Brazil seizures of smuggled Wegovy and Mounjaro surge as officials investigate deaths

Brazilian customs officers seized more than 76,000 pens, vials and other GLP-1 weight-loss products at the border with Paraguay in the first half of 2026, according to Brazil's Federal Revenue Service — nearly three times the number confiscated in all of 2025 ^[2]. A separate count by Brazil's Anti-Counterfeiting Association put nationwide seizures of illegal GLP-1 drugs at 60,787 units in 2025, up from 609 in 2024 ^[1]. The two figures come from different agencies and cover different areas.

On April 30, 2026, agents searching a tourist bus arriving from Paraguay at Foz do Iguaçu found more than 2,500 vials of tirzepatide, the active ingredient in Mounjaro, packed inside jars of dulce de leche, according to the Federal Revenue Service ^[1]. Along that border, agents have also found slimming drugs hidden in motorcycle exhaust pipes and false shoe soles ^[1], and in boot soles, shampoo bottles, massage gel containers and secret compartments in cars, with some shipments moved by boat across the Paraná River ^[2]. Flávio Bernardino de Carvalho, a federal tax auditor, told CNN that weight-loss drugs now rank second in value among goods seized in the southern states of Paraná and Santa Catarina, behind only cell phones ^[2]. "They come on public buses, in cars, in trucks, with tourists. Every possible way," he said ^[2].

About 51% of Brazil's estimated $7 billion in weight-loss drug sales this year is expected to come from pharmacies that custom-mix medications and from products smuggled from Paraguay, according to the investment bank Itaú BBA ^[1]. In Brazil, a four-week supply of Mounjaro costs about $290 at the lowest dose, 2.5 mg, while a high-dose, 2.4-mg Wegovy box sells for close to $340 online through a patient support program ^[1]. The doses are not comparable because the two drugs have different active ingredients ^[1]. Across the border, an ampoule of locally manufactured tirzepatide sells for about 340 reais, or roughly $68, according to the Federal Revenue Service, against upwards of 1,400 reais (about $280) for Mounjaro in Brazil ^[2].

Brazil's GLP-1 usage rate is 5.5% of the population, above the global average of 3.7%, according to the market research firm Euromonitor International ^[1]. Online orders tied to GLP-1 medications rose 149.3% in the first half of 2026, climbing from 547,249 in the previous six-month period to more than 1.36 million, representing more than 2.3 billion reais (about $460 million) in purchases, according to Serasa Experian, a Brazilian data company ^[2].

Brazilian authorities recorded 83 deaths under investigation and more than 3,600 complications linked to weight-loss drugs between 2018 and mid-August 2026, and were notified of more than 60% of those complications in 2025 and 2026 ^[1]. Officials said untracked versions of the drugs likely played a significant role; Reuters said it could not independently establish what role unauthorized GLP-1 products played in those cases ^[1]. One death under review is that of Jessica Ataide, 31, who died last November after her blood sugar dropped sharply following a dose and she lost consciousness and choked, according to Flavio Fabres, who heads the medical examiner's office in João Pessoa and performed the autopsy ^[1]. Reuters could not establish what type of weight-loss drug she had been using ^[1].

Anvisa, Brazil's health regulator, has warned of a rising number of reports of acute pancreatitis linked to improper use of GLP-1s, and labeling for Mounjaro and Wegovy notes a risk of acute pancreatitis affecting 0.1% to 1% of patients ^[1]. Dr. Alexandre Hohl, a professor of endocrinology at the Federal University of Santa Catarina, told CNN that peptide drugs such as semaglutide and tirzepatide can lose stability above 30 degrees Celsius (86 degrees Fahrenheit) or below 0 degrees Celsius (32 degrees Fahrenheit), conditions unlikely to be met when products are carried across the border concealed in vehicles, shoes or against a person's body ^[2]. Hohl said one patient ended up in intensive care with lactic acidosis after using a product sold as tirzepatide from Paraguay, and another developed nausea, vomiting and diarrhea after switching from an authorized version ^[2].

Why it matters for patients

The reporting describes a market where the price gap between regulated and unregulated injections is wide enough that consumers seek out products whose origin cannot be traced. CNN reported that consumers may have no reliable way of knowing exactly what they are injecting, that smuggled peptides may lose potency from heat or cold exposure, and that impurities can remain when manufacturing is not properly controlled ^[2]. Anvisa says only smuggled products bypass official evaluation, while custom-mixed compounded medications must meet technical standards and pass local inspections ^[1]. Andreia Kohout of the Brazilian Anti-Counterfeiting Association said consumers often mistakenly view compounded drugs as identical to brand-name products ^[1].

Brazilian regulators are betting that cheaper authorized supply will pull buyers away from smuggled injections. Anvisa approved Ozivy, the country's first domestic alternative to Novo Nordisk's Ozempic, in May 2026, and it can sell for less than $100 for a four-week supply; other brands have been cleared since ^[1]. "Controlling demand is difficult," Anvisa Director-President Leandro Safatle told reporters this month. "But if that demand is already being met by a regulated, safer product priced similarly to unauthorized imports, people will naturally choose the regulated option" ^[1]. Whether that shift happens has not been established.

What happens next

Anvisa signed an agreement with Paraguay's health regulator Dinavisa to strengthen border oversight, according to CNN ^[2]. Eli Lilly has said it plans to submit retatrutide, an experimental weight-loss drug not approved by any regulator, to the US Food and Drug Administration in the first quarter of 2027, while products marketed as retatrutide are already being sold in Paraguay and one patient in Brazil reported using one, Hohl said ^[2]. Brazil's revenue service said its officers act broadly against illegal goods but has no operation specifically targeting weight-loss drugs ^[1]. Seizures have continued to rise sharply in 2026 ^[1].