Pros
Addresses both diabetes management and weight loss
May reduce the risk of heart attacks and strokes in high-risk patients
May improve weight-related comorbidities such as high blood pressure, high cholesterol, sleep apnea, and high sugars
- Weight Loss
- GLP-1
Semaglutide
Compounded semaglutide online for type 2 diabetes and weight loss
Semaglutide, the active ingredient in Ozempic® and Wegovy®, helps regulate blood sugar levels and promote significant weight loss. Book an appointment with one of our board-certified primary care doctors to discuss the treatment of diabetes or weight-related medical conditions with compounded semaglutide, in addition to healthy lifestyle changes, to achieve your long-term health goals.*
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Convenient diabetes and weight management
Average of 12% body weight loss with sustained diet and exercise(1)
Compounded semaglutide sent to your doorstep
*Prescriptions for compounded semaglutide are currently restricted to residents in the following states: AZ, CA, CO, DC, DE, FL, GA, HI, IA, ID, IL, KS, MA, MD, ME, MO, MT, ND, NE, NH, NM, NV, NY, OH, OK, OR, PA, RI, TN, TX, UT, WA, WY. It is important to note that compounded semaglutide is only available as an alternative to branded Ozempic® and Wegovy® as long as they remain on the FDA drug shortages list. If those branded medications are no longer on the FDA shortage list, compounded semaglutide will no longer be available. Although compounded semaglutide is not FDA-approved, our pharmacy provider complies with pertinent federal and state laws and FDA regulations. Prescriptions are provided at the doctor’s discretion. Learn more about our controlled substances policy.
What is semaglutide, and how does it work?
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is the active ingredient in both Wegovy® and Ozempic®. It plays a vital role in both diabetes and weight management because it helps control hunger and regulate blood sugar.
It is available to patients with a body mass index (BMI) of over 30 kg/m² or individuals with a BMI of over 27 kg/m² alongside at least one weight-related condition, such as type 2 diabetes, prediabetes, high cholesterol, or sleep apnea.
Combined with a healthy, low-calorie diet and exercise routine, semaglutide has shown promising results. Many patients report enhanced blood sugar control and noticeable weight loss with semaglutide. It's important to note that individual responses may vary. Lifestyle changes, including a healthy fitness plan and diet, are the cornerstones of health and wellness. Medications for weight management used without these cornerstones will only provide a temporary change and not be effective long term.
Benefits of semaglutide include:
Medically significant weight loss: One study found that patients taking weekly semaglutide maintained an average weight loss of 15% of body weight after two years.2
Blood sugar control: Semaglutide helps the body regulate blood sugar levels, supporting overall metabolic health.
Cardiovascular benefits: For patients who are overweight and have coronary artery disease, semaglutide reduces the risk of heart attacks or strokes.
What should I know about the availability of compounded semaglutide?
Compounded semaglutide will only remain available as an alternative to branded Ozempic® and Wegovy® as long as it remains on the FDA drug shortages list. Once there is no shortage, you can ask your doctor about Ozempic® for type 2 diabetes, Wegovy® for weight loss, or other alternative medications.
What is the difference between semaglutide and compounded semaglutide?
Semaglutide is the active ingredient in Ozempic® and Wegovy®, which come as injection pens. Compounded forms of semaglutide usually come in a vial with syringes and are combined with a small amount of vitamin B12.
With our preferred compounding pharmacy, the compounded semaglutide is an exact molecular copy of the semaglutide base. An outside lab also verifies its authenticity and potency. The compounded semaglutide from our preferred pharmacy is not a salt form of semaglutide. The FDA warns the public that products containing salt formulations are not proven to be safe and effective.
What are the pros and cons?
Compounded semaglutide
Cons
Not available in every state (see above for which states are available)
Rather than coming in a pre-filled pen, you will measure doses yourself with syringes and needles
Pre-existing conditions like kidney problems or gallstone issues may require careful monitoring or be contraindicated to the medication
Semaglutide side effects and risks
It’s essential to be aware of potential semaglutide side effects. These can include:
Upset stomach
Nausea and vomiting
Gas, bloating, diarrhea, or constipation
Fatigue
Depression
Delayed stomach emptying (gastroparesis)
Abdominal discomfort is not a typical side effect of semaglutide. Many initial side effects diminish as your body becomes accustomed to the medication. However, if your side effects persist or worsen, talk to your doctor for support.
