Let's be real. If you’re looking for a compounded semaglutide dosage chart, you’re probably staring at a tiny vial of clear liquid and feeling slightly terrified about how much of it is actually supposed to go into your body.
You aren't alone.
The surge in popularity for GLP-1 medications has created a bit of a Wild West. Since the FDA added semaglutide to its drug shortage list, compounding pharmacies have stepped in to fill the gap. But here's the kicker: unlike the brand-name pens (Ozempic or Wegovy) that come with "click" dialers, compounded versions usually require you to draw the medication into a syringe yourself.
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Mistakes happen. Often.
I’ve seen people accidentally take ten times the dose because they confused "units" on an insulin syringe with "milligrams" of the actual drug. That is a fast track to a weekend spent in the bathroom—or the ER. Understanding the titration schedule isn't just about weight loss; it's about not making yourself incredibly sick.
Why the Math Gets Messy
Compounded semaglutide isn't a "one size fits all" liquid. Different pharmacies mix their batches at different concentrations. One pharmacy might send you a vial where there is 2.5 mg of semaglutide per milliliter (mL). Another might send a much more potent version with 5 mg per mL.
This is where the compounded semaglutide dosage chart becomes your best friend, but only if it matches your specific vial.
Most people use U-100 insulin syringes. These are measured in "units," which are volume, not weight. If your doctor tells you to take 0.25 mg, you have to figure out how many units that equals based on your pharmacy's specific concentration. It's confusing. Honestly, it's a bit much for most people to do while they're caffeinating on a Tuesday morning.
The Standard Titration Schedule
Most clinicians follow the protocol established by Novo Nordisk’s clinical trials (like the STEP trials). The goal is "low and slow." You want to trick your body into accepting this hormone without triggering a massive "get this out of me" response from your digestive system.
Typically, the month-by-month breakdown looks like this.
Month 1: The Induction Phase
You start at 0.25 mg once a week. You won't lose twenty pounds this month. You might not lose any. That’s fine. This dose is purely to get your brain and gut used to the slowed gastric emptying. If your concentration is 5mg/mL, this is usually just 5 units on a syringe. Tiny.
Month 2: Stepping Up
You move to 0.5 mg once a week. This is often where the "food noise" starts to quiet down. You might find you can't finish a sandwich. It's a weird feeling, right?
Month 3: The Intermediate Dose
The dose increases to 1.0 mg. For many, this is the "sweet spot" where weight loss becomes consistent.
Month 4 and Beyond: Therapeutic Doses
From here, doctors might move you to 1.7 mg and eventually the maximum dose of 2.4 mg. Not everyone needs to go this high. If you are losing weight at 1.0 mg without feeling like a zombie, many practitioners—like those at the Obesity Medicine Association—suggest staying put.
Reading Your Compounded Semaglutide Dosage Chart
You have to look at the "mg/mL" on your vial. If you ignore that number, you're guessing.
Let's look at a common example. If your vial says 5mg/mL:
- For a 0.25 mg dose, you draw to the 5 unit mark.
- For a 0.5 mg dose, you draw to the 10 unit mark.
- For a 1.0 mg dose, you draw to the 20 unit mark.
Now, imagine your vial is a different concentration, say 2.5mg/mL. Everything doubles. That 0.25 mg dose now requires 10 units. See how easy it is to mess up? If you switch pharmacies and they change the concentration but you keep pulling the same "units," you’ve just doubled or halved your dose without knowing it.
Always double-check the label every single time a new shipment arrives. Pharmacies change their formulas based on ingredient availability. It happens more than you'd think.
Side Effects: The Price of Admission
Let's talk about the elephant in the room. Nausea. Constipation. The "sulfur burps" that smell like a literal swamp.
These aren't just "possible" side effects; they are the reality for about 40% of users. The compounded semaglutide dosage chart is designed to minimize this, but it’s not a guarantee. If you jump a dose too early because you’re impatient for results, you will pay for it.
I’ve talked to patients who thought they were "tough" and skipped from 0.5 mg to 1.7 mg. They ended up on a literal IV drip for dehydration. Don't be that person.
If the side effects are brutal, talk to your provider about "split dosing" or staying at a lower dose for an extra two weeks. There is no prize for reaching 2.4 mg the fastest. The real prize is sustainable health.
The Quality Control Issue
Compounded drugs are not FDA-approved in the same way as the brand name. The pharmacy is regulated by the state board, but the specific mixture in your hand hasn't gone through a multi-year clinical trial.
This is why sourcing matters.
You want a pharmacy that is PCAB-accredited. You want to see a Certificate of Analysis (COA). If your semaglutide is coming from a "med spa" that won't tell you which pharmacy they use, run. Seriously.
There have been reports of "semaglutide sodium" or "semaglutide acetate" being used. The FDA has explicitly warned against these salt forms because they haven't been proven safe or effective for humans. You want the base form of semaglutide.
Practical Steps for Injection Day
- Check the liquid. It should be clear and colorless. If it's cloudy or has "floaties" (particulates) in it, do not inject it. Throw it out.
- Alcohol prep is non-negotiable. Swipe the top of the vial. Swipe your skin. Infection at the injection site is rare but totally avoidable.
- Pinch the skin. Most people inject in the stomach, but the thigh is a great alternative if you’re dealing with heavy nausea. Some anecdotal evidence suggests thigh injections might lessen the GI hit.
- The "Wait" Count. After you push the plunger, count to five before pulling the needle out. This ensures the full dose stays under the skin and doesn't leak back out.
What to do if you miss a dose
Life happens. You go on vacation and forget your vial in the fridge.
If it’s been fewer than 5 days since your scheduled dose, take it as soon as you remember. If it’s been more than 5 days, skip it and wait for your next scheduled day.
Whatever you do, do not take two doses at once to "make up" for it. You will regret that decision within six hours. Your gallbladder will not be happy with you.
Actionable Next Steps
To manage your treatment safely, take these steps immediately:
- Audit your vial: Read the concentration (mg/mL) right now. Write it down in your phone notes.
- Verify your math: Use your pharmacy's specific compounded semaglutide dosage chart to confirm that the "units" you are drawing match the "mg" your doctor prescribed.
- Get a side-effect kit: Buy some ginger chews, electrolytes, and a stool softener before you need them.
- Track your triggers: Keep a simple log of what you eat on the day of your injection. High-fat meals right before a shot are a recipe for disaster.
- Consult the pros: If you feel "stuck" or the side effects won't quit, don't just stop cold turkey. Ask your doctor about a slower titration or a maintenance dose that feels manageable for your lifestyle.