Semaglutide Compounding

Everything You Need to Know About Semaglutide Compounding (Right Now!)

Compounding Semaglutide dosges after the shortage

Introduction

Semaglutide has quickly become one of the most sought-after treatments for weight loss and blood sugar management in recent years. Originally developed as a GLP-1 receptor agonist for managing type 2 diabetes, semaglutide has gained tremendous popularity as a weight loss aid under brand names like Ozempic® and Wegovy®. However, due to skyrocketing demand and intermittent shortages, compounding pharmacies have stepped in to provide patients with custom-formulated alternatives. But what exactly is semaglutide compounding, and what should patients and providers know about it?

In this comprehensive guide, we'll explore everything you need to know about semaglutide compounding—including its benefits, how it's made, safety considerations, legal aspects, and why more patients and providers are considering alternative dosage forms.

What Is Semaglutide?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics the natural hormone GLP-1. It works by:

• Increasing insulin secretion when blood sugar levels are high
• Slowing gastric emptying
• Suppressing appetite and promoting satiety

These actions make semaglutide effective not only for controlling blood glucose but also for aiding in substantial weight loss.

Why Compound Semaglutide?

Pharmaceutical brands like Ozempic® and Wegovy® are FDA-approved versions of semaglutide, manufactured by Novo Nordisk. However, several factors have led to the rise of compounded versions:

1. Drug Shortages: Ongoing demand has created national shortages, leaving many patients unable to access commercial versions.
2. Customization: Compounding allows pharmacists to tailor dosages and delivery forms to meet individual patient needs.
3. Cost: Compounded semaglutide can often be more economical  than brand-name medications, especially for cash-pay patients when no longer covered by insurance plans. 
4. Additives: Compounding allows for semaglutide to be micro dosed to maintain weight loss once weight loss is complete.

How Is Compounded Semaglutide Made?

Semaglutide can be compounded in different forms and doses, including:

• Injectable solutions: (During a shortage) The most common method, usually in pre-filled syringes or multi-dose vials.
• Oral troches or tablets or buccal films: Less common but suitable for patients averse to invasive injections.

Compounded semaglutide is often made using either:

• Semaglutide base (chemically identical to branded versions)
• Semaglutide sodium salt (a newer form, but with less data behind it)

Important Note: Compounding pharmacies must source semaglutide from FDA-registered facilities that follow strict USP standards or use FDA approved products (Rybelsus) in alternative dosage forms or strengths. 

Dosing Protocols

Dosing for compounded semaglutide generally follows a titration schedule similar to commercial versions to minimize side effects:

• Week 1-4: 0.25 mg once weekly
• Week 5-8: 0.5 mg once weekly
• Week 9-12: 1.0 mg once weekly
• Maintenance: 1.0 to 2.4 mg weekly based on individual goals

Dosing can be adjusted by the prescriber and compounding pharmacist to meet the patient's needs.

Semaglutide + B12 or B6: The Compounding Advantage

Many compounded formulations include additional nutrients to enhance tolerability and outcomes:

• B12: Reduces fatigue, supports metabolism, and may reduce nausea
• B6: reduces anxiety, fatigue, supports metabolism
• L-Carnitine: Promotes fat metabolism and energy production
• Nalterxone: Has been used with other medications (bupropion) to help with weight loss in a medication- known as Contrave

These additions can differentiate your therapy and provide a unique solution compared to standard injections.

Who Can Benefit from Compounded Semaglutide?

Compounded semaglutide is suitable for:

• Patients unable to access commercial semaglutide
• Individuals seeking a custom dose or delivery method
• Weight loss patients managed by functional or integrative providers
• Clinics offering medical weight loss programs

Always consult with a licensed provider before beginning treatment.

Are Compounded Versions FDA-Approved?

No, compounded medications are not FDA-approved. However, they are legally permitted under Section 503A of the Federal Food, Drug, and Cosmetic Act, provided:

• The compound is prepared for an individual patient with a prescription
• It's made in a licensed pharmacy
• It's formulated from ingredients from FDA-registered facilities

Patients and providers should choose compounding pharmacies to ensure the highest quality and safety standards.

Safety and Side Effects

Semaglutide, whether commercial or compounded, can cause side effects such as:

• Nausea
• Vomiting
• Diarrhea or constipation
• Fatigue
• Headache

Serious (but rare) side effects may include:

• Pancreatitis
• Gallbladder disease
• Thyroid tumors (seen in animal studies)

A gradual dose escalation and provider monitoring are critical to minimize risks.

Legal and Ethical Considerations

The FDA has issued statements warning against using semaglutide sodium salt due to lack of equivalence data. Reputable pharmacies use semaglutide base, which aligns more closely with clinical studies and approved products.

Providers should:

• Ask for sourcing documentation
• Work with transparent, licensed compounding partners
• Ensure they’re using the compound for specific, documented patient needs

How to Prescribe Compounded Semaglutide

Providers can write a prescription for compounded semaglutide including:

• Dose (Sublingual) 0.07mg daily for 1 week, then titrate to the desired dose. 
• Quantity (e.g.,1/4 -1 daily)
• Directions (e.g., Dissolve under the tongue as directed)
• Optional: Additives like B12 or naltrexone

We can assist with customized Rx templates and dosing protocols.

Choosing the Right Pharmacy

When selecting a compounding pharmacy, look for:

• Transparent ingredient sourcing
• Reliable turnaround times
• Provider support (including Rx templates and clinical assistance)
• Positive reviews and testimonials

FAQs About Compounded Semaglutide

Q: Is compounded semaglutide safe?A: When prepared by a reputable pharmacy using USP standards and semaglutide base, it can be a safe and effective option.

Q: Is it legal?A: Yes, under Section 503A, compounding for individual patients with prescriptions is legal. Compounding pharmacies are not able to compound copycats of the same commercially available drug when it is readily available. 

Q: Can insurance cover it?A: Compounded medications are usually cash-pay, but they qualify for HSA/FSA reimbursement.

Q: Can I add other ingredients like B12 or L-carnitine?A: Yes! As long as your prescriber thinks its appropriate.  Many compounded versions include metabolic support ingredients for enhanced results.

Final Thoughts

Semaglutide compounding represents a powerful option for patients and providers looking for flexible, personalized, and often more affordable weight loss and metabolic support. With demand for GLP-1 medications soaring, compounded alternatives fill a critical gap—provided they are used responsibly, legally, and with clinical guidance.

At Webster Pharmacy, we proudly pharmacist-supported compound weight loss options tailored for functional medicine, concierge practices, and cash-based clinics.

Want to Learn More?

Contact Webster Pharmacy today to:

• Request sample Rx templates
• Get provider-specific pricing

Email: store@websterrx.com Phone: (314)962-1065 Website: https://webster-pharmacy.com

Your patients deserve options. Let’s compound a solution together.