Affiliate disclosure
We earn a commission if you sign up with Ivy Rx through the links on this page. It did not buy a favourable review.
Ivy Rx is a US telehealth provider founded in 2023 by Phong Truong, PharmD, selling compounded semaglutide from around $165 a month on longer plans and compounded tirzepatide from $275. It gets two important things right that most of this market gets wrong: the price does not rise as your dose does, and it publicly names the pharmacies that compound your medication. With more than 3,800 Trustpilot reviews it also has a real evidence base. The problem is what a meaningful minority of those reviews describe: packages that never showed up.
Overview
Ivy Rx is pharmacist-founded, which shows in the disclosure. It claims more than 200,000 members — a figure we could not verify and report as a company claim — and includes 24/7 provider access and temperature-controlled shipping in its programme. Temperature-controlled shipping is a real inclusion for a cold-chain product that most providers do not mention at all.
Ivy Rx at a Glance
| Medications offered | Compounded semaglutide and compounded tirzepatide; brand-name available but not competitively priced |
|---|---|
| Brand-name or compounded | Compounded — not FDA-approved |
| Consultation process | Online intake with clinician review; 24/7 provider access included |
| Eligibility | Assessed at intake; criteria not published in detail |
| Provider involvement | 24/7 provider access included in the programme |
| Lab requirements | Not stated as required |
| Pharmacy fulfillment | Named — Greenwich RX and ERXHub, described as 503B and USP <797> compliant |
| Shipping frequency | Temperature-controlled shipping included; non-delivery is the leading complaint |
| Support services | 24/7 provider access; support quality is inconsistent in reviews |
| Membership fees | None published separately |
| Medication fees | Compounded semaglutide from about $165/month on longer commitments, $175–$197 otherwise; compounded tirzepatide $275–$297; brand-name quoted around $1,399 |
| Cancellation policy | Not published in detail |
| Refund policy | Not published in detail |
| Insurance | Not accepted |
| HSA/FSA | Not stated |
| Availability | Not published in detail; US only |
It Names Its Pharmacies
Ivy Rx publicly names its compounding partners — Greenwich RX and ERXHub — and describes both as 503B and USP <797> compliant. That is a specific, checkable claim about the facilities that make your medication.
This matters for the reason the FDA spent early 2026 writing to telehealth companies about: patients frequently cannot tell who compounded the drug they are injecting. Our MEDVi and Strut Health reviews cover warning letters where the brand's own name on the label implied it was the compounder when it was not. Ivy Rx has taken the opposite approach.
Two qualifications. 503B registration means an outsourcing facility subject to more oversight than a 503A pharmacy — a meaningful distinction — but it still does not make the product FDA-approved. And the FDA's 30 April 2026 proposal to exclude semaglutide and tirzepatide from the 503B bulks list targets exactly this supply route, so a 503B-based provider is more exposed to that decision than a 503A one, not less. Greenwich RX also appears as a named partner of Trimi Health.
Pricing and Flat Dose Costs
| Medication | Price | Notes |
|---|---|---|
| Compounded semaglutide | $165–$197/mo | $165 on longer commitments; flat at every dose |
| Compounded tirzepatide | $275–$297/mo | Flat at every dose |
| Brand-name | ~$1,399/mo | Not competitive — buy direct instead |
Flat dose pricing is the feature worth paying for. Most of the compounded market raises the price at each titration step, so the headline you sign up for is not the price you pay at maintenance — see our Maximus review for a provider that does exactly that. Ivy Rx holding the rate flat means the number you are quoted is the number you can budget against.
The level is mid-market: above Trimi Health at $99, comparable to RenewMD. The brand-name quote of around $1,399 is close to full retail and should be ignored — NovoCare Pharmacy sells brand-name semaglutide from $149.
Two Different Companies in the Reviews
Ivy Rx has one of the larger review bases we have assessed — more than 3,800 Trustpilot reviews, averaging around 4 out of 5, with some sources putting it nearer 4.5. That is a real sample, and most of it is positive.
But independent coverage describes Ivy Rx as living "in two worlds: one where everything runs like clockwork, and another where the package just never shows up". Non-delivery is the specific failure mode, and it is the one that matters most for a titrated medication — money gone, treatment interrupted.
That pattern — a strong average with a hard tail of fulfilment failures — is the same shape we found at Fridays. It is not evidence of a bad company so much as an operations problem the company has not solved at scale. Practically: keep a buffer of medication in hand, do not let supply run to zero before the next shipment is confirmed, and use a card with chargeback protection.
Eligibility, Contraindications, and Side Effects
Ivy Rx assesses eligibility at intake but does not publish criteria or a state list. See our eligibility guide.
Semaglutide and tirzepatide carry a boxed warning regarding thyroid C-cell tumours, based on rodent studies. You should not take these medications if you or a family member have had medullary thyroid carcinoma, if you have Multiple Endocrine Neoplasia syndrome type 2, or if you have had a serious hypersensitivity reaction to the active ingredient. They are not for use in pregnancy. A history of pancreatitis, gallbladder disease, gastroparesis or other severe gastrointestinal disease, or diabetic retinopathy, warrants specific discussion first.
