§ 01 Overview
Overview
Long-acting GLP-1 receptor agonist approved for type 2 diabetes and chronic weight management, with established cardiovascular benefit.
FDA-approved under Ozempic (2017), Wegovy (2021), and Rybelsus (oral). Multiple Phase III trials (STEP, SUSTAIN, SELECT) with tens of thousands of participants.
§ 02 Mechanism
Mechanism of action
Semaglutide is a GLP-1 analog that slows gastric emptying, increases satiety, enhances glucose-dependent insulin secretion, and suppresses glucagon. Its 94% homology with native GLP-1 and albumin binding extend half-life to approximately 7 days, enabling weekly dosing.
- 01Significant weight loss (10–17% of body weight in STEP trials)
- 02Improved glycemic control in type 2 diabetes
- 03Reduced major adverse cardiovascular events (SELECT trial)
- 04Appetite and food-noise reduction
§ 03 Dosing
Dosing protocol
Standard Protocol
- Vial
- 2 mg or 4 mg typical
- BAC Water
- 2 ml BAC water for 2 mg vial
- Dose Range
- 0.25 – 2.4 mg weekly
- Starting Dose
- 0.25 mg once weekly
- Route
- SubQ
- Timing
- Any time of day, consistent weekly
- Frequency
- Weekly
- Cycle
- Titrate every 4 weeks: 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg. Long-term use; discontinuation typically causes rebound weight gain.
Storage
Refrigerate 36–46°F. Can be left at room temperature up to 28 days after first use.
§ 04 Evidence
Evidence & research
FDA-approved under Ozempic (2017), Wegovy (2021), and Rybelsus (oral). Multiple Phase III trials (STEP, SUSTAIN, SELECT) with tens of thousands of participants.
FDA Status
FDA-approved (T2D and chronic weight management). Removed from FDA shortage list in early 2025, limiting compounded versions.
§ 05 Stacks
Common stacks
§ 06 News
In the news
8 articles from the last 12 months · updates hourly
Teen Ozempic use soars while weight-loss surgery drops - NewsNation
Teen Ozempic use soars while weight-loss surgery drops NewsNation
OneSource Q1FY27 slides: semaglutide drives 37% revenue growth - Investing.com
OneSource Q1FY27 slides: semaglutide drives 37% revenue growth Investing.com
Millions are losing weight on Ozempic and Wegovy — here's what an orthopedic surgeon wants every patient to know - Yahoo Creators
Millions are losing weight on Ozempic and Wegovy — here's what an orthopedic surgeon wants every patient to know Yahoo Creators
Comparative Cardiovascular Pharmacovigilance of Semaglutide and Tirzepatide: A Food and Drug Administration Adverse Event Reporting System (FAERS) Database Analysis (2022-2026) - Cureus
Comparative Cardiovascular Pharmacovigilance of Semaglutide and Tirzepatide: A Food and Drug Administration Adverse Event Reporting System (FAERS) Database Analysis (2022-2026) Cureus
Some people are getting shut out when it comes to GLP-1 drugs. Here’s why. - The Washington Post
Some people are getting shut out when it comes to GLP-1 drugs. Here’s why. The Washington Post
ONESOURCE: Q1 revenue and EBITDA surged on semaglutide launches and capacity expansion, supporting robust FY 2028 guidance - TradingView
ONESOURCE: Q1 revenue and EBITDA surged on semaglutide launches and capacity expansion, supporting robust FY 2028 guidance TradingView
Large BMJ Study Confirms GLP-1 Drugs Like Ozempic and Mounjaro Are Linked to a Real Hair Loss Risk - Medical Daily
Large BMJ Study Confirms GLP-1 Drugs Like Ozempic and Mounjaro Are Linked to a Real Hair Loss Risk Medical Daily
Oral GLP-1 drugs may quiet the brain’s food craving circuit - ScienceDaily
Oral GLP-1 drugs may quiet the brain’s food craving circuit ScienceDaily
§ 07 Sourcing
Sourcing & supply
Regulatory status
FDA-approved
This compound has an FDA approval for at least one indication. Brand pharmacy channels exist. Compounding may or may not be available depending on shortage status.
503B pharmacies · 4
Empower Pharmacy
Rx requiredOne of the largest US compounders by volume; dual 503A + 503B. Repeat FDA enforcement history and ongoing Lilly litigation.
Olympia Pharmaceuticals
Rx required35+ year family-owned dual 503A/503B licensed in 48–49 states. Among the cleanest mid-sized 503Bs operating today.
Strive Pharmacy
Rx required503A, licensed in all 50 states. Triple-credentialed (PCAB + NABP + LegitScript). Partner of Lavender Sky.
ProRx
Rx requiredFDA-registered 503B. Major semaglutide/tirzepatide recall in August 2024 over sterility concerns.
