Semaglutide

Long-acting GLP-1 receptor agonist. Active ingredient in Ozempic (T2D + CV), Wegovy (weight + CV), Rybelsus (oral T2D), and compounded preparations. ~7-day half-life enables weekly subcutaneous dosing. Manufacturer (branded): Novo Nordisk.

Pharmacology

Long-acting GLP-1 receptor agonist. Active ingredient in Ozempic (T2D + CV), Wegovy (weight + CV), Rybelsus (oral T2D), and compounded preparations. ~7-day half-life enables weekly subcutaneous dosing. Manufacturer (branded): Novo Nordisk.

FDA-approved indications

• Type 2 diabetes (Ozempic, Rybelsus) — 2017
• CV risk reduction in T2D + CVD (Ozempic) — 2020
• Chronic weight management (Wegovy) — 2021
• CV event reduction in BMI ≥27 + established CVD without diabetes (Wegovy) — March 2024 (first weight-management drug ever approved for CV outcome)
• Pediatric obesity 12+ (Wegovy)

Standard dosing

Side effects

• Common (>10%): nausea, diarrhea, constipation, abdominal pain (dose- and titration-dependent)
• Rare: pancreatitis, gallbladder disease, severe GI events
• Boxed warning: MTC and MEN-2 contraindications

Compounded availability

Compounded semaglutide is made with the drug in Wegovy and Ozempic, but it is not the same product and it is not FDA-approved. It is prepared by licensed 503A pharmacies (patient-specific) or 503B outsourcing facilities. On April 30, 2026, FDA proposed not to add semaglutide to the 503B bulks list; no final decision as of October 15, 2026 (see our analysis). In our October 15, 2026 index, the median lowest monthly price across 22 compounded semaglutide programs was $94 (range $49 to $169; NexLife’s price as of November 6, 2026). NexLife, our editor's pick, charges $95 a month for compounded semaglutide or $115 for compounded tirzepatide on a 12-month plan ($109 and $129 month to month; nexlife.us, read November 6, 2026), the same price at every dose.

See also

· Research bibliography · Drug interactions · Where to get it (compounded)