What is Semaglutide?

Semaglutide is a prescription medication that belongs to a class of drugs known as GLP-1 receptor agonists. Certain formulations of semaglutide are FDA-approved for the treatment of type 2 diabetes and for chronic weight management in specific adult populations, when used alongside lifestyle modifications such as nutrition and physical activity.

Semaglutide works by influencing hormonal pathways involved in blood sugar regulation and appetite signaling. It is typically administered as a once-weekly subcutaneous injection, which may be self-administered after appropriate instruction from a licensed healthcare provider. The appropriateness of semaglutide, including dose and duration, must be determined through a medical evaluation.

How Semaglutide Works in the Body

Semaglutide affects several physiological processes related to metabolism and appetite regulation. Its primary mechanisms include:

  • Delayed gastric emptying, which can contribute to a prolonged sensation of fullness after eating

  • Improved insulin response, which supports blood sugar regulation in individuals with insulin resistance or type 2 diabetes

  • Central appetite signaling, which may reduce hunger and food intake in some patients

Individual responses to semaglutide vary. Some patients experience gastrointestinal side effects such as nausea, constipation, or changes in appetite, particularly during dose escalation. These effects are typically monitored by a healthcare provider, and dietary adjustments—such as eating smaller meals and slowing eating pace—may be recommended as part of clinical guidance.

Semaglutide does not produce the same effects in all individuals, and no specific outcomes can be guaranteed. It is not appropriate for everyone and may not be suitable for individuals with certain medical conditions. Ongoing medical supervision, laboratory monitoring, and lifestyle support are important components of care.

Semaglutide is a prescription-only medication and should only be used under the direction of a qualified healthcare professional as part of a comprehensive treatment plan.

What Are Common Semaglutide Side Effects?

Semaglutide can cause side effects, such as nausea, constipation, tiredness, headaches, and fatigue. These can be managed with over-the-counter medication and sometimes prescription medications for nausea. It is important to be in touch with your provider regularly about any side effects your experience as it may be a sign of other medical issues. Nausea can be managed with medication like zofran, which dissolves under your tongue, and constipation is often treated with laxatives for relief.

How Do You Inject Semaglutide?

Semaglutide is a subcutaneous injection. If you use compounded semaglutide from a vial, follow the step below for injecting. Patients should be aware that the concentration of compounded semaglutide differs from one pharmacy to the next. Check with your local or telehealth provider about your dosing schedule.

  • The medication must be kept in the fridge
  • Never inject more than once a week
  • Take Zofran and or Tums every 6 hours as needed for nausea
  • Fast for 12-14 hours before injecting, and eat lightly the day before
  • Avoid dairy the day before and the first few days after you inject
  • Take a stool softener the day before if your bowels move slow
  • Wipe the vial top with an alcohol pad, pull back the plunger to fill the syringe with air
  • Turn the vial upside down, insert the needle and push the air into the vial
  • Withdraw the desired dose – Place the vial back in the fridge!!
  • Turn the vial right side up, so the needle is no longer in the liquid, and remove
  • Exchange the needle for a new one. Warm up your meds! (room temp)
  • Use your thumb and index finger and pinch the skin on your abdomen. Lift the skin away from your body. Wipe the area with an alcohol pad and remove the needle cap
  • Poke the needle straight into the skin you are pinching at a 90-degree angle
  • While keeping the skin pinched, slowly push the plunger on the syringe to push the medication into your subcutaneous tissue
  • Once all medication goes in, you can stop pinching the skin and remove the needle
  • Place the needle into the puncture-resistant container.
Semaglutide Injection

How To Start Semaglutide

Weight Management

 

When semaglutide is prescribed—whether FDA-approved or compounded—dosing is typically initiated at a low level and adjusted gradually over time, based on clinical response and tolerance. Dose escalation schedules and treatment duration vary by patient and must be determined and monitored by the prescribing provider.

Some compounded formulations may be supplied in lyophilized (powder) form and require reconstitution prior to administration. In such cases, patients should follow the instructions provided by their pharmacy and healthcare provider, including the proper use of sterile or bacteriostatic diluent, handling, storage, and injection technique. Patients should not mix or administer any injectable medication without appropriate instruction.

Key Considerations

  • Compounded semaglutide is not equivalent to FDA-approved semaglutide products

  • Safety, efficacy, and quality may vary among compounded formulations

  • Use requires medical supervision and ongoing monitoring

  • Cost, availability, and formulation differ depending on the pharmacy and prescription

Patients should discuss FDA-approved options, compounded alternatives, potential risks, and expected outcomes with their healthcare provider before starting treatment.

 

Compounded tirzepatide/semaglutide with vitamin B12 is prepared by a state-licensed pharmacy for individual patients and has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety, effectiveness, or quality. FDA-approved medications in this class are available; your provider will discuss all options and determine what is appropriate for you. Individual results vary. Medication use requires medical supervision and ongoing lifestyle support.

Articles on this site are for general education and do not substitute for professional medical advice. Consult our providers for personalized recommendations.