Telehealth (Rx) · 11
Defy Medical
Rx requiredBroadest peptide formulary in legitimate US telehealth. 13-year history, concierge cash-pay, no known lawsuits.
Ro
Rx requiredOnly major telehealth that avoided lawsuits by signing direct partnerships with LillyDirect and NovoCare.
Hims & Hers
Rx requiredAll 50 states. Owns its own FDA-registered compounding facility. Under FDA scrutiny.
Henry Meds
Rx requiredAsynchronous budget GLP-1 platform. Named in Lilly litigation; pharmacy partner has federal plea history.
Mochi Health
Rx requiredCentral defendant in Lilly v. Mochi: bellwether case on telehealth-pharmacy vertical integration.
Marek Health
Rx requiredPremium hormone optimization. All 50 states. 4.8 Trustpilot. Partners include Hallandale.
Ivim Health
Rx required~100 providers. Filed amicus brief supporting OFA's tirzepatide appeal. Joined Outsourcing Facilities Association.
Maximus Tribe
Rx requiredPerformance medicine platform. Flagship 'Oral TRT+' (enclomiphene + pregnenolone). Claims LegitScript-certified pharmacy partners.
Blokes / Joi Women's Wellness
Rx requiredMen's + women's optimization platform. TRT in 34 states. 4.6–4.8 Trustpilot.
Fountain TRT / Fountain Vitality
Rx requiredUrologist-led TRT + GLP-1 platform. 4-star Trustpilot. Distinct from Fountain Life.
Superpower
Rx requiredLongevity-biomarker subscription ($199/yr, 100+ biomarkers) with narrow prescription formulary.
International · 1
Trident Peptides
1,299+ Trustpilot reviews (5-star). Strongest review base in UK research peptides. No visible ISO/GMP; COAs not posted.
Research-use-only · 6
Limitless Life Nootropics
'Only BBB-accredited peptide company' (since 2020). Claims three-lab third-party testing. Broad catalog.
Core Peptides
Broad catalog, widest payment range. Mid-credibility: Knoji 2.5/5 and one scam-impersonation report.
Elite Research USA
High-risk. Finnrick tested 47 samples across 7 products → ratings B to E. Heavy TikTok marketing. No accreditations verified.
Prime Peptides
Uses Janoshik testing. FDA warning letter December 2024 for GLP-1s.
Summit Research
FDA warning letter December 2024 across multiple GLP-1s.
Listings are informational, not endorsement. Verify credentials and flags against FDA and PCAB databases before purchasing. Full directory & how to verify →
§ 09 Safety
Safety & side effects
Side effects
- 01Nausea (most common, dose-dependent)
- 02Constipation or diarrhea
- 03Delayed gastric emptying
- 04Fatigue during titration
- 05Rare: gallbladder issues, pancreatitis
Contraindications
- 01Personal/family history of medullary thyroid carcinoma
- 02Multiple Endocrine Neoplasia type 2
- 03Active pancreatitis
- 04Pregnancy
§ 10 Questions
Semaglutide FAQ
- What is Semaglutide?
- Long-acting GLP-1 receptor agonist approved for type 2 diabetes and chronic weight management, with established cardiovascular benefit. Semaglutide is a GLP-1 analog that slows gastric emptying, increases satiety, enhances glucose-dependent insulin secretion, and suppresses glucagon. Its 94% homology with native GLP-1 and albumin binding extend half-life to approximately 7 days, enabling weekly dosing.
- What is Semaglutide used for?
- Reported uses include significant weight loss (10–17% of body weight in step trials), improved glycemic control in type 2 diabetes, reduced major adverse cardiovascular events (select trial), and appetite and food-noise reduction. Evidence strength is rated Established — see the evidence section for detail.
- How is Semaglutide dosed?
- Commonly referenced dosing is 0.25 – 2.4 mg weekly, administered SubQ. This is educational reference only; consult a licensed clinician before use.
- How do you reconstitute Semaglutide?
- For Semaglutide, vials commonly come in 2 mg or 4 mg and a common reconstitution is 2 ml BAC water for 2 mg vial. Use the reconstitution calculator to convert any vial size and water volume into exact insulin-syringe units.
- What are the side effects of Semaglutide?
- Commonly reported side effects include nausea (most common, dose-dependent), constipation or diarrhea, delayed gastric emptying, fatigue during titration, and rare: gallbladder issues, pancreatitis. This list is not exhaustive.
- Is Semaglutide legal?
- This compound has an FDA approval for at least one indication. Brand pharmacy channels exist. Compounding may or may not be available depending on shortage status. FDA status: FDA-approved (T2D and chronic weight management). Removed from FDA shortage list in early 2025, limiting compounded versions..
§ 11 References
Selected references
- 01
STEP 1 — weight management
NEJM 2021
- 02
SELECT — cardiovascular outcomes
NEJM 2023
- 03
SUSTAIN — T2D
Lancet 2017