# Semaglutide

> Source: https://peptidestogo.com/peptides/semaglutide/
> Last updated October 31, 2026 · PeptidesToGo Editorial Team · Educational, not medical advice

GLP-1 receptor agonist

**Status:** FDA-approved · Prescription only

**How it is delivered:** Injection · Oral — once weekly.

Semaglutide is a GLP-1 receptor agonist — a synthetic version of a hormone your gut releases after you eat. The native peptide is gone in minutes; semaglutide was engineered to last roughly a week, which is what makes once-weekly dosing possible.

The drug works across multiple tissues. In the pancreas it amplifies glucose-dependent insulin release (so hypoglycemia risk as monotherapy is low) while suppressing glucagon. In the stomach it slows gastric emptying. In the hypothalamus it suppresses appetite directly — the channel patients describe when the “food noise” stops. GLP-1 receptors on heart, kidney, muscle, and fat tissue explain why metabolic effects reach beyond appetite suppression.

> “Semaglutide doesn’t speed up your metabolism or block fat absorption — it works by making you eat less and keeping food in your stomach longer.”

In 2024, Wegovy added a second indication: cardiovascular risk reduction in adults with obesity plus established CV disease. The SELECT trial showed benefit separating from placebo early — before weight-loss curves diverged — suggesting direct effects on inflammation or endothelial function. For the full trial breakdown and the compounded-vs-brand regulatory timeline, see our PeptideWellness deep-dive.

Last updated October 31, 2026 · PeptidesToGo Editorial Team ·
[Educational, not medical advice](https://peptidestogo.com/legal/medical-disclaimer/)

## Who it's for (or who should avoid)

### What it's aimed at

Semaglutide protocols are most commonly prescribed for:

- **Adults with obesity (BMI ≥30)** — the core FDA-approved Wegovy indication
- **Overweight (BMI ≥27) plus at least one weight-related comorbidity** — hypertension, dyslipidemia, sleep apnea, T2D, or CV disease
- **Established cardiovascular disease + BMI ≥27** — the SELECT population, where CV benefit is strongest
- **T2D patients whose metformin response has plateaued** — Ozempic is approved at lower doses (0.5–2 mg weekly)
- **Patients who lost weight through behavioral work and regained it** — the STEP-trial population

The label describes it as an addition to a reduced-calorie diet and more physical activity, and the STEP trials gave it that way. What happens after stopping is in the timeline below.

### Who should avoid it

- Personal or family history of medullary thyroid carcinoma or MEN2 — boxed contraindication
- Past pancreatitis or severe gastroparesis
- Planned pregnancy in the next twelve months (no controlled human data)
- Active eating disorder or severe depression history — appetite suppression can complicate treatment
- Surgery in the next two months — gastric emptying delay creates aspiration risk; pause at least a week before
- Pre-existing renal or hepatic disease

Semaglutide is approved for, and trial-validated in, patients with obesity or overweight plus comorbidities. Below that threshold, off-label cosmetic use is a clinical choice — the version that goes wrong is weight regained, muscle lost on the way down, patient worse off than when they started.

## Route, dose and course

**Used for:** Appetite and glycemic control in obesity, or overweight with a weight-related comorbidity

**How it’s taken:** Once-weekly injection — brand pens or compounded vials — or, since December 2025, a daily Wegovy tablet for weight. Rybelsus is the oral form for type 2 diabetes. Some sellers also offer compounded tablets or drops that dissolve under the tongue.

**Label dose:** 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg weekly, four weeks per step

**Cycle:** Continuous — the therapeutic dose is not reached until about month five

**Legal status:** FDA-approved as Ozempic and Rybelsus (type 2 diabetes) and as Wegovy injection and Wegovy tablets (weight management, plus cardiovascular risk reduction). Compounded versions are regulated separately.

**What it costs:** About $78 to $498 a month — From the sellers' own pages between November 4, 2026 and November 10, 2026. Each figure, with what it leaves out, is in the table under “Can I actually get it?”. Brand Wegovy lists on the order of $1,000–1,400 a month without coverage; the providers below are the lower routes.

Semaglutide is most commonly prescribed as a once-weekly subcutaneous injection. Brand Ozempic and Wegovy come in pre-filled pens; compounded versions arrive as vials with syringes. There are two oral forms: Rybelsus for T2D and, since December 2025, [Wegovy tablets](https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=218316 "Source — Drugs@FDA, NDA 218316") for weight. Both share the absorption rules — empty stomach, 30 minutes before anything else, up to four ounces of plain water — which make adherence harder than the injection. Some sellers also sell compounded semaglutide as tablets or drops that dissolve under the tongue; those are not the approved tablets, which the [Wegovy label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b "Source — Wegovy prescribing information, DailyMed") says must be swallowed whole and not dissolved, and the only published absorption study of sublingual semaglutide [was done in rats](https://pubmed.ncbi.nlm.nih.gov/41386332/ "Source — PubMed 41386332").

What the label and the trials say:

- **Wegovy titration (weight loss):** 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg weekly, four weeks at each step. The therapeutic dose isn’t reached until month five.
- **Wegovy tablets (weight loss):** 1.5 mg a day for the first 30 days, then 4 mg, then 9 mg, and 25 mg from day 91.
- **Ozempic schedule (T2D):** 0.25 mg start → 0.5 mg therapeutic → 1 mg → 2 mg ceiling. Lower doses than weight-loss protocols because glycemic control responds to less.
- **Cycling:** most patients stay on continuously; STEP 4 showed that patients who discontinued after a 20-week run-in regained most of the lost weight over the following 48 weeks.

## Stage by stage

**Read this first.** Every stage below comes from the Wegovy label or the STEP trials. Response varies from person to person, and the trials paired the drug with diet and activity advice.

Semaglutide is titrated up over weeks, so the early weeks are about getting used to it, not the scale. The windows below come from the Wegovy label and the STEP trials, with a link under each.

**WEEK 1–16 Titration** The starter dose (0.25 mg) is not the treatment dose. The label raises it every four weeks: 0.5, 1.0, 1.7 and then 2.4 mg. Stomach effects such as nausea are most common while the dose is climbing.

**WEEK 68 Where STEP 1 ended** STEP 1, the trial behind Wegovy's approval, averaged 14.9% of body weight lost at 68 weeks, against 2.4% on placebo.

**AFTER STOPPING Most of it comes back** One year after stopping, STEP 1 participants had regained about two-thirds of the weight they had lost, and most heart and metabolic markers drifted back toward baseline.

## Available · from about $78/mo

Every headline price in this market excludes something. These are normalized to a
 calendar month, cheapest first, with the exclusion spelled out — the published figure
 is the footnote under it. Monthly figures here run from about $78 to $498. We may earn a commission when you purchase from some of the partners listed
 here, at no extra cost to you.

| Provider | From, per month | What that figure excludes | Coverage | Their own site |
| --- | --- | --- | --- | --- |
| [Lavender Sky Health](https://peptidestogo.com/providers/lavender-sky/) — Twelve named pharmacies, priced per vial | $78 (read 2026-11-04) | The $65 new-patient consultation and $40 follow-ups. The plan is paid up front; the pharmacy is the patient’s choice and the same tier costs up to $275 elsewhere on the list. | All 50, stated | [Go to site ↗](https://lavenderskyhealth.com/) |
| [BiltRx](https://peptidestogo.com/providers/biltrx/) — Performance telehealth, Houston TX (formerly DietDoc) | $82 (read 2026-11-10) | The $50 consult fee, billed once per 12 weeks, and $30 shipping per order. The product page prices a month at $82 to $147 depending on the weekly dose (0.2 to 2.5 mg). | All 50, stated | [Go to site ↗](https://biltrx.com/) |
| [Nu Image Medical](https://peptidestogo.com/providers/nu-image-medical/) — Cash-pay telehealth since 2004, Tampa FL | $89 (read 2026-11-04) | The dose the figure buys, which is not published; the figure assumes a 6-month supply. | All 50, stated | [Go to site ↗](https://nuimagemedical.com/) |
| [TrimRx](https://peptidestogo.com/providers/trimrx/) — Compounded GLP-1 only | $89 (read 2026-11-09) | The offer note says the plan is billed annually upfront, about $1,068 for the year, and that the price stays the same on every renewal. Month to month, the terms page prices the first month at $199 and every month after at $299. | Not published | [Go to site ↗](https://trimrx.com/) |
| [Eden](https://peptidestogo.com/providers/eden/) — Telehealth with its own pharmacy, Denver CO (also tryeden.com) | $99 (read 2026-11-04) | Nothing: no membership fee for the compounded GLP-1s. The dose is not published. | All 50, stated | [Go to site ↗](https://www.eden.health/) |
| [Live Vital](https://peptidestogo.com/providers/live-vital/) — Physician-led, monthly pricing, Draper UT | $99 (read 2026-11-04) | The dose the figure buys, which is not published; sold as a 10-week protocol, $299 total. | All 50, stated | [Go to site ↗](https://livevital.io/) |
| [TeleZenMD](https://peptidestogo.com/providers/telezenmd/) — Widest peptide menu | $99 (read 2026-11-09) | The page does not say whether $99 needs a prepaid term; until 8 November it did, and month to month was $128. | All 50, stated | [Go to site ↗](https://telezenmd.com/glp-1-therapy/?tap_a=169200-319bf4&ref=njk2m2z) |
| [Mochi Health](https://peptidestogo.com/providers/mochi/) — Compounded marketplace | $139 (read 2026-11-04) | The $79 membership, which does not end when the medication does. | Not published | [Go to site ↗](https://joinmochi.com/) |
| [Maximus](https://peptidestogo.com/providers/maximus/) — Men's hormone focus | $249.99 (read 2026-11-04) | Labs. | Not published | [Go to site ↗](https://www.maximustribe.com/) |
| [Henry Meds](https://peptidestogo.com/providers/henry-meds/) — Compounded, broad menu | $297 (read 2026-11-04) | Nothing is itemised separately, but stopping a multi-month plan early may require paying out the balance unless the stop is medical. | Not published | [Go to site ↗](https://henrymeds.com/) |
| [Hims](https://peptidestogo.com/providers/hims/) — Branded GLP-1, public company | $348 (read 2026-11-04) | The $149 membership is mandatory, and their page states that it does not guarantee a prescription. | All 50, stated | [Go to site ↗](https://www.hims.com/) |
| [Ro](https://peptidestogo.com/providers/ro/) — Branded GLP-1, private | $498 (read 2026-11-04) | The membership is counted here at the one-month rate; it falls to $74/month only if you prepay for twelve. The advertised $199 medication rate is a promotion limited to the 0.25 and 0.5 mg doses with a 31 December 2026 sign-up deadline. | Not published | [Go to site ↗](https://ro.co/) |
| [AgelessRx](https://peptidestogo.com/providers/agelessrx/) — Longevity prescribing, runs its own trials | No price for this compound | Every headline figure on the site is a first-month rate. Sermorelin and NAD+ both advertise below $100 and both go to $149 a month after it. | All 50, stated | [Go to site ↗](https://agelessrx.com/) |
| [MadeMed](https://peptidestogo.com/providers/mademed/) — Compounded, billed every 30, 90 or 360 days | No price for this compound | The smaller monthly figures need a 360-day plan paid at once — $1,718 for sermorelin — and neither the blood test each injectable requires nor the $20 consultation fee is in them. | A named list | [Go to site ↗](https://mademed.com/) |
| New Blue Health — Peptide, GLP-1 and hormone telehealth | No price for this compound | On most products the monthly figure is the 3-month plan, paid upfront; a $75 clinician review is kept if no prescription is issued, and neither the prescriber nor the pharmacy is named. | All but some, named | [Go to site ↗](https://newbluehealth.com/) |
| PeRx — Peptide-only telehealth, Wellness MD Group PC | No price for this compound | The only peptide figure on the site is a floor for the whole menu — treatment plans "starting at $199" — so there is no price for any individual compound. The provider review is included; there is no separate consultation fee. | All 50, stated | [Go to site ↗](https://www.perxpeptides.com/) |
| ProvnRx — Compounded storefront, launched April 2026 | No price for this compound | Every figure is a "from" rate with no strength or vial size published anywhere on the site, and neither the prescriber nor the pharmacy is named. | A named list | [Go to site ↗](https://provnrx.com/) |
| [RxPepsDirect](https://peptidestogo.com/providers/rxpepsdirect/) — Per-vial prices, 503A pharmacy in Texas | No price for this compound | Prices are per vial or per container, not per month; the $39 medical review is charged per order, before the intake and non-refundable once review starts, and the pharmacy adds $15 shipping to each order. Their menu is far wider than the rows here: it runs to sixty-odd compounds, several of which have no clinical pathway at all. | A named list | [Go to site ↗](https://rxpepsdirect.com/) |
| [Strut Health](https://peptidestogo.com/providers/strut-health/) — Compounded multi-category, Dallas | No price for this compound | Every figure is an auto-refill rate advertised against a one-time price the site never publishes, and their own fine print says final pricing is set after the consultation. | All but some, named | [Go to site ↗](https://www.struthealth.com/) |

### Will it work where you live?

Most sellers claim all fifty states or publish nothing about coverage; a few name
 the states they serve or the ones they exclude, and the Coverage column says which.
 Either way it is the seller's own claim, so we can't filter this list by state
 without inventing a fact. What we can tell you is which state-level rules decide
 access: telehealth rules, non-resident pharmacy licensing, and who is allowed to
 prescribe.

[What shapes access in your state →](https://peptidestogo.com/tools/state-checker/)

### Prices and providers change. We keep track.

## Questions we get about Semaglutide

### Is semaglutide FDA-approved?

Yes — as Ozempic (T2D, 0.5–2 mg weekly, December 2017), Wegovy (chronic weight management and CV risk reduction, 2.4 mg weekly, June 2021, expanded March 2024), and Rybelsus (oral, T2D, September 2019), and Wegovy tablets (oral, weight management and CV risk reduction, December 2025). Compounded semaglutide is not an FDA-approved drug, and FDA says the salt forms some pharmacies use, such as semaglutide sodium, are not the ingredient in the approved products. The shortage-based legal pathway closed in 2025; narrow patient-specific compounding remains under clinical-necessity criteria.

### Is it legal?

Brand Ozempic, Wegovy and Rybelsus, with a prescription, yes. Compounded semaglutide, only narrowly. It is not FDA-approved, and since the shortage ended in February 2025 the FDA's position is that pharmacies may not routinely make copies of it. A pharmacy may still compound it for an individual patient when the prescriber documents a clinical reason the brand product will not do, such as an allergy to an ingredient or a dose the brand does not come in, and many telehealth companies sell it on that basis. The FDA has also proposed removing semaglutide from the list outsourcing facilities can compound from, and in June 2026 it posted 25 warning letters over how compounded semaglutide and tirzepatide were marketed. We list who sells it and what they charge; a listing is not a statement that a given seller is operating within the rules. Availability also varies by state.

### Are there side effects?

The most common are GI: nausea (28–44%), vomiting, diarrhea, constipation — clustered during dose escalation and improving at steady state. Rare serious risks include pancreatitis, gallbladder disease, and a boxed warning for thyroid C-cell tumors based on rodent data (no human signal in trials of 46,719 patients). One to plan for: delayed gastric emptying creates aspiration risk during anesthesia — flag the medication to your surgical team at least a week before any procedure.

### Can I take it with my current medications?

Most patients take semaglutide without significant interactions, but exceptions exist. It can cause low blood sugar with sulfonylureas or insulin (dose adjustment required) and slows gastric emptying, which affects oral medication absorption. Disclose your full medication list to your provider.

### How much does it cost?

In the price table on this page, monthly figures run from about $78 to $498, read between November 4, 2026 and November 10, 2026. Brand Wegovy carries a US list price on the order of $1,000-1,400 per month without coverage; what telehealth sellers charge for the pen, membership included, is in the table on this page. Some plans cover it for weight loss or cardiovascular risk reduction; others do not. Compounded semaglutide costs a fraction of the list price and its figures move often, so each row carries the date we read it, and the hub's price index tracks GLP-1 prices over time. Most patients need ongoing therapy to hold the result, so price the year, not the month.

### Does tirzepatide work better than semaglutide?

In the only head-to-head trial, SURMOUNT-5, adults with obesity and without diabetes lost 20.2% of their body weight on tirzepatide and 13.7% on semaglutide over 72 weeks, at the highest dose each tolerated. Side effects were similar and mostly gastrointestinal. Semaglutide has the stronger evidence on heart outcomes.

We publish no medical reviewer by design. Every claim on this page traces to a
 source we hold on file, and the reviewed write-up with those citations lives on our
 hub.
[Read the full research on PeptideWellness ↗](https://peptidewellnessusa.com/peptides/semaglutide/)

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