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1st Optimal vs Velvet Rx

An in-depth comparison of two leading GLP-1 Providers

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6.7

1st Optimal

Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program
★★★☆☆3.4
Semaglutide GLP-1Tirzepatide GLP-1Oral tablet optionAt-home lab testing
Visit 1st Optimal
6.6

Velvet Rx

Best for cash-pay compounded GLP-1 with bundled shipping across three SKUs
★★★☆☆3.3

Starting at $139/mo

CompoundedOral OptionSemaglutideTirzepatide
Visit Velvet Rx

Side-by-Side Comparison

Feature1st OptimalVelvet Rx
Overall Score6.7/106.6/10
Starting Price$139/mo
Editorial Rating3.4 ★ /53.3 ★ /5
Features8 features6 features
States Available00
Compounded✓ Yes
Brand Name
FSA/HSA Accepted✓ Yes
FDA WarningsNoneNone

Pros & Cons

1st Optimal

Pros

  • Offers both semaglutide and tirzepatide with injectable and oral formats
  • Functional-medicine approach with at-home labs and blood-work interpretation
  • Unlimited coaching and ongoing support included
  • No long-term contracts
  • Board-certified doctors and nurse practitioners referenced

Cons

  • No public monthly pricing disclosed
  • No published state availability list
  • Compounded vs branded sourcing not clarified on site
  • Pricing only revealed after quiz or consultation

Velvet Rx

Pros

  • Public pricing across 3 SKUs (semaglutide $299, tirzepatide $359, oral GLP-1 $349) — uncommon in compounded telehealth
  • First-month promo pricing shown upfront ($139 sema / $199 tirz / $189 oral)
  • Single monthly price includes consult, prescription, 4 weeks of medication, and free 1–2 day shipping
  • FSA/HSA eligible
  • Three options under one roof: injectable sema, injectable tirz, and an oral GLP-1
  • Fully cash-pay with no membership fee

Cons

  • Oral GLP-1 SKU doesn't name the specific drug — a real gap given Rybelsus, Foundayo, and compounded oral semaglutide differ clinically
  • No LegitScript or NABP .pharmacy seal displayed
  • No legal entity name disclosed
  • No physical address disclosed
  • Compounding pharmacy partner not named
  • States served not listed
  • Pricing display is internally inconsistent — headline promo math doesn't match the pricing card
  • Marketing cites unverifiable success percentages with no methodology or sample size

Our Verdict

Winner: 1st OptimalScore: 6.7/10

1st Optimal edges out Velvet Rx with a higher overall score of 6.7/10 and is particularly strong for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. Velvet Rx remains a solid alternative, especially if you're looking for cash-pay compounded GLP-1 with bundled shipping across three SKUs.

Glossary references

Key terms in this article, linked to their canonical definitions.

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Wegovy®, Ozempic®, and Rybelsus® are trademarks of Novo Nordisk A/S. Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. All other product names and trademarks referenced on this page belong to their respective owners. WeightLossRankings.org is not affiliated with any pharmaceutical manufacturer. See trademark disclaimer.