Compounded Semaglutide Medication Guide

What is Compounded Semaglutide?

Compounding is the process of combining or altering two or more drugs to create a personalized medication tailored to a patient. Although compounded medications are not evaluated by the FDA, compounding helps expand patient access to life-saving medications and provides customized options for patients with specific and complex needs.

Semaglutide is the active ingredient in the commercially available GLP-1 medications Wegovy and Ozempic. These medications are currently on the FDA drug shortage list, which means that compounding pharmacies can offer compounded semaglutide in order to expand patient access.

Dosing and Storage Instructions

See instructions

How To Store Your Medication

  • Store your semaglutide vials in the refrigerator, and discard the vials 28 days after you open them.
  • See our guide here or the insert included with your medication for more details. 

How To Take Your Medication

Take your medication as prescribed by your doctor. Compounded semaglutide is typically a weekly injection.

To take your medication, you will need to check your dosage, draw the right amount of medication from the vial using the syringe provided, and give yourself a subcutaneous injection, typically in your abdomen, thigh or arm. You can find instructions on the insert in your package, or access our step-by-step guide on how to prepare and take your medication.

What If I Miss a Dose of Medication? 

  • If you miss a dose of compounded semaglutide, please take the dose as soon as possible, but within 48 hours of when you were originally supposed to take your scheduled dose.  
  • If it has been more than 9 days since you missed your last dose and you are taking a dose higher than 0.25mg (the starting dose), it is recommended that you temporarily decrease your dose to the starting dose of 0.25mg, to lessen the risk of significant side effects such as abdominal pain, nausea, and vomiting.

When Should I Stop Taking Medication?

  • At the beginning of the Sunrise program, you communicate your goal weight to your Sunrise affiliated physician. When you achieve your goal weight or achieve a body mass index (BMI) less than 27, message your doctor. Your doctor may recommend you transition to a maintenance dose to maintain your weight loss.
  • If you believe you may have a BMI less than 30, please proactively communicate with your doctor every month regarding your current weight because it may inform the dosage for future prescriptions.

How to Refill Your Semaglutide Prescription

How to refill your semaglutide prescription

For the initial four to six months of the Sunrise program, refilling your compounded semaglutide prescription requires a monthly check-in with your Sunrise affiliated physician. During this check-in, your physician will evaluate your weight-loss progress and determine the best weight loss path for the next month. After 6 months, your doctor will reassess the frequency of your check-ins.

The goal of the monthly check-in with your physician is to determine the proper dose of compounded semaglutide which will optimize your weight-loss progress while minimizing side effects. 

Every month, we will reach out via email during Week 3 to initiate your check-in with your physician.

You can also initiate a check-in via the Sunrise refill page.

When You Should Message Your Sunrise Affiliated Physician

You can message your physician at any time through the Sunrise messaging portal. In addition, below are specific times you should reach out to your Sunrise affiliated physician:

  • If you have not taken a dose of medication within the last 10 days.
  • Any time you experience severe side effects, including allergic reactions, severe dehydration, syncope/passing out, or any Emergency Room visits that may be related to your medication.
  • Any time you are hospitalized with other medical conditions, or starting new medications.
  • Any planned procedures that require anesthesia or fasting prior to the procedure.
  • When your BMI is less than 27.
  • Please notify your primary care doctor that you are starting on a GLP-1 agonist.

Additional compounded semaglutide FAQs

What are common side effects of semaglutide?

Common side effects of semaglutide include diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, heartburn, dizziness, stomach fullness, flatulence/gas, belching, gastroenteritis, and gastroesophageal reflux disease. 

Click here for the full list of semaglutide side effects.

Because nausea is most common in patients beginning treatment with semaglutide, you will be prescribed generic Zofran (ondansetron) to help alleviate nausea when you start taking semaglutide. ONLY take this medication if you experience nausea.

I didn’t inject any medication - it went on the floor! What should I do? 

Contact, and we can help you with next steps.

I accidentally injected too much/too little - what are my next steps? 

Contact your doctor  via your Sunrise medical portal immediately. If you have any severe or life-threatening side effects, please dial 911 and seek emergency services.

What if I have an allergic reaction?

You might experience a minor site reaction, meaning mild redness around the injection site.  If you are having a severe allergic reaction with hives, shortness or breath, eye swelling, or any other significant reaction, dial 911 or visit your nearest emergency room.

What if I need more supplies - syringes or needles? What if my supplies are damaged?

Contact for additional supplies. Immediately discard any damaged supplies.

Can I reuse my needles? 

Do not reuse needles. You can read more about safe needle disposal here.

I left the package out after delivery/the weather in my region is warm. Can I still use the medication?

According to studies by our partner pharmacy, your compounded semaglutide vials have demonstrated stability for a period of 7 days at temperatures of up to 140°F (60°C). Since shipping time is two days, if your vials were left out after delivery for more than 24 hours, please contact our team at Your vials should be immediately stored in your refrigerator upon arrival.

Who should not take compounded semaglutide?

Your Sunrise affiliated physician evaluated your health history prior to writing your initial prescription based on the medical intake form you filled out when signing up for Sunrise. As a result, some patients may not be eligible to take compounded semaglutide.

If you develop any of these conditions after starting your prescription, please stop using compounded semaglutide and reach out to your Sunrise affiliated physician right away.

  • Family or personal history of medullary thyroid cancer
  • Family of personal history of multiple endocrine neoplasia Type 2 (MEN-2) syndrome
  • Sensitivity or previous allergic reaction to cobalt and/or vitamin B12
  • Currently pregnant or planning to become pregnant in the next two months
  • Currently breastfeeding
  • Retinopathies (diseases of the retina)
  • Type 1 Diabetes
  • Early Leber’s disease 
  • Serious gastrointestinal disorders (Severe GERD/hiatal hernia/Crohn's diagnosis/ulcerative colitis)
  • Recent bariatric surgery (within past 6 months)
  • Pancreatitis using GLP-1s in the past or patients with chronic pancreatitis
  • Drug use disorder
  • Alcohol use disorder
  • Disordered eating
  • Suicidal ideation or behavior
  • Gallbladder disease (does not include gallbladder removal)

Warning: Semaglutide may cause worsening depression or suicidal thoughts, intestinal blockage, or thyroid cancer. Watch for possible symptoms, such as mood changes, abdominal pain, swelling in the neck, trouble swallowing, hoarseness, and shortness of breath. If you have any of these symptoms, tell your healthcare provider.

Additional Online Resources

Last Updated: 22/08/2023

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