Common side effects are gastrointestinal — nausea, vomiting, diarrhoea, constipation and abdominal pain — worst after a dose increase. Serious but less common risks include pancreatitis, gallbladder disease and acute kidney injury from dehydration. The 24/7 provider access is a genuine asset when a dose step goes badly. Our side effects guide covers management, and our storage guide covers what to do when a cold-chain delivery goes wrong.
How Ivy Rx Compares
| Provider | Semaglutide | Flat at every dose | Names pharmacy | Review base | Our rating |
|---|---|---|---|---|---|
| Ivy Rx | $165–$197 | Yes | Yes — two named 503B | 3,800+ reviews | 3.7 / 5 |
| Trimi Health | $99 | Yes | Yes — two named 503A | Tens of reviews | 3.6 / 5 |
| Precision Telemed | $139.99 | Yes | Yes | Established | 4.4 / 5 |
| Cora Health | $99–$175 | Banded ceiling | Yes — PCAB | Established | 4.5 / 5 |
Ivy Rx has by far the largest review base of the flat-price, named-pharmacy group, which counts for something. Precision Telemed and Cora Health both undercut it while matching the disclosure, which is why they rate higher.
Pros and Cons
Pros
- Publicly names both compounding partners, Greenwich RX and ERXHub
- Describes them as 503B and USP <797> compliant
- Flat pricing at every dose — no escalation as you titrate
- Pharmacist-founded, with a named founder
- More than 3,800 Trustpilot reviews averaging around 4 / 5
- 24/7 provider access included
- Temperature-controlled shipping — rarely mentioned elsewhere
- No separate membership fee
Cons
- Recurring reports of orders that never arrive
- Support quality is inconsistent between customers
- More expensive than named-pharmacy rivals at $99–$140
- Brand-name quoted near full retail at about $1,399
- 503B supply is directly exposed to the FDA's pending bulks-list decision
- State coverage, eligibility, cancellation and refund terms not published
- The claimed 200,000+ members could not be verified
- Compounded only; insurance not accepted
Who Should Pick It, and Who Should Look Elsewhere
Ivy Rx suits you if you want named, 503B-compliant pharmacies and a price that will not climb as you titrate, and you value buying from a provider with thousands of reviews rather than dozens. The temperature-controlled shipping and 24/7 provider access are real inclusions.
Look elsewhere if price is the priority — Trimi Health at $99 and Precision Telemed at $139.99 match the flat-price and named-pharmacy combination for less. And if an interrupted supply would be a serious problem for you, the non-delivery reports here deserve weight.
Limitations of This Review
This review is based on independent coverage and review platforms, checked on 7 August 2026. Reported pricing varies between sources ($165, $175–$197) and we could not verify a definitive rate card. We did not independently verify the pharmacies' 503B registrations, the founder's credentials or the claimed membership figure, and we could not locate a BBB rating. State coverage, cancellation and refund terms are not published. The non-delivery reports are customer accounts; we have not signed up or been prescribed.
Frequently Asked Questions
Which pharmacies does Ivy Rx use?
Greenwich RX and ERXHub, both described as 503B and USP <797> compliant. Naming them publicly is unusual and is one of the strongest points in Ivy Rx's favour.
How much does Ivy Rx cost?
Compounded semaglutide from about $165/month on longer commitments, or $175–$197 otherwise, and compounded tirzepatide at $275–$297. Pricing is flat at every dose. Brand-name is quoted around $1,399 and is not competitive.
Does the price go up as my dose increases?
No. Ivy Rx uses flat dose pricing, so the rate you start on is the rate you keep as you titrate — a meaningful saving over dose-scaled competitors.
Is Ivy Rx legit?
Yes — pharmacist-founded, with named compounding partners and more than 3,800 Trustpilot reviews averaging around 4 out of 5. The recurring problem is fulfilment: a minority of customers report orders that never arrived.
Verdict
3.7 / 5
Names its pharmacies, holds its price at every dose, and has thousands of reviews behind it — held back by a minority of customers whose medication simply never arrived.
Ivy Rx does the two things we most often criticise this market for failing to do, and it does them at scale. Naming Greenwich RX and ERXHub is a real answer to the question every compounded buyer should ask, and flat dose pricing means the quote you get is the quote you keep. What stops it rating higher is a fulfilment tail that a company with 3,800 reviews should have engineered out by now, and a price above rivals offering the same disclosures for less. Good provider, beatable on both price and reliability.
Medical Disclaimer & Review Date
This review is general consumer information, not medical advice. GLP-1 medications are prescription drugs with serious contraindications, and whether any treatment is appropriate for you is a decision only a licensed healthcare provider who knows your medical history can make. Nothing here should be used to start, stop, or change a medication.
Details in this review come from Ivy Rx's own published materials as of the date below. Pricing, medication availability, state coverage, and policies in this category change frequently — verify current terms directly with the provider before purchasing.
Date reviewed: August 7, 2026
Keep a Buffer in Hand
Given the non-delivery reports, do not let your supply run to zero before the next shipment is confirmed, and pay with a card that carries chargeback protection.