Semaglutide Reconstitution & Dosing Guide

Important Note

Semaglutide (brand names Ozempic and Wegovy) is a prescription GLP-1 receptor agonist. Compounded semaglutide requires a prescription and should be used under medical supervision. This guide is for informational purposes only.

What Comes in a Compounded Semaglutide Vial

Compounded semaglutide typically arrives as a multi-dose vial already dissolved in a solution — most compounding pharmacies ship it pre-mixed in bacteriostatic water or a sterile diluent at a stated concentration (e.g., 5 mg/mL).

Always read your pharmacy's label. The concentration on the label determines your dose calculations. Do not assume a default concentration.

If you receive a lyophilized (powder) vial, follow the reconstitution steps below.

Reconstituting Lyophilized Semaglutide

Supplies Needed

• Semaglutide vial (lyophilized powder)
• Bacteriostatic water (BAC water)
• Insulin syringes (U-100)
• Alcohol swabs

Steps

• Wipe both vial tops with alcohol swabs, let dry 30 seconds.
• Draw the specified amount of BAC water (see table below).
• Inject the water slowly along the glass wall of the peptide vial — do not spray directly on the powder.
• Gently swirl (never shake) until fully dissolved. Semaglutide dissolves easily.
• The solution should be clear and colorless. Refrigerate immediately.

Common Concentrations

A 2 mL + 5mg vial = 2.5 mg/mL is a common concentration for weekly dosing.

The Titration Protocol

Semaglutide must be dose-titrated slowly to minimize GI side effects (nausea, vomiting, constipation). Rushing the titration is the most common mistake.

Standard Titration Schedule

Stay at each dose level for at least 4 weeks before increasing. If side effects are significant, hold the current dose for an additional 4 weeks before advancing.

Calculating Injection Volume

To figure out how many mL to inject:

Volume (mL) = Target dose (mg) ÷ Concentration (mg/mL)

Example: 0.5 mg dose from a 2.5 mg/mL solution:

• 0.5 ÷ 2.5 = 0.20 mL = 20 IU on a U-100 syringe

Use the Reconstitution Calculator for precise calculations — enter your vial size in mg (×1000 for mcg) and your BAC water volume.

Storage

• Reconstituted: refrigerate at 2–8°C. Stable for 28–56 days depending on the compounding pharmacy's guidance.
• Never freeze reconstituted semaglutide.
• Pre-filled syringes: store in fridge, protected from light.
• Unopened vials: refrigerate or store per pharmacy instructions.

Side Effects and Management

Most common:

• Nausea (most common, especially during dose increases)
• Constipation
• Fatigue in the first 1–3 days after injection

Management tips:

• Inject in the evening to sleep through early nausea
• Eat smaller, lower-fat meals
• Stay well hydrated
• Ginger tea or B6 can help with nausea
• If nausea is severe, hold the dose increase for another 4 weeks

Disclaimer

Semaglutide is a prescription medication. Use only under the supervision of a licensed healthcare provider. This guide is for informational and tracking purposes only.