WEIGHT LOSS · Injectable
Semaglutide.
Proven GLP-1 receptor agonist for weight loss
How it works
Class & mechanism.
In short
Semaglutide is a GLP-1 receptor agonist FDA-approved as Ozempic (type 2 diabetes) and Wegovy (chronic weight management, cardiovascular risk reduction in adults with CVD). It works by slowing gastric emptying and suppressing appetite centrally, producing 12–15% average body weight loss over 68 weeks in the STEP trials. Compounded semaglutide formulations exist outside these approved brand-name products and carry different regulatory status.
Class
GLP-1 Receptor Agonist
Mechanism
Semaglutide is a synthetic analogue of human glucagon-like peptide-1 (GLP-1) with 94% structural homology, engineered with fatty acid side chains that enable albumin binding and extend half-life to approximately 7 days for once-weekly dosing. Upon binding to GLP-1 receptors — distributed across the pancreas, gastrointestinal tract, and central nervous system — it activates cAMP-dependent signaling cascades that enhance glucose-dependent insulin secretion, suppress glucagon release, and slow gastric emptying. Its primary weight-loss mechanism operates centrally: GLP-1 receptor activation in the hypothalamus and brainstem reduces appetite signaling, diminishes food cravings, and accelerates satiety, producing a sustained reduction in caloric intake.
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Did you know
The SELECT trial proved semaglutide reduces heart attacks and strokes by 20% independent of its weight-loss effects — a direct cardiovascular action that led to FDA approval for cardiovascular risk reduction in 2024, making it the first obesity drug with a proven cardiac survival benefit.
Half-life
168 h
Bioavailability
89%
Tmax
72 h
Cmax
30 nmol/L
Route
SC
Molecular weight
4114 Da
Pharmacokinetic data shown for educational context. Individual response varies. Not a substitute for clinical dosing guidance.
Benefits
What it does.
Clinically meaningful weight loss: 12–15% body weight reduction over 68 weeks (STEP trials)
Cardiovascular risk reduction: 20% decrease in MACE (cardiovascular death, MI, stroke) in SELECT trial
Resolution of metabolic dysfunction-associated steatohepatitis (MASH) in 62.9% of patients vs 34.3% placebo (ESSENCE trial)
Improved glycemic control and insulin sensitivity — approved for T2D management at 0.5–1.0 mg (Ozempic)
Reduced systemic inflammation and improved lipid profiles including triglycerides and cholesterol
FDA-approved for chronic weight management (Wegovy 2.4 mg) and cardiovascular risk reduction in obese/overweight adults
The science
Peer-reviewed findings.
Research supporting this compound's mechanisms and safety profile.
What this does not mean
Semaglutide is FDA-approved as Ozempic and Rybelsus for type 2 diabetes management and as Wegovy for chronic weight management and cardiovascular risk reduction in adults with obesity/overweight and established cardiovascular disease. The 2022–2023 shortage under the FDA's compounding exception has been resolved, and bulk compounding of semaglutide under that shortage exception has ended. Compounded formulations combining semaglutide with additional components (such as B12, glycine, or NAD+) may qualify as 503A patient-specific preparations when structurally differentiated from the FDA-approved products, subject to state pharmacy board and FDA oversight. This page describes educational context only and does not recommend, endorse, or prescribe any compound. Always consult a qualified healthcare provider.
STEP-1 trial: Participants receiving semaglutide 2.4 mg achieved a mean 14.8% weight reduction vs 2.4% with placebo over 68 weeks; 86.4% achieved ≥5% weight loss vs 31.5% with placebo
SOURCE · STEP-1 Trial, NEJM 2021 (NCT03693430)
SELECT trial (NEJM 2023): Semaglutide 2.4 mg reduced MACE risk by 20% (HR 0.80) in 17,604 patients with obesity/overweight and established CVD but without diabetes over ~48-month follow-up; cardiovascular benefits shown to be partially independent of weight loss
SOURCE · SELECT Trial, NEJM 2023 / The Lancet 2025 analysis
ESSENCE trial: 62.9% of semaglutide-treated patients achieved resolution of metabolic dysfunction-associated steatohepatitis (MASH) without worsening fibrosis at 72 weeks, compared to 34.3% placebo (ETD: 28.7%)
SOURCE · ESSENCE Trial, 2024
STEP-4 extension: Participants who discontinued semaglutide after achieving 10.6% weight loss regained an average of 6.9% baseline body weight by week 68, confirming the need for continuous therapy
SOURCE · STEP-4 Trial, NEJM 2021
Protocol
How to use it.
Dosing
Weight management (Wegovy): Starting dose 0.25 mg SC once weekly, escalating every 4 weeks — 0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → maintenance 2.4 mg at week 17. T2D (Ozempic): 0.5 mg or 1.0 mg once weekly. Oral semaglutide (Rybelsus): 3 mg → 7 mg → 14 mg daily. Injection sites: thigh, abdomen, or upper arm.
Cycle
Ongoing maintenance therapy required. Discontinuation leads to average regain of 68% of lost weight within 12 months (STEP-1 extension). Indicated for long-term chronic use alongside reduced-calorie diet and increased physical activity. Approved for ages 12+ (obesity) and adults with CVD risk.
Contraindications
When to skip it.
Contraindicated with personal or family history of medullary thyroid carcinoma or MEN-2. Use with caution in patients with history of pancreatitis. Associated with gallbladder/biliary disease (cholelithiasis, cholecystitis). Commonly reported: nausea, diarrhea, vomiting, constipation (mostly transient, peak during dose escalation). Up to 25–45% of total weight loss may include lean body mass — resistance training and adequate protein intake recommended.
Always cleared with your concierge before protocol start.
Regulatory Context
FDA compounding status.
| FDA Status | Risk Level | Compounding | Key Date |
|---|---|---|---|
| FDA-Approved (Wegovy/Ozempic) | 🟢 Stable | 503A patient-specific only (stacked formulations) | Shortage resolved Feb 21, 2025 |
FDA-approved GLP-1 receptor agonist. Shortage resolved — bulk compounding under shortage exception ended. Stacked formulations (with B12, Glycine, NAD+, etc.) may qualify as 503A patient-specific if structurally differentiated. Not an "essentially copy" of the branded drug. FDA actively enforcing against misleading marketing claims.
Source: FDA Federal Register, PCAC agendas, industry analyses. Educational context only — not legal advice. Review after July 23-24, 2026 PCAC meeting.
Pricing
What it costs.
Indicative range for Semaglutide, sourced from vetted US and EU dispensing suppliers. Concierge confirms the exact figure once your match is locked.
Indicative range (USD)
Sourced through vetted dispensing partners in the United States and European Union. Concierge confirms the exact figure once your match is locked.
- 0199% purity verified, third-party tested
- 02Includes vial and reconstitution guidance
- 03Concierge supplier match included with every protocol
See Semaglutide pricing — and your supplier match.
Pricing is unlocked once we know who you are. Take the 3-minute quiz and we'll match you to a US or EU dispensary based on your location and protocol fit.
- Live USD price range
- US & EU supplier shortlist
- Concierge sign-off on dosing
Indicative price range: $115–$173 USD