Product photography is representative. Vial size and labeling vary by pharmacy and dose.
Semaglutide
One injection a week, at a dose your provider sets and adjusts with you. Semaglutide is one of the most studied GLP-1 options, and it is where most of our patients start.
How the dose usually goes up
Semaglutide starts low on purpose. The slow ramp is what keeps side effects manageable. Below is the typical pattern. Your provider sets your schedule and can hold you at a dose, step you up slower, or move you back down.
Typical titration schedule for compounded semaglutide
| Weeks | Typical weekly dose | What most people notice |
|---|---|---|
| Weeks 1 to 4 | 0.25 mg | The starting dose. It is meant to let your body adjust, not to drive results. Most side effects show up here and usually settle within a couple of weeks. |
| Weeks 5 to 8 | 0.5 mg | The first step up, and only if you handled the starting dose well. Appetite changes are often clearer at this point. |
| Weeks 9 to 12 | 1 mg | A common place to settle. Plenty of patients stay here for months and never need more. |
| Weeks 13 to 16 | 1.7 mg | Your provider steps you up only if progress has stalled and you are tolerating the current dose. |
| Week 17 and after | Up to 2.4 mg | The upper end of the usual range. Many people never get here, and that is fine. |
Same day, every week
Pick a day and stick to it. If you miss a dose and it has been less than five days, take it when you remember. If it has been longer, skip it and go back to your normal day.
Rotate the site
Stomach, thigh, or the back of the arm. Move the spot each week. Your kit comes with everything you need and written instructions.
Speak up early
If a step up is rough, message your care team. Holding a dose longer is normal and costs you nothing. Nobody gets pushed up a ladder on a schedule.
This schedule is a general reference, not medical advice or a prescription. Your provider sets your dose. Compounded medications are not FDA-approved. Results vary and are not guaranteed.
Want a provider's read on this? Answer a few questions and a US-licensed provider tells you what actually fits, if anything does.
Start the assessmentSide effects, plainly
Semaglutide is a real medication with real side effects. Most are stomach related, most show up in the first weeks or after a dose increase, and most ease as your body adjusts. Read this part before you start, and ask your provider anything it raises.
The common ones
These are reported often and usually get better with time or a slower dose ramp.
- Nausea, especially in the first week at a new dose
- Constipation or diarrhea
- Vomiting
- Heartburn, burping, or a full feeling that lasts
- Stomach pain or bloating
- Tiredness and headache
- Soreness, redness, or itching at the injection site
What helps: smaller meals, less greasy and fried food, drinking water through the day, and not rushing to the next dose. Your provider can slow the ramp or hold you where you are.
Call your provider right away if
- You have severe stomach pain that will not go away, with or without vomiting, and it may move to your back. This can be a sign of pancreatitis.
- You cannot keep fluids down, or you feel dizzy, weak, or your urine is very dark. That is dehydration, and it can affect your kidneys.
- You have pain in your upper right stomach, fever, yellowing skin or eyes, or clay-colored stools. That can point to a gallbladder problem.
- You notice a lump or swelling in your neck, trouble swallowing, hoarseness, or shortness of breath.
- You have vision changes, especially if you have diabetic eye disease.
- You have signs of low blood sugar such as shakiness, sweating, confusion, or a fast heartbeat, which is more likely if you also take insulin or a sulfonylurea.
- You have a rash, swelling of the face, lips, or tongue, or trouble breathing.
If it feels like an emergency, call 911 or go to the nearest emergency room. Do not wait on a message.
Who should not take semaglutide
Do not use semaglutide if you or a family member has had medullary thyroid carcinoma, or if you have Multiple Endocrine Neoplasia syndrome type 2. In animal studies, semaglutide caused thyroid C-cell tumors. It is not known whether it does that in people.
Tell your provider before you start if you are pregnant, planning to become pregnant, or breastfeeding; if you have had pancreatitis, gallbladder disease, or an eating disorder; if you have gastroparesis or another serious stomach problem; if you have kidney or liver disease; if you have diabetic retinopathy; or if you take insulin, a sulfonylurea, or any other medication for diabetes. Semaglutide slows how fast your stomach empties, which can change how other oral medications are absorbed, so list everything you take including birth control and supplements.
Semaglutide is not a treatment for type 1 diabetes and is not for people with a history of severe allergic reaction to semaglutide or any ingredient in the formulation.
Compounded medications are not FDA-approved. Compounded semaglutide is prepared by a licensed compounding pharmacy and is not reviewed by the FDA for safety, effectiveness, or quality. Weight-loss results vary and are not guaranteed. This page is general information, not medical advice, and it does not replace a conversation with your provider. Medication is prescribed only if a licensed provider determines it is appropriate after an evaluation. Before you start, you will review and sign our telehealth consent.
Semaglutide or tirzepatide?
