Drug facts

Compounded semaglutide with B12, B6 or glycine

By ·Editor·Reviewed

Quick answer

Wegovy and Ozempic injections contain no B12, no B6 and no glycine. When compounded semaglutide comes “with B12”, the pharmacy added it — and FDA has used exactly that product as its example of something it may still treat as essentially a copy of the approved drug. There is no approved dosage chart for the combination: the semaglutide dose follows the ordinary ladder.

What is in Wegovy1

The label’s section 11 is the full list. Each milliliter of a single-dose Wegovy pen or syringe holds semaglutide with disodium phosphate dihydrate, sodium chloride and water for injection; the FlexTouch pen, which holds four doses, uses phenol and propylene glycol in place of the salt. Acid or base may be added to adjust the pH. Nothing else.

On the label — Wegovy / Ozempic

Every STEP trial result — the 14.9% in STEP 1 included — was measured on the approved product, which contains none of these add-ins.

In a compounded vial

A vial with B12, B6 or glycine is not what any semaglutide trial tested. Whatever the add-in is meant to do, the evidence for semaglutide neither shows that it does it nor rules out that it changes anything.

What FDA says about B125

Since the semaglutide shortage ended, a 503A pharmacy may not regularly compound essentially a copy of an approved drug. The one exception in the statute is a change made for an identified patient that produces, for that patient, a significant difference as determined by the prescriber.4 An added vitamin looks like a difference, and FDA took the question head on in April 2026, naming semaglutide and B12:

For example, FDA may consider a compounded drug product that combines semaglutide API and another API, such as vitamin B12 (cyanocobalamin), to be essentially a copy of a commercially available drug product

— when it is given the same way as the approved products and “the amounts of semaglutide and vitamin B12 in the compounded drug product are within 10% of the strengths of the respective commercially available drug products.” B12 is itself an approved injection, which is why FDA can treat the combination as two approved drugs in one vial rather than as something new.

So “with B12” is not a legal category. What matters is whether a prescriber documented that you needed the change. The wider position, including the four-prescription policy large sellers rely on, is on is compounded semaglutide still legal?

Is there a separate dosage chart for semaglutide with B12?

No approved one, because no approved product combines them. The semaglutide part is dosed on the same ladder as anything else — 0.25 mg, then 0.5, 1 and 1.7 mg at four-week steps, then maintenance, on the dosage chart. The B12 part is whatever amount the pharmacy put in each milliliter, which is why a “B12 dosage chart” from one seller does not apply to another seller’s vial.

The number that decides what you draw is the semaglutide concentration on your label, in milligrams per milliliter. The B12 does not change that arithmetic, but a different vial can — see the dose-in-units calculator.

Why the vial may be red3

Cyanocobalamin’s own label describes it as “dark, red crystals or as an amorphous or crystalline, red powder.” Wegovy is a “clear, colorless solution,” and Ozempic’s label tells users to check that it looks clear and colorless and not to use it if coloration is seen.2

That instruction is for the approved product. A compounded vial with B12 in it may be pink or red by design, which is not a fault in itself — but it means the approved product’s visual check does not tell you anything about yours. Only the pharmacy that made it can say what it should look like; ask, and ask before a vial that looks different from the last one.

An add-in is not a salt form

These get confused, and they are opposite problems. An add-in is a second ingredient beside semaglutide, and it is usually named on the product. A salt form — semaglutide sodium or semaglutide acetate — replaces the active ingredient itself, and FDA says it is a different active ingredient from the one in the approved drugs, with no lawful basis for compounding that it knows of. A vial can have neither, either or both. Why the second one matters more is on does compounded semaglutide work?

Sellers in this index selling an add-in version6

At least 8 sellers here sell a semaglutide product whose own page names an add-in: 7 with B12, 2 of them with glycine as well or instead. Ingredients were not recorded for every seller, so treat this as a floor rather than a count of the market.

Each seller’s page shows what it bills per calendar month and the product page the price was read from.

Questions

Why is compounded semaglutide mixed with B12?
No approved semaglutide injection contains B12, so the reason is not in any label. Where it matters is legal: a pharmacy may not regularly compound essentially a copy of an approved drug, and FDA has said semaglutide combined with B12 may still count as essentially a copy unless a prescriber documents a significant difference for an identified patient.
Is there a dosage chart for compounded semaglutide with B12?
No approved one. The semaglutide dose follows the ordinary ladder — 0.25 mg, then 0.5, 1 and 1.7 mg at four-week steps — and the B12 amount is whatever the pharmacy put in each milliliter. What you draw is decided by the semaglutide concentration on your label.
Is compounded semaglutide with B12 better?
There is no evidence either way. Every semaglutide trial tested a product containing no B12, so no efficacy or safety figure you have seen was measured on a B12 combination.
Why is my compounded semaglutide red or pink?
If it contains B12, that may be why: cyanocobalamin is itself a red compound, while Wegovy and Ozempic are clear and colorless. Only the pharmacy that made your vial can say what color it should be.
What is compounded semaglutide with glycine?
Semaglutide with an amino acid, glycine, added by the pharmacy. No approved semaglutide injection contains glycine, and no semaglutide trial tested the combination.

Sources

  1. FDA prescribing information for WEGOVY (semaglutide), section 11, revision 6/2026 DailyMed
  2. FDA prescribing information for OZEMPIC (semaglutide) injection, section 2.1, revision 5/2026 DailyMed
  3. Cyanocobalamin Injection, USP prescribing information (Fresenius Kabi), Description DailyMed
  4. 21 U.S.C. 353a(b)(1)(D) and (b)(2), section 503A of the Federal Food, Drug, and Cosmetic Act U.S. Code
  5. FDA, 'FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize', content current as of 04/01/2026 FDA
  6. This site's price index — the product page each price was read from Read it