Compounded sema math got messier in 2026. The FDA called the shortage over in Feb 2026 and most 503A access shrunk overnight. If you're still pinning compounded sema through a narrow clinical exception, or running it research-grade, the vial-to-units math hasn't changed. This page runs the exact numbers for the standard titration (0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg, 4-week steps). Pre-filled free calculator link below.
Key Takeaways
- —Compounded sema typically shipped in 5 mg or 10 mg vials before the shortage ended. 2 mL BAC water is the standard diluent.
- —At 5 mg + 2 mL, concentration is 2.5 mg/mL (2,500 mcg/mL). The 0.25 mg starting pin = 0.1 mL = 10 units on a U-100 slin pin.
- —Standard titration: 0.25 mg × 4 wk → 0.5 mg × 4 wk → 1.0 mg × 4 wk → 1.7 mg × 4 wk → 2.4 mg maintenance (Wegovy), or → 1.0 mg maintenance (Ozempic for T2D).
- —FDA ended sema compounding in February 2026. Most 2026 access is via NovoCare direct (~$499/month) or full-price Wegovy/Ozempic (details).
- —Compounded sema and Wegovy/Ozempic share the same molecule. The dose math is equivalent if you can swap one for the other.
| Vial Size | BAC Water | Concentration | Notes |
|---|---|---|---|
| 5 mg | 2 mL | 2.5 mg/mL (2,500 mcg/mL) | Most common for compounded protocols |
| 5 mg | 1 mL | 5 mg/mL (5,000 mcg/mL) | Higher concentration; halves draw volume |
| 10 mg | 2 mL | 5 mg/mL (5,000 mcg/mL) | Most common for 10 mg vials |
| 10 mg | 4 mL | 2.5 mg/mL | Matches 5 mg / 2 mL draw volumes |
Default for most people running compounded sema: 5 mg + 2 mL BAC. It gives clean syringe marks at every titration step from 0.25 mg through 2.4 mg, no fractional unit guessing.
Using 5 mg vial + 2 mL BAC water (2,500 mcg/mL):
| Titration Phase | Weekly Dose | Draw Volume | U-100 Units |
|---|---|---|---|
| Weeks 1–4 | 0.25 mg | 0.1 mL | 10 units |
| Weeks 5–8 | 0.5 mg | 0.2 mL | 20 units |
| Weeks 9–12 | 1.0 mg | 0.4 mL | 40 units |
| Weeks 13–16 | 1.7 mg | 0.68 mL | 68 units |
| Weeks 17+ (Wegovy max) | 2.4 mg | 0.96 mL | 96 units |
At 96 units the 2.4 mg pin nearly fills the slin pin. Some people swap to a 1 mL tuberculin syringe at the top dose so they don't lose volume to an incomplete draw.
For the 10 mg / 2 mL (5,000 mcg/mL) variant, halve every unit count: 0.25 mg = 5 units, 2.4 mg = 48 units. Smaller draws read harder on a U-100 slin pin, so most people stick with the 5 mg + 2 mL math at the start of titration.
A common move once people are stable on 1.0 mg+ is the split dose, half Mon, half Thurs, instead of one full weekly pin. Anecdotally that smooths out the trough side effects (sulfur burps, fatigue late in the week) without changing total mg. Rotate sites either way: belly, thigh, love handles, alternate week to week.
Two things that trip people up when they switch between sema and tirz:
The calculator handles both automatically when you update the vial mass input.
Compounded sema vial math for a typical maintenance plan:
| Maintenance Dose | Weekly mg | Year-1 mg | 5 mg Vials | 10 mg