Although rare, it’s also crucial to be aware of potential risks:
Kidney health: Stay hydrated with 1.5-2L fluids to prevent dehydration and kidney issues.
Gallbladder health: If you experience upper abdominal pain, discomfort on the right side, right shoulder pain, dark urine, or notice yellowing of the skin or eyes, seek immediate medical attention.
Pancreatic health: Minimize alcohol consumption while on semaglutide to reduce the potential risks of pancreatitis.
Thyroid concerns (rare): In the rare event of thyroid enlargement or pain, immediately follow up with your doctor to address any potential thyroid nodules. This medication may not be suitable for people who have had a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia.
Mental health: While rare, there have been studies that showed patients who have had a history of suicidal ideations start to have recurring thoughts of self-harm while taking this class of medication (GLP-1s). If you experience this, please talk to your physician right away, or in cases of a medical or mental health emergency, call 911 or go to the nearest emergency room.
Hypoglycemia (low blood sugar): This is more common in diabetic patients taking medication such as insulin or medications that increase insulin secretion (i.e., sulfonylureas like glipizide). Be aware of lightheadedness, fatigue, sweating, shakiness, rapid heartbeat, or headaches indicating low blood sugar. Keep a sugar replacement, such as fruit juice or glucose alternatives, on hand if you experience these symptoms.
Pregnant or breastfeeding: This medication is contraindicated for people who are breastfeeding, pregnant, or planning to become pregnant within the next three months.
Decreased oral birth control effectiveness: GLP-1 medications, including semaglutide, can decrease the effectiveness of oral contraception because the stomach does not empty as quickly. If you are using oral birth control, you should also use condoms or another form of contraception for four weeks after starting the medication and for four weeks after each dose increase. Alternatively, you can talk to your doctor about switching to non-oral contraceptive methods.
How to take compounded semaglutide:
Your doctor will provide instructions on taking your semaglutide prescription. You will be measuring the amount of medication that you give yourself with sterile insulin syringes and needles.
Semaglutide is injected under the skin, no more than once weekly at any time of the day, with or without food. Inject the medication on the same day of each week. Unlike the brand name medications, compounded semaglutide is drawn from a vial using small syringes and needles. All materials needed will be provided in the prescription.
Semaglutide dosage is designed to gradually increase over time to minimize side effects. Currently, our doctors can prescribe compounded semaglutide in 0.25 mg, 0.5 mg, 1 mg, and 1.7 mg doses, as those are the doses that are currently on the FDA shortage list. You must stay at each dose for at least four weeks. You will meet with your doctor monthly while you are adjusting your medication dose and developing your healthy diet and exercise routines. Your doctor will walk you through this process and be there for you each step of the way.
General instructions may include:
Store the semaglutide in its original packaging in a refrigerator.
Remember to label the date you opened the medication since it's only suitable for 28 days after opening.
Use a syringe to fill the correct amount of medication from the vial.
Position the needle at a 90-degree angle, straight up and down, and carefully insert it into the injection site (subcutaneous injections are primarily injected into the abdomen or optionally the upper/outer thigh)
Gradually press down the plunger until it reaches the bottom, and then withdraw the needle gently.
Safely dispose of the used needle and syringe using a sharps disposal container.
For more details on administering the medication, review the guide from our pharmacy provider. Once the medication is prescribed, your physician will instruct you on how much medication to administer weekly. The medication is started at the lowest dose.
Semaglutide FAQs
What's the cost of compounded semaglutide?
We currently offer compounded semaglutide for a cash-pay option of $299 per month for the medication for individuals outside of California. For California patients, the cost is $399 per month for the 0.25 mg, 0.5 mg and 1.0 mg doses and $599 per month for the 1.7 mg dose. for the same amount of medication. When the medication is ordered during your appointment, you will be charged this amount to the card on file. Please make sure you have an active card on file and a current address. If there is no card on file or address, this may delay the prescription.
Can I use insurance for compounded semaglutide?
This is a cash-pay-only option and does not go through insurance. It will not count towards a pharmacy deductible. Patients can submit the cost for reimbursement through their HSA/FSA, but we do not currently accept these cards.
Does compounded semaglutide come as a pen or a syringe and needle?
This medication usually comes in the form of a syringe and needle, unlike branded semaglutide products that come in a pen. You must fill the syringe yourself with the correct dose from the vial.
When will my semaglutide arrive?
You should expect your semaglutide shipment to arrive within a week after being prescribed, as long as your address and credit card are up to date in your PlushCare account. Semaglutide is a long-acting medication. If your shipping is delayed for some reason, you can safely wait up to two weeks to take your next dose.
Is compounded semaglutide safe?
Not all compounding pharmacies create compounded semaglutide the same. Our medical directors have worked closely with the compounding pharmacy to make sure that they meet quality and safety expectations. Our pharmacy partner(s) complies with all federal and state laws and FDA regulations. With our preferred compounding pharmacy, the compounded semaglutide is an exact molecular copy of the semaglutide base. The compounded semaglutide from our preferred pharmacy is not a salt form of semaglutide. The authenticity and potency of the compounded semaglutide are also verified by an outside lab. The FDA warns the public that products containing salt formulations have not been shown to be safe and effective.
Which labs are required to get a compounded semaglutide prescription?
Your doctor will order labs for you before prescribing semaglutide to determine if semaglutide is an appropriate medication for you. These labs typically include an obesity lab panel, which measures CBC (blood count), CMP (metabolic function), lipids (cholesterol levels), A1C (diabetes), TSH (thyroid function), and insulin. Your doctor will then review the lab results with you to see if semaglutide is a recommended treatment option for you.
How to get compounded semaglutide during the Wegovy® and Ozempic® shortage
Step 1
Book a visit with an online primary care doctor to discuss compounded semaglutide.
During your first visit, your PlushCare doctor will review your medical history and health goals.
Step 2
Talk to your physician regarding a compounded semaglutide prescription.
Visit with a doctor on your smartphone or computer. Often, lab work is required, and they’ll send an order to your preferred lab. Once your results are available, your doctor will review them with you at a second visit and discuss treatment options.
Step 3
Get your compounded semaglutide delivered if prescribed.
Prescriptions are provided based on eligibility and safety. Our physicians may prescribe medications, help you set diet and exercise goals, and monitor your weight loss progress. If compounded semaglutide is recommended, a prescription will be sent to your preferred pharmacy and delivered to your home in about a week.
Compounded semaglutide pricing details
How it works
Compounded semaglutide is not covered by insurance. For patients outside of CA, the out-of-pocket cost is $299/month for one vial. For CA patients, it’s $399/month for the 0.25 mg, 0.5 mg and 1.0 mg doses, and $599/month for the 1.7 mg dose.*
Paying with insurance
Membership
$16.99/month
First month free
Visits
Copay
30 days of free membership
Same-day appointments 7 days a week
Unlimited messages with your Care Team
Exclusive discounts on lab tests
Free memberships for your family
Cancel anytime
Visit price with insurance
Often the same as an office visit. Most patients with in-network insurance pay $30 or less!
- We accept these insurance plans and many more:
Paying without insurance
Membership
$16.99/month
First month free
Visits
$129
30 days of free membership
Same-day appointments 7 days a week
Unlimited messages with your Care Team
Exclusive discounts on lab tests
Free memberships for your family
Cancel anytime
Visit price without insurance
Initial visits are $129.
Book an appointment
* Please note that this does not include the cost of the physician visits, labwork, or our membership. If we're unable to treat you, we'll provide a full refund.
Sources:
PlushCare is dedicated to providing you with accurate and trustworthy health information.
Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity." Published in JAMA Network Open, Accessed on November 13, 2023 at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796491.
Nature Medicine Journal. "Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial." Published in Nature Medicine, Accessed on November 13, 2023 at https://www.nature.com/articles/s41591-022-02026-4.
National Center for Biotechnology Information (NCBI). "Once-Weekly Semaglutide in Overweight or Obese Adults." Published on PMC, Accessed on November 13, 2023 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/.
U.S. Food and Drug Administration (FDA). "Medications Containing Semaglutide Marketed for Type 2 Diabetes or Weight Loss." Published on FDA, Accessed on November 13, 2023 at https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss.
Ozempic. Accessed on November 13, 2023 at https://www.ozempic.com/.
Wegovy. Accessed on November 13, 2023 at https://www.wegovy.com/.
National Center for Biotechnology Information (NCBI). "Weight Loss Medications." Published on PMC, Accessed on November 13, 2023 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/.
American College of Cardiology (ACC). "SELECT." Published on ACC, Accessed on November 13, 2023 at https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/11/09/15/04/select.