurance is not billed. Whether a brand-name or compounded medication is appropriate for you is determined by a clinician licensed in Washington, DC during intake.

That is a decision you make with your clinician. Semaglutide activates the GLP-1 receptor; tirzepatide activates both the GLP-1 and GIP receptors. In the SURMOUNT-5 head-to-head trial of the FDA-approved products, Zepbound^® (tirzepatide 10 mg or 15 mg weekly) produced greater average weight loss than Wegovy^® (semaglutide 1.7 mg or 2.4 mg weekly) — 20.2% versus 13.7% of body weight over 72 weeks. Wegovy^®'s maximum dose is now 7.2 mg weekly, which was not studied in SURMOUNT-5; in the separate STEP UP trial it reached 18.7% average weight loss over 72 weeks. Clinical trial outcomes for the FDA-approved products have not been established for compounded preparations. Individual results vary. Semaglutide plans cost less and semaglutide has the longer post-market record; a clinician licensed in Washington, DC weighs your history, goals, and budget to recommend a starting point.