Fat lossFDA-approved useSubQ

Semaglutide

Also: Ozempic, Wegovy

Ozempic and Wegovy. Weekly shot that slows your stomach and quiets hunger. The drug that started the GLP-1 wave.

Typical dose

0.5 mg/wk

10u, Weekly

Cycle

Ongoing per FDA Wegovy/Ozempic labels

Timing

Weekly, same day each week

Where

Abdomen, outer thigh, or upper arm

FDA titration

Weeks 1–4

0.25 mg/wk · Weekly

FDA Wegovy starting dose. At U-100 precision floor; draw carefully. Hold 4 wks, most GI side effects occur early.

Weeks 5–8

10u

0.5 mg/wk · Weekly

FDA step 2. Step up only if Weeks 1–4 tolerated. (Ozempic maintenance range.)

Weeks 9–12

20u

1 mg/wk · Weekly

FDA step 3. Ozempic max is 2 mg/wk; higher steps are Wegovy-only.

Weeks 13–16

34u

1.7 mg/wk · Weekly

FDA step 4 (Wegovy intermediate).

Weeks 17+

48u

2.4 mg/wk · Weekly

FDA Wegovy maintenance (maximum). Stop at any earlier rung that controls appetite without intolerable side effects.

Phase	How often	Dose	Units	Notes
Weeks 1–4	Weekly	0.25 mg/wk	5u	FDA Wegovy starting dose. At U-100 precision floor; draw carefully. Hold 4 wks, most GI side effects occur early.
Weeks 5–8	Weekly	0.5 mg/wk	10u	FDA step 2. Step up only if Weeks 1–4 tolerated. (Ozempic maintenance range.)
Weeks 9–12	Weekly	1 mg/wk	20u	FDA step 3. Ozempic max is 2 mg/wk; higher steps are Wegovy-only.
Weeks 13–16	Weekly	1.7 mg/wk	34u	FDA step 4 (Wegovy intermediate).
Weeks 17+	Weekly	2.4 mg/wk	48u	FDA Wegovy maintenance (maximum). Stop at any earlier rung that controls appetite without intolerable side effects.

Cycle & timing

Cycle: Ongoing per FDA Wegovy/Ozempic labels; no scheduled off-cycle. Discontinue ≥2 months before planned pregnancy (long half-life).

Timing: Weekly, same day each week.

Where: Abdomen, outer thigh, or upper arm.

What to expect

Appetite reduction within week 1. Nausea peaks weeks 1–4 then diminishes. Weight loss most apparent at 12–16 weeks. Titrate slowly to minimise GI side effects.

How much to buy

For 17-wk @ 2.4 mg × 1/wk:

× 10mg vials

× 15mg vials

× 20mg vials

× 50mg vials

Men & women

Men: In men, excess fat lowers testosterone; GLP-1 raises total testosterone, SHBG and gonadotropins as weight drops, and improves sperm and erectile function; and preserves fertility, unlike TRT (which suppresses sperm).

Women: Women lose more than men at the same dose but report more GI (start lower). In PCOS they improve cycles, lower free testosterone and raise ovulation; a real unplanned-pregnancy risk. Stop before conceiving.

Dilution calculator

Set to the guide's typical mix for Semaglutide. Change anything to see where to draw.

Vial size

BAC water added

Dose you want

Draw to

48u

Volume

0.48 mL

Strength

5 mg/mL

Doses per vial

Assumes a U-100 insulin syringe (100 units = 1 mL). Double-check against the compound's page before you draw.

Recommended mixes

Vial	Water	Strength
10 mg	2 mL	5 mg/mL
15 mg	3 mL	5 mg/mL
20 mg	4 mL	5 mg/mL
50 mg	10 mL	5 mg/mL

10 mg: 1 unit = 0.05 mg

Storage

PowderFreeze-dried: -4°F.
MixedReconstituted: 36–46°F. See vial label.

