What is Compounded Semaglutide? A Complete Guide

If you've been researching weight loss options, you've probably heard of Ozempic and Wegovy—the brand-name semaglutide medications that have helped millions of people lose weight. But with prices often exceeding $1,000 per month without insurance, many people are turning to compounded semaglutide as a more affordable alternative.

In this guide, we'll explain exactly what compounded semaglutide is, how it's made, how it compares to the brand-name versions, and what you need to know before deciding if it's right for you.

What is Compounded Semaglutide?

Compounded semaglutide is a prescription medication prepared by a licensed compounding pharmacy, rather than manufactured by a large pharmaceutical company. It contains semaglutide—the same active ingredient found in Ozempic and Wegovy—but is prepared in smaller batches, often customized for individual patients.

Think of it like the difference between buying bread from a bakery versus a factory. Both can use the same recipe and ingredients, but one is made on a smaller, more personalized scale. Compounding pharmacies have existed for decades and prepare all kinds of medications—everything from custom hormone treatments to specialized pediatric formulations.

Compounded semaglutide typically comes in one of these forms:

• Injectable vials: Multi-dose vials that you draw from using a syringe. This is the most common form.
• Sublingual drops or tablets: Placed under the tongue for absorption. Growing in popularity as a needle-free option.
• Troches: Dissolvable lozenges that absorb through the mouth.

Many compounded formulations also include additional ingredients like Vitamin B12 or L-carnitine, which some providers believe may support energy levels and metabolism during weight loss.

How is Compounded Semaglutide Made?

Compounding pharmacies purchase pharmaceutical-grade semaglutide from FDA-registered suppliers. This raw ingredient, called an Active Pharmaceutical Ingredient (API), is the same molecule used to make Ozempic and Wegovy.

The pharmacy then compounds (mixes and prepares) the medication according to a prescription from a licensed healthcare provider. This process happens in a sterile environment following strict protocols to ensure safety and consistency.

There are two types of compounding pharmacies, and understanding the difference is important:

Want to learn more about this distinction? Read our detailed guide on 503A vs 503B compounding pharmacies.

Is It the Same Molecule as Ozempic and Wegovy?

Yes—semaglutide is semaglutide. The active pharmaceutical ingredient in compounded semaglutide is chemically identical to what's found in Novo Nordisk's brand-name products. It's the same molecule with the same mechanism of action.

However, there are some important differences to understand:

The key difference is that compounded medications haven't gone through the FDA approval process for that specific formulation. This doesn't mean they're unsafe—millions of compounded medications are prescribed safely every year—but it's an important distinction to understand.

Is Compounded Semaglutide Legal in 2025?

This is one of the most common questions we get, and the answer requires some context.

The FDA declared the semaglutide shortage officially over in February 2025. During the shortage, compounding pharmacies were allowed to produce "essentially a copy" of the brand-name drug to help meet patient demand. Once the shortage ended, that specific allowance expired.

However, compounding didn't become illegal. Under federal law, compounding pharmacies can still prepare semaglutide if they create a formulation with a "clinical difference" from the commercially available product. This is why many compounded versions now include:

• Added vitamins (B12, B6)
• Added amino acids (L-carnitine, glycine)
• Different delivery methods (sublingual, troches)

These modifications create a formulation that's legally distinct from Ozempic or Wegovy, allowing compounding to continue.

For more details, read our full explainer: Is Compounding Still Legal After the Shortage Ended?

How Much Does Compounded Semaglutide Cost?

One of the biggest reasons people turn to compounded semaglutide is the cost savings. While brand-name Wegovy can cost $1,300+ per month without insurance, compounded versions typically range from $150 to $500 per month, depending on the provider and dosage.

Here's what you can generally expect:

• Starting doses (0.25mg-0.5mg): $150-$250/month
• Maintenance doses (1mg-2.4mg): $250-$500/month
• Initial consultation: $0-$100 (some providers include this)
• Ongoing provider fees: $0-$50/month (varies by provider)

Some providers bundle everything into one monthly price, while others charge separately for medication, consultations, and supplies. Be sure to understand the full cost before committing.

Many providers also accept HSA and FSA cards, which can provide additional tax savings. Learn more in our guide: Can You Use HSA/FSA for Compounded GLP-1s?

Who is Compounded Semaglutide Good For?

Compounded semaglutide may be a good option if you:

• Don't have insurance coverage for brand-name GLP-1 medications
• Can't afford the $1,000+ monthly cost of Ozempic or Wegovy
• Have been denied insurance coverage due to prior authorization requirements
• Meet the medical criteria for GLP-1 treatment (typically BMI of 30+ or 27+ with weight-related health conditions)
• Are comfortable with a compounded medication that's not FDA-approved

Compounded semaglutide may NOT be the best choice if you:

• Have insurance that covers brand-name GLP-1s at an affordable copay
• Prefer the convenience of pre-filled injection pens
• Want an FDA-approved medication with clinical trial data behind that specific formulation
• Have concerns about compounded medication quality

Ultimately, this is a personal decision to make with your healthcare provider. Both options can be effective—it comes down to your circumstances, preferences, and comfort level.

How to Get Compounded Semaglutide

Getting compounded semaglutide typically involves these steps:

1. Choose a telehealth provider – Most compounded GLP-1 providers operate online, offering virtual consultations. Look for providers that are transparent about their pharmacy partnerships and pricing.
2. Complete a health questionnaire – You'll answer questions about your medical history, current medications, and weight loss goals.
3. Virtual consultation – A licensed healthcare provider will review your information and determine if you're a good candidate.
4. Prescription and shipping – If approved, your prescription is sent to a compounding pharmacy, and medication is shipped to your door (usually within 3-7 days).
5. Ongoing support – Most providers offer regular check-ins and dosage adjustments as you progress.

When choosing a provider, we recommend checking for:

• LegitScript certification – Verifies the provider meets operational and legal standards
• Transparent pharmacy information – They should disclose which pharmacy compounds your medication
• 503B pharmacy partnerships – Indicates stricter federal oversight of the compounding process
• Clear pricing – No hidden fees or surprise charges

Ready to compare your options? Check out our provider comparison page to see verified GLP-1 providers with transparent pricing and safety information.

The Bottom Line

Compounded semaglutide offers a more affordable path to GLP-1 weight loss treatment for people who can't access or afford brand-name medications. While it's not FDA-approved and comes from compounding pharmacies rather than major manufacturers, it contains the same active ingredient that has helped millions of people lose weight.

The key is working with reputable providers who partner with licensed, certified compounding pharmacies. By doing your research and asking the right questions, you can make an informed decision about whether compounded semaglutide is right for you.