Brazil seizures of smuggled semaglutide and tirzepatide nearly triple in first half of 2026

Brazilian customs officers seized more than 76,000 pens, vials and other products containing semaglutide or tirzepatide at the border with Paraguay in the first half of 2026, nearly three times the amount confiscated during all of 2025, according to Brazil's Federal Revenue Service ^[2]. Brazil's anti-counterfeiting association separately counted 60,787 units of illegal GLP-1 weight-loss drugs seized nationwide in 2025, up from 609 in 2024 ^[1].

One of the largest finds came on April 30, when agents opened jars of dulce de leche aboard a bus arriving from Paraguay and found more than 2,500 vials of tirzepatide, the active ingredient in Mounjaro, mixed into the spread ^[1]. Along that border, agents have also found the drugs under boot soles, inside shampoo bottles, in containers of massage gel, in motorcycle exhaust pipes and in hidden vehicle compartments, with some shipments crossing the Paraná River by boat ^[1][2].

Weight-loss drugs now rank second in value among goods seized in the region covering the states of Paraná and Santa Catarina, behind only cell phones, federal tax auditor Flávio Bernardino de Carvalho told CNN Brasil ^[2]. At peak times, more than 100,000 people and 45,000 vehicles cross the Friendship Bridge between the two countries each day ^[2].

Price is the main driver. Investment bank Itau BBA estimates that 51% of Brazil's roughly $7 billion weight-loss drug market this year will come from pharmacies that custom-mix medications and from products smuggled out of Paraguay ^[1]. In Brazil, a four-week supply of Mounjaro costs about $290 at the lowest 2.5 mg dose, and a high-dose 2.4 mg box of Wegovy sells for close to $340 through a patient support program ^[1]. In Paraguay, a vial of locally manufactured tirzepatide sells for about 340 reais, roughly $68, according to Brazil's Federal Revenue Service ^[2]. One Rio pet groomer who earns Brazil's minimum wage of $300 a month said she pays about $75 every six weeks for a Paraguayan product called T.G., which Brazilian regulators have not vetted ^[1].

Health officials are investigating 83 deaths and more than 3,600 complications linked to weight-loss drugs recorded between 2018 and mid-August 2026, with more than 60% of the complications reported in 2025 and 2026 ^[1]. Reuters could not establish what role unauthorized versions played in those cases ^[1]. One autopsy reviewed by Flavio Fabres, who heads the medical examiner's office in João Pessoa, involved a 31-year-old woman, Jessica Ataide, who died last November after her blood sugar dropped sharply, she lost consciousness and choked; she had used medication without consulting a health professional, and Reuters could not establish which product ^[1].

Dr. Alexandre Hohl, an endocrinology professor at the Federal University of Santa Catarina, said peptide drugs such as semaglutide and tirzepatide can lose stability above 30 degrees Celsius (86 F) or below 0 C (32 F), conditions unlikely to be met when products travel concealed in vehicles, shoes or against a person's body ^[2]. He described one patient who developed lactic acidosis, a potentially serious acid buildup in the blood, after using a product sold as tirzepatide from Paraguay, and another who needed emergency care after switching to a Paraguayan product and raising the dose ^[2].

Online ordering is climbing too. The Brazilian data company Serasa Experian recorded GLP-1-related orders rising 149.3% in the first half of 2026, from 547,249 in the previous six months to more than 1.36 million, worth over 2.3 billion reais (about $460 million) ^[2].

Labeling for Mounjaro and Wegovy notes a risk of acute pancreatitis in 0.1% to 1% of patients, and Brazil's regulator Anvisa has warned about aspiration and pneumonia risks during anesthesia because the drugs slow digestion ^[1].

Why it matters for patients

With smuggled product, there is no reliable way to know what is being injected ^[2]. Hohl said impurities can remain if a manufacturing process is not properly controlled, and that poor storage may mean a buyer pays less for a drug that does not work as intended ^[2]. Brazilian regulators say only smuggled products bypass official evaluation, while compounded medications must meet technical standards and pass local inspections ^[1]. Andreia Kohout, pharmaceutical director of the Brazilian Anti-Counterfeiting Association, said consumers often mistakenly treat compounded drugs as identical to brand names, and that the compounded market, frequently promoted by influencers, includes unreliable suppliers ^[1]. Whether these suppliers and routes also ship to buyers in the United States has not been reported. Products sold as retatrutide, an experimental Lilly drug not approved by the FDA or any other regulator and legally available only to clinical trial participants, are already being sold in Paraguay, Hohl said ^[2].

What happens next

Anvisa signed an agreement with Paraguay's health regulator, Dinavisa, in late August 2026 to strengthen oversight along the border ^[2]. Brazil approved Ozivy, its first domestic alternative to Ozempic, in May 2026, priced under $100 for a four-week supply, and Anvisa has approved other brands since ^[1]. Anvisa director-president Leandro Safatle said that if demand is met by a regulated, safer product priced similarly to unauthorized imports, "people will naturally choose the regulated option" ^[1]. Eli Lilly says it plans to submit retatrutide to the FDA in the first quarter of 2027 ^[2].