A colleague brings it up on break, an ad scrolls by on your phone, a cousin swears he found the same product on an unknown website. GLP-1 medications take up a lot of space in conversations, and the information going around is not always reliable. Here is where GLP-1 comes from in the body, what a class of prescription drugs is, what an assessment by a health professional covers, which pitfalls to avoid and which questions to ask. The choice of a treatment is made during a consultation, never alone in front of a screen.
On this page
- GLP-1, a hormone the body already makes
- A class of prescription medications, not a single product
- What an assessment by a clinician covers
- Known side effects and precautions for the class
- Counterfeit products and online purchases: the risk to avoid
- Coverage: what varies with the product and the indication
- Other approaches and their limits
- Questions to ask your health professional
- Myths and misconceptions
- Frequently asked questions
- Sources
GLP-1, a hormone the body already makes
Before it was the name of a class of medications, GLP-1 was a hormone that the body makes on its own. Its full name, glucagon-like peptide-1, refers to a molecule released in the intestine in response to food intake, as explained by Diabetes Quebec in its magazine Dia·Logue.
What happens after a meal
According to this source, the hormone stimulates the release of insulin by the pancreas when blood sugar is high, while reducing the secretion of glucagon, a hormone that raises blood sugar. It also slows the emptying of the stomach, which prolongs the feeling of fullness. These adjustments are part of how the body normally works: they happen without you thinking about it, between bites.
What physiology does not tell you
Understanding a hormone says nothing about the effect a specific medication will have on a specific person. The name of the class refers to this hormone, nothing more. What a given product does, for whom and with what risks is a matter for its product monograph and a professional’s judgment.
A class of prescription medications, not a single product
A class of medications groups products that share a target in the body, but each product keeps its own sheet: its indications, contraindications, adverse effects and how it is given. The medications discussed here are prescription drugs, and this text describes the class without recommending any of them. In the public sphere, they are mostly discussed in connection with type 2 diabetes and obesity.
Which medications belong to this class
In Canada, this class includes the following licensed products, among others, grouped by active ingredient. This list sets no order of preference and does not say which one might suit a given person.
- Semaglutide: Ozempic, Wegovy, Rybelsus
- Liraglutide: Saxenda, Victoza
- Dulaglutide: Trulicity
- Tirzepatide, which also acts on GIP, another gut hormone: Mounjaro, Zepbound
Where to find a product’s indications
Each product has indications authorized by Health Canada, set out in its product monograph. This document can be found in Health Canada’s Drug Product Database where you can search by drug identification number (DIN), by classification code, or by product or company name.
What no document replaces
A monograph describes a product in general. It does not say whether it is right for a particular person. Eligibility for a treatment and the choice of a product depend on a clinician’s assessment.
To remember
- GLP-1 is a natural hormone, released by the intestine after a meal.
- A class of medications brings together several products, each with its own indications.
- A product’s authorized indications are set out in its monograph, available in the Health Canada database.
- Eligibility and the choice of a treatment depend on a clinician’s assessment.
- Counterfeit or unauthorized products sold online carry risks that Health Canada has documented.
- Several approaches exist, and none is the best for everyone.
What an assessment by a clinician covers
A clinical assessment is not a form to fill out in order to get something. It is a structured conversation, led by a doctor or another qualified professional, that serves to understand the situation before discussing any option. For adult obesity care, the Canadian guidelines fromObesity Canada state that a clinical assessment is needed to guide the choice of an approach, that it may include a physical examination and a mental health assessment, and that professionals must conduct it without judgment.
What gets discussed
The conversation starts with personal and family medical history, any current or planned pregnancy and breastfeeding, then covers everything the person already takes: prescription medications, over-the-counter products, natural products, supplements. This list matters because Health Canada reports a risk of hypoglycemia, especially in combination with other medications. Next come lifestyle habits, sleep, stress and the person’s expectations.
Follow-up and shared decision-making
An assessment ends neither with an automatic prescription nor with an automatic refusal. It leads to a plan: what will be done, what will be monitored, when you will talk again. Diabetes Quebec stresses this point: the decision to use this type of medication is made together with the doctor, the pharmacist or the nurse, based on the person’s individual needs and tolerance.
Known side effects and precautions for the class
Every prescription medication has side effects, and it is better to know them than to fear or ignore them. Some situations must be raised before any decision, because they can rule out a drug in this class: pregnancy, planning a pregnancy, breastfeeding, medullary thyroid cancer in yourself or your family, or multiple endocrine neoplasia type 2. Contraception is part of that discussion, and a pregnancy that occurs during treatment should be reported without delay.
Digestive effects
Diabetes Quebec writes that gastrointestinal side effects are common with this class: nausea, vomiting, diarrhea, constipation. They tend to ease over time, but they can be uncomfortable enough for some people to stop treatment. The organization also notes practical drawbacks to weigh: the cost and, for several products, the need for injections.
