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Compounded Semaglutide (Compounded Semaglutide (503B Pharmacy))

Category: Weight Management. Status: Compounded medication.

Compounded semaglutide from 503B pharmacies became the most prescribed telemedicine weight loss medication. Provides the same GLP-1 receptor agonism as brand-name Ozempic/Wegovy at lower cost through compounding pharmacies.

How it works

Identical to branded semaglutide - a GLP-1 receptor agonist with a fatty acid chain for albumin binding, providing extended half-life. Reduces appetite, slows gastric emptying, and improves insulin sensitivity.

Key facts

  • Molecular weight: 4113.58 Da
  • Half-life: ~7 days
  • Bioavailability: ~89% subcutaneous
  • Storage: Refrigerate 2-8°C before first use. Room temp up to 30 days after.

Dosing overview

  • Typical dose: 0.25-2.4 mg
  • Frequency: Once weekly
  • Duration: 12-52+ weeks
  • Route: Subcutaneous injection

Protocol notes

  • Start at 0.25 mg once weekly for ~4 weeks (a tolerance dose, not yet therapeutic).
  • Step up roughly every 4 weeks: 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg as tolerated.
  • Hold at the lowest dose that controls appetite/weight; many don't need the full 2.4 mg.
  • Keep the same injection day each week.

Reported benefits

  • Significant weight loss (15-20%)
  • Appetite suppression
  • Improved glycemic control
  • Cardiovascular benefits
  • Reduced food noise

Possible side effects

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Injection site reactions
  • Potential pancreatitis (rare)

Research

  • STEP trials semaglutide 2.4mg (2022): Achieved mean 14.9% body weight loss at 68 weeks in non-diabetic adults with overweight/obesity.

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Research and educational reference only. Not medical advice.