Both are once-weekly injections and both are prescribed only when a provider decides they fit. The honest short answer is that most people start on semaglutide, and your provider can move you if it is not doing enough.
| Semaglutide | Tirzepatide | |
|---|---|---|
| How it works | Acts on the GLP-1 pathway, which affects appetite and how full you feel. | Acts on two pathways, GLP-1 and GIP. |
| Program price | From $99 a month | From $249 a month |
| How you take it | One injection a week | One injection a week |
| Typical dose range | 0.25 mg up to 2.4 mg, stepped up over months | 2.5 mg up to 15 mg, stepped up over months |
| Common side effects | Mostly stomach related, heaviest in the first weeks and after a step up | Similar profile, and some patients report the early weeks feel stronger |
| Often chosen when | You want the more established option, or the lower monthly price, or you are starting from scratch | You want the dual pathway option, or semaglutide has not been enough at a full dose |
| Switching later | Tell your provider your current medication and dose, and they review whether to continue or change | Same. Nothing about starting one locks you into it. |
This comparison is general information, not medical advice, and it is not a claim that either medication works better for you. Neither is a compounded product reviewed by the FDA. Your provider chooses based on your history, your other medications, and how you respond. Results vary and are not guaranteed.
What patients on semaglutide say
Individual experiences. They are not a promise of what will happen for you.
"The first two weeks were rough and I almost quit. I messaged the team on a Sunday night and someone answered. They kept me at the same dose an extra month instead of pushing me up, and that fixed it."
Verified patient · results vary"I had been paying almost double somewhere else and getting a form letter every month. Here the same provider follows my chart and actually remembers what we changed last time."
Verified patient · results vary"The shipping window slipped by two days once and that was annoying. Everything else has been straightforward, and the monthly check-in is a real conversation, not a checkbox."
Verified patient · results varyStill deciding? You do not have to know what you want. That is what the provider review is for.
Start the assessmentQuestions about semaglutide
How do I actually take it?
One small injection under the skin, once a week, on the same day each week. You can do it in the stomach, thigh, or the back of your arm, and you rotate the spot. Your first shipment includes the vial, syringes, alcohol wipes, and written instructions, and your care team walks you through the first dose if you want.
Is compounded semaglutide the same as the brand-name version?
No. Compounded semaglutide is prepared by a licensed compounding pharmacy and is not FDA-approved. Brand-name products are separately approved and are a different product with different labeling. We do not claim they are equivalent. Your provider will explain what compounded means for you before you start.
When would I notice anything?
Appetite changes are often the first thing people report, sometimes in the first few weeks. The starting dose is deliberately low, so it is normal to feel very little at first. Results vary and are not guaranteed, and your provider tracks how you are doing at each monthly check-in.
The nausea is bad. What do I do?
Message your care team. Do not white-knuckle it and do not stop on your own without telling anyone. In most cases a provider will keep you at your current dose longer, step you back down, or suggest changes to how and when you eat. Holding a dose costs you nothing extra. If you have severe stomach pain that will not stop, or you cannot keep fluids down, contact a provider right away or seek emergency care.
What does the $99 cover, and what is not included?
It covers your provider visit and review, your medication when it is prescribed, dose changes, injection supplies, monthly check-ins, unlimited messaging with your care team, and shipping. It does not cover lab work if your provider orders it outside our program, or care from other clinicians. No insurance is billed. You are not charged at all if a provider decides semaglutide is not appropriate for you.
Do I have to stay on it forever?
That is a conversation with your provider, not a policy. Some people taper down after they reach a goal and work on holding it with food and activity changes. Some stay on a maintenance dose. Weight often comes back when a GLP-1 stops, so your provider will plan the exit with you rather than leaving you to guess. You can cancel your program anytime, and one message to the care team is enough to do it.
I am already on a GLP-1. Can I keep my dose?
Often, yes. Tell us your current medication, your current dose, and how long you have been at it during the health check. Your provider reviews it and decides whether to continue at the same dose, adjust, or restart lower. Bring your bottle or a photo of the label if you have it.
Which states can you ship to?
Nationwide. Medication ships from a US licensed pharmacy and typically arrives in 3 to 5 days after a provider prescribes. Details are on the shipping page.
How long until it shows up?
A licensed provider usually reviews your intake within 24 to 48 hours. If you are approved, your medication ships from a US-licensed pharmacy and generally arrives in 3 to 5 days in plain packaging with no branding on the outside.
Still have a question? Message our care team or read the full FAQ.
Find out if semaglutide is a fit
The health check takes about two minutes. A US-licensed provider reads it, usually within 24 to 48 hours, and tells you either way.
Checking if you qualify is free. You only pay if a provider prescribes.
Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality. Medication is prescribed only if a licensed provider determines treatment is appropriate after an evaluation. Results vary and are not guaranteed. Semaglutide is not for everyone. Do not use it if you or a family member has had medullary thyroid carcinoma or if you have Multiple Endocrine Neoplasia syndrome type 2, and tell your provider if you are pregnant, planning to become pregnant, or breastfeeding, or if you have a history of pancreatitis. Program pricing shown is the monthly cost and includes the provider visit, prescribed medication, dose titration, monthly check-ins, and shipping. No insurance is billed. We ship nationwide from a US licensed pharmacy. This page is general information and not medical advice.