Rarer but known risks
In its public advisory, Health Canada lists among the known risks of the class serious gastrointestinal problems, pancreatitis, worsening kidney damage and hypoglycemia, particularly when these medications are used with other medications. Diabète Québec states that pancreatitis remains rare and that doctors closely monitor the people concerned. This is one of the reasons for follow-up. Health Canada has also established a possible link between this class and an increased risk of pulmonary aspiration, meaning the passage of stomach contents into the lungs, during a procedure under general anesthesia or deep sedation. This treatment should therefore be mentioned to the care team before such a procedure.
When to consult, and who to tell
A symptom that worries you, persists or gets worse warrants a call to your healthcare professional or to Info-Santé at 811. The product monographs for this class also name specific warning signs. Severe, persistent abdominal pain, with or without vomiting, sudden pain with fever or yellowing of the skin, or vomiting and diarrhea that cause extreme thirst or dizziness call for immediate medical attention. Call 911 for difficulty breathing, swelling of the face or throat, significant confusion, loss of consciousness or seizures. A lump in the neck, persistent hoarseness, a vision problem or a worrying change in mood should be reported promptly to your healthcare professional. Thoughts of suicide call for immediate help: call 811 or, if there is immediate danger, 911. Health Canada also invites people to report to it any side effect related to a health product.
Counterfeit products and online purchases: the risk to avoid
The counterfeit products follow the craze. Health Canada states this in the notice cited above: retailers across the country sell unauthorized products of this class, in stores and online, and some websites and ads misuse its logos and display fake testimonials. Yet Health Canada never endorses a health product and does not allow its logo to be used in the advertising or packaging of these products.
What a questionable product may or may not contain
According to this advisory, an unauthorized or counterfeit medication may contain too much, too little or none of the active ingredient, unlisted, dangerous or unknown ingredients, or contaminants such as solvents, heavy metals, particles or microorganisms. Injectable products add the risk of infection from a lack of sterility and of allergic reaction. TheQuebec Order of Pharmacists describes buying online without a prescription in the same terms: unknown origin, no quality control, danger of contamination, no medical or pharmaceutical follow-up.
Check before you buy
- Buy a prescription medication only from a licensed pharmacy: in Canada, only licensed pharmacies can legally sell them.
- Look on the label for the eight-digit drug identification number (DIN), then check it in the Health Canada database.
- Do not buy or use products labelled “for research use only, not for human consumption”: according to Health Canada, this wording does not make them legal.
- Be wary of fake testimonials, misused official logos and websites that require neither a prescription nor a conversation with a professional.
If a questionable product has already been used
Health Canada asks people to stop using the product, to see a healthcare professional without delay if they feel unwell or are concerned, to return the product to a pharmacy for safe disposal and to report the problem. To learn how to verify a source, our article on false health information offers simple guidance.
A question about a product you saw online, a concern or simply the wish to talk it over with a professional? You can book an appointment at a clinic or consult online, throughout Quebec.
Coverage: what varies with the product and the indication
The coverage of a prescription medication in Quebec depends on several things at once: the product, the indication it is prescribed for, the person’s plan and, at times, special conditions.
The public plan
The List of Medications, published by the Régie de l’assurance maladie du Québec (RAMQ), includes exception medications: their cost is covered by the general plan in the cases, under the conditions or for the indications that the minister determines by regulation. According to theINESSS, payment is guaranteed only for indications recognized by the Institute. Diabète Québec also notes that medications prescribed solely for obesity are not reimbursed by the public plan.
Private insurance
Conditions may also differ depending on whether coverage comes from the RAMQ or from group insurance or an employee benefit plan, INESSS points out. Diabetes Quebec adds that more and more private insurers are asking for a justification before covering a treatment in this class.
| Question to ask | Where to find the answer |
|---|---|
| Is this product on the List of Medications? | The pharmacist, or the RAMQ List of Medications |
| Does a special condition apply, as with an exception drug? | The prescriber, and the INESSS page on exception drugs |
| Does my group insurance cover it, and under what conditions? | The insurer or benefit plan, before you buy |
Other approaches and their limits
There are several options for taking care of your health, and none is right for everyone. The Canadian guidelines fromObesity Canada put it in their own way when it comes to psychological interventions: there is no single path, and goals must be individualized, important to the person and not only to the clinician.
Nutrition
The guidelines recommend personalized nutrition advice based on each person’s values, preferences and goals, with the support of a dietitian-nutritionist when one is available. Its limit has to do with time: the approach must be realistic and affordable so that it can be kept up over the long term. A consultation with a nutritionist can also take place remotely, as described on our page about seeing a nutritionist online.
Physical activity
The guidelines specify that weight should not be the only measure of success for physical activity. Moving regularly can also improve cardiorespiratory fitness, mood and body image. Its limit: it requires consistency and must be adapted to each person’s physical condition.
Sleep, stress and psychological support
Sleep and stress are part of what a professional can discuss with the person. Psychological and behavioural interventions aim for lasting change. Their limit: you need to find a clinician trained in behaviour change, and the right combination varies from one person to another.
