Semaglutide: Dosing, Side Effects, and Real-World Data

Semaglutide is the most-prescribed GLP-1. It's the molecule behind Ozempic® (for type 2 diabetes) and Wegovy® (for weight management), and it's also the one most often compounded.

How does semaglutide work?

Semaglutide is a GLP-1 receptor agonist — it mimics your gut's GLP-1 hormone but resists the enzyme that normally breaks it down, so it stays active long enough to reduce appetite, slow stomach emptying, and improve blood-sugar control once a week.

How is semaglutide dosed?

In the branded products, semaglutide starts low and ramps up over several weeks to let your body adjust, which reduces nausea. The exact titration schedule and target dose are set by your clinician based on your goal — this is not a dosing guide.

What do the semaglutide trials show?

• Around 15% average weight loss over ~68 weeks in the weight-loss trial (Wegovy®).
• Meaningful A1c reduction in type 2 diabetes (Ozempic®).
• Cardiovascular benefit shown in the large SELECT trial (for the diabetes formulation).
• Most common side effects: nausea, GI upset — usually early and dose-related.

Is compounded semaglutide the same as Wegovy, and can you still get it?

For several years a large share of the semaglutide people actually took was compounded, because branded Wegovy® supply was short. That window has closed. The FDA declared the semaglutide shortage resolved in February 2025, and the deadlines to stop compounding under the shortage exemption passed that spring — April 22 for 503A pharmacies, May 22 for 503B outsourcing facilities.

Compounded semaglutide is not FDA-approved and is not interchangeable with Wegovy® or Ozempic®. A 503A pharmacy can still prepare a patient-specific formulation where the prescriber documents a clinically significant difference from the approved product for that patient, but that is a narrow exception rather than a general supply channel. Ask any provider, directly, which product you would be getting and what the documented basis is.