Drug facts
Compounded semaglutide facts: what the label says
Compounded semaglutide has no label of its own. The label belongs to the approved products — Wegovy and Ozempic, both from Novo Nordisk — and everything below is drawn from it.
That distinction runs through every page here, because it is the most useful thing this section can tell you: what is established about semaglutide was established about the approved product, and a compounded vial does not automatically inherit it.
- Pages in this corpus
- 44
- Sellers of the compounded version
- 409
- Approved products with a label
- 2
Taking it
- Dosage and titrationThe approved schedule: 0.25 mg for four weeks, then 0.5, 1 and 1.7 mg at four-week steps, to a maintenance dose of 1.7 or 2.4 mg — and a 7.2 mg maximum for adult weight reduction.
- Dosage in units: mg to units chartWegovy's dose steps in syringe units at 1, 2.5 and 5 mg/mL, and the FDA alert on five- to 20-fold dosing errors with compounded vials.
- Storage and beyond-use datingThe label's room-temperature windows — 28 days for a single-dose pen, 56 for a FlexTouch after first use — and FDA's rule to discard an opened compounded vial after 28 days.
- Surgery, sedation and delayed stomach emptyingThe label reports rare aspiration under anesthesia in people who fasted as instructed — and says plainly that the data are insufficient to recommend what to do about it.
- Switching sellers, or switching moleculesNeither label publishes a conversion between semaglutide and tirzepatide — and moving between compounded sellers can change the mark on your syringe without changing your dose.
- A missed doseWhat the label says to do, measured to your next dose rather than from the one you missed — and what changes after two in a row.
- Where to inject: stomach, thigh or armStomach, thigh or upper arm: the label reports similar exposure at all three, and site reactions in 1.4% on Wegovy against 1% on placebo.
- Microdosing, and is there a chart?The 0.25 mg starting step is the smallest injected dose in the Wegovy and Ozempic labels. Neither has a microdose schedule.
- How long it takes to workWeight loss from week 4, maintenance from week 17, and what the label says the starting doses are for.
- What to eatThe label names no food to eat or avoid. What it does specify, and what STEP 1's participants were told.
- Metformin and semaglutideDifferent drugs and approvals, no head-to-head trial, and Ozempic's trials run on top of metformin.
Safety
- Side effects and how common they areEvery reaction the label reports in 2% or more of trial participants, with the placebo rate beside each one.
- Constipation17% at 5 mg against 5% on placebo — and the one common reaction that gets less frequent as the dose rises, for a reason that is not reassuring.
- The boxed warningThe thyroid C-cell tumor warning, verbatim, and the contraindications that follow from it.
- Interactions with other medicinesOral drugs, contraceptives, and the hypoglycemia risk when combined with insulin or a sulfonylurea.
- Pregnancy and birth controlStop at least two months before a planned pregnancy, and what the labels say, and do not say, about the pill.
- BreastfeedingWhat section 8.2 of the label actually states.
- Is compounded semaglutide safe?The three risks FDA has named for compounded semaglutide (salt forms, dosing errors, quality) and the 990 reports it has counted.
- Diarrhea30% on Wegovy 2.4 mg against 16% on placebo, 8.5–8.8% on Ozempic, and the dehydration warning behind it.
- Bone density and fracturesThe label’s own fracture rows — 1% against 0.2% in women — and the one trial built around bone.
- Eyes, vision and NAIONNAION appears nowhere in the current US labels — a word-by-word census — while Europe lists it as a very rare side effect.
- PancreatitisThe symptoms both labels list, what they say to do, the confirmed trial cases, and the gallbladder warning.
What people report
- Hair lossA listed adverse reaction — with the trial rate and the placebo rate beside it.
- FatigueReported in 5 to 7% of participants against 3% on placebo.
- What is “Ozempic face”?A lay term, not a label one. What imaging studies measured in the face during GLP-1 weight loss, and what they did not.
- Muscle lossThe label says fat loss outpaces lean loss. What MRI in STEP UP and DXA in SUSTAIN 8 measured, and what protein and training add.
- Anxiety and moodWhat both labels say, and the suicidality warning FDA had removed.
- AlcoholWhat the label addresses, and where it is silent.
- Obstructive sleep apneaSemaglutide is not approved for it, and tirzepatide is. What this label covers beyond weight instead.
- Not losing weightHow many people in STEP 1 lost under 5%, the week-60 plateau, diabetes, and still being hungry.
- Headache14% against 10% on placebo, so most of it is not the drug. Also on the label's list of low-blood-sugar signs.
- Heartburn, reflux and burpingBurping 7% against under 1% on placebo, indigestion 9% against 3%, reflux 5% against 3%. "Sulfur burps" is not label language.
What you are buying
- How semaglutide worksA GLP-1 receptor agonist (one receptor, not two), and what that single action actually does.
- What compounded semaglutide isPrepared by a pharmacy, not FDA-approved and not a generic — and possibly a salt form FDA says is a different active ingredient.
- Does it work?STEP 1 measured 14.9% at 2.4 mg. No trial has measured a compounded vial, and FDA has warned about semaglutide salt forms.
- B12, B6 and glycineNo approved semaglutide injection contains them — and FDA's own example of "essentially a copy" is semaglutide with B12.
- “Research use only” vialsA vial labeled “for research use only” is an unapproved new drug in FDA’s words — the letters it has sent, the salt forms, and the dosing errors.
- What it is approved forSix approved uses, quoted from section 1 of both labels — and the trial results that are not indications.
- Who compounds it for online sellers?Pharmacy names as semaglutide sellers give them, counted across the sellers listed here, plus how many name none.
- Is compounded semaglutide the same as Wegovy?The molecule matches; the product does not. Approval, labeling, concentration, and the evidence behind each.
- Ozempic vs WegovySame molecule, two approvals. What actually differs.
- Retatrutide vs semaglutideOne is approved and hits one receptor; the other hits three and is still in trials, with no approved product anywhere.
- Wegovy pill vs injectionYes — an approved tablet exists, with its own schedule ending at 25 mg daily. What sellers market as oral semaglutide is not that product.
- Compounded semaglutide vs OzempicSemaglutide approved for type 2 diabetes, dosed to a 2 mg maximum. What a compounded vial shares with it, and what it does not carry.
Informational only. Nothing here is medical advice, and none of it replaces the judgment of a prescriber who knows your history.