Don't use if: Personal or family history of medullary thyroid carcinoma (MTC) or MEN 2; personal/family history of any thyroid cancer · Personal history of pancreatitis (any cause) · Pre-existing gastroparesis or significant gastric motility disorder; severe GERD, scleroderma, or other delayed-emptying conditions · Prior serious hypersensitivity to the compound or excipients · Pregnancy and lactation; discontinue 2 months before planned conception · History of cholelithiasis / gallbladder disease · Active or pre-existing diabetic retinopathy; eating-disorder history; CKD stage 4–5

Stop if you notice

Creatinine rise >0.3 mg/dL or eGFR drop >20%: hold, rehydrate
Severe abdominal pain: evaluate for pancreatitis
Vision changes: ophthalmology
Persistent vomiting >48h: hold
New neck mass / hoarseness / dysphagia: thyroid workup

Side effects

Nausea, vomiting, diarrhea, constipation, decreased appetite. Rare: NAION (sudden, usually irreversible vision loss); added to EU labels 2025; pooled risk ~2× vs non-users.

Drug interactions

Delayed gastric emptying affects oral absorption (levothyroxine, oral contraceptives, warfarin); separate timing. Insulin / secretagogues: reduce at initiation. Do not combine with other GLP-1 agonists.

Labs

Baseline: BMP/CMP, CBC, HbA1c, lipid panel, TSH, pregnancy test. BMP at every dose escalation and any time GI side effects cause >24h reduced intake. HbA1c at 3 + 6 mo; lipids at 6 mo; repeat eGFR if dehydration. Lipase if abdominal pain. Drop hsCRP / routine calcitonin. Out of range? Rising glucose/HbA1c = blood sugar creeping toward diabetes (recheck, tighten diet); a falling eGFR = kidney strain, usually dehydration (hydrate, hold the dose).

What these labs mean →

Warnings

Acute pancreatitis: discontinue if suspected (severe abdominal pain radiating to back). Acute gallbladder disease; diabetic-retinopathy progression; acute kidney injury from GI-related volume depletion (highest during escalation). NAION (non-arteritic anterior ischemic optic neuropathy), rare sudden monocular vision loss; EU label change 2025. Severe GI: ileus, obstruction, severe constipation, impaction. Anaphylaxis/angioedema reported. Tachycardia (1–4 bpm). Aspiration risk under anesthesia.

Patient education

Acute kidney injury on GLP-1s is from dehydration, not the drug. Target 2.5–3 L water/day; hold next dose for any day of vomiting/diarrhea/reduced food; resume same level after 24h recovery. Required during any GLP-1 cycle: protein 1.2 g/kg IBW/day (1.6 if training), resistance training 2–3×/wk, creatine 5 g/day; else 25–40% of weight lost is lean mass with rapid regain. Eat slowly, stop at first fullness. Hold ≥1 week before general anesthesia/deep sedation (check current ASA position). Inform any anesthesiologist. Use contraception; discontinue ≥2 months before planned pregnancy. Pen sharing prohibited even with a new needle.

These apply on top of the universal safety rules.

What it does

FDA-approved GLP-1 receptor agonist (Ozempic®/Wegovy®), appetite suppression via hypothalamic satiety centres + gastric-emptying delay. 94% amino-acid homology to native GLP-1.

FDA indications & 2026 compounding

FDA indications (injectable): T2D glycemic control; CV-risk reduction (established CVD); CKD (FLOW, Jan 2025); MASH with F2–F3 fibrosis (Wegovy, Aug 2025).

2026 compounding: FDA proposed removing semaglutide / tirzepatide / liraglutide from the 503B bulks list (public comments to Jun 29, 2026); 503A compounding continues under added scrutiny.

FDA label vs community dosing

Approach	Ramp / dose (weekly)	Philosophy
FDA, Wegovy (weight loss)	0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg, +4 wks per step	Escalate to the max approved dose (2.4 mg) for maximum weight loss.
FDA, Ozempic (type-2 diabetes)	0.25 → 0.5 → 1.0 → up to 2.0 mg	Glycemic control; lower ceiling than Wegovy.
Community	Same ramp, but hold at the lowest effective dose (often 0.5–1.0 mg); microdose 0.25 for tolerance	Titrate to effect, not to the max; step up only if progress stalls.

Bottom line: the FDA ramp targets the maximum dose; community practice targets the lowest dose that keeps working, to minimize nausea and cost. Both use the same 4-week step cadence, never escalate faster.

References

rxlist researchdosing peptidedosages DailyMed PubMed ClinicalTrials GLP-1 sex differences Jensterle 2020

From the guide, page 83–84.