Bariatric Surgery
Bariatric surgery is one option among others, within a strict framework. The guidelines call for a complete medical and nutritional assessment before the procedure, mental health screening, then long-term follow-up: lifelong nutritional supplements, an eating and exercise plan, follow-up appointments. Complications can occur. Whether it is indicated is decided case by case, with a specialized team.
Questions to ask your health professional
Coming to a consultation with written questions changes the quality of the conversation. A person who brings a screenshot of a website, the list of their medications and three specific questions gives the clinician something to work with. The following table suggests topics to raise.
| Topic to raise | Why it helps |
|---|---|
| My medical history and my family’s | They help determine what is safe and what calls for more caution: medullary thyroid cancer in the family, pancreatitis, gallbladder, kidney or liver disease, diabetic retinopathy, depression. |
| Everything I take, including natural and over-the-counter products | Interactions and the risk of hypoglycemia linked to certain combinations can only be spotted with the complete list. |
| My expectations and what matters to me | Goals must be important to the person, not only to the clinician. |
| The possible options, with or without medication, and their limits | A shared decision means knowing all the paths. |
| Side effects to watch for and the planned follow-up | Knowing what to watch for and when to call back avoids both waiting too long and worrying for nothing. |
| Coverage and the steps to take | This avoids unpleasant surprises with the RAMQ or the insurer. |
The pharmacist, another person to talk to
L'Quebec Order of Pharmacists writes that doctors and pharmacists are the professionals best placed to help, and encourages people to share their situation with them. Our article on what a pharmacist can prescribe in Quebec explains what the profession can do.
Myths and misconceptions
A product everyone is talking about must be safe
False. Popularity is not an assessment. Health Canada reports websites that use fake testimonials and its own logos to mislead consumers.
Buying online is the same as buying from a pharmacy
False. In Canada, only licensed pharmacies can legally sell prescription drugs. A website that requires neither a prescription nor a conversation with a professional shows the warning signs described by the Ordre des pharmaciens du Québec. Health Canada explains that an online pharmacy may be legitimate if it requires a valid prescription, is licensed by a Canadian pharmacy regulatory body and has a pharmacist available to answer questions.
A medication that suits one person suits those around them
False. Every situation is individual. Health Canada points out that a health professional can help determine whether a product is right for the person.
The side effects of a prescription medication are always mild
Nuanced. Digestive effects are common and tend to ease, according to Diabetes Quebec. Health Canada, however, also lists more serious harms among the known risks of the class, hence the importance of follow-up.
There is one right approach for everyone
False. The Canadian guidelines speak of several paths and individualized goals. No option is the best for everyone.
Frequently asked questions
What does GLP-1 mean?
GLP-1 stands for glucagon-like peptide-1. It is a natural hormone, released in the intestine in response to food intake. The same abbreviation is also used to name a class of prescription medications.
Which medications belong to the GLP-1 class?
In Canada, the class includes semaglutide (Ozempic, Wegovy, Rybelsus), liraglutide (Saxenda, Victoza), dulaglutide (Trulicity) and tirzepatide (Mounjaro, Zepbound), which also acts on another hormone, GIP. This list recommends no product: the choice comes from an assessment by a health professional.
Are GLP-1 medications sold without a prescription?
No. They are prescription medications, and Health Canada points out that in Canada only licensed pharmacies can legally sell prescription medications. A website offering them without a prescription should raise suspicion.
How can you recognize a counterfeit or unauthorized product?
Look on the label for the eight-digit drug identification number (DIN), then check it in Health Canada’s Drug Product Database. This check rules out unauthorized products, but it is not enough: a counterfeit product can look identical to the approved drug. So buy only from a licensed pharmacy. If in doubt, the pharmacist can help.
Who decides whether a treatment in this class is appropriate?
An individual assessment by a clinician, meaning a physician or another professional authorized to prescribe. It takes into account medical history, any current or planned pregnancy, breastfeeding, medications already taken and the person’s expectations. The decision is made in collaboration with the professional.
Does the RAMQ or private insurance cover these medications?
It depends on the product, the indication and the plan. The public plan does not reimburse medications prescribed solely for obesity. The List of Medications includes exception medications, paid for according to indications recognized by INESSS. Group insurance plans have their own conditions. The prescriber and the pharmacist can guide the process, and the insurer confirms coverage.
Sources
- Health Canada, Recalls and safety alerts: public advisory on counterfeit or unauthorized products in the GLP-1 class
- Health Canada, public advisory: injectable peptides bought online and unauthorized products
- Health Canada, Drug Product Database
- INESSS, Exception drugs
- Obesity Canada, Canadian Adult Obesity Clinical Practice Guidelines
- Diabetes Quebec, Dia·Logue magazine: article on GLP-1 agonists (PDF, in French)
- Ordre des pharmaciens du Québec, blog: Buying your medications online? No! (in French)
- Health Canada, summary safety review: GLP-1 receptor agonists and pulmonary aspiration
- Health Canada, Counterfeit prescription drugs
- Health Canada, Choosing a safe online pharmacy
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