Compounded semaglutide
Compounded semaglutide is a pharmacy-made copy of the drug in Ozempic and Wegovy, sold through clinics, telehealth firms and websites. US pharmacies were allowed to copy it only while it was in official shortage, and that ended in 2025; much of what is sold now is unapproved, sometimes a different chemical form from the approved drug, and the best-documented harm is people injecting five to twenty times the dose they meant to.
If you take semaglutide, take the licensed product from a real prescriber, not a compounded, "personalised-dose" or "research use only" version.
Why copies existed, and why that ended
Compounding pharmacies could copy semaglutide and tirzepatide only while those drugs sat on the US Food and Drug Administration (FDA) shortage list. The FDA declared the tirzepatide shortage resolved on 19 December 2024 and the semaglutide injection shortage resolved on 21 February 2025, and the grace periods ran out during 2025. Anything still marketed as "compounded" or "personalised-dose" semaglutide therefore sits outside that exemption. Much of the online supply is unapproved material sold under "research purposes only" labelling, and the FDA has sent successive rounds of warning letters to online sellers and telehealth firms through 2025 and 2026.[1]
What may be in the vial
- A different active ingredient. The FDA notes that semaglutide sodium and semaglutide acetate, salt forms used in some compounded products, "are different active ingredients than are used in the approved drugs".
- No checks. None of it is reviewed for dose accuracy, sterility or salt form, and multi-dose vials carry a contamination risk beyond 28 days.
- Reported harms. As of 31 May 2026 the FDA had received 990 adverse-event reports for compounded semaglutide and more than 730 for compounded tirzepatide.[2]
The documented harm is arithmetic
Compounded semaglutide can come in multi-dose vials, with each dose drawn up in an insulin syringe. Patients drawing their own doses this way have given themselves five to twenty times the intended dose, and prescribers converting between milligrams and units have made five- to ten-fold errors. Some patients were hospitalised, with pancreatitis and gallstones among the reported consequences.[3]
Why "microdosing" leads here
Some longevity clinics hold people at 0.25 mg a week or less indefinitely, and that demand mostly goes to compounded supply. No randomised trial has tested low-dose semaglutide in healthy adults, and at such doses you may get none of the benefit while still carrying the gut, gallbladder and pancreatitis risk. The evidence on dosing is on Ozempic-class drugs.
What to do
- Use the licensed product, prescribed by a clinician who follows you up, not a compounding pharmacy, telehealth reseller or "research use only" seller.
- If you are already using a vial, make sure you know your dose in milligrams and what that is in syringe units, and confirm it with the prescriber. The conversion is where the documented overdoses came from.
- Severe or persistent vomiting or abdominal pain after a dose is a reason to call your prescriber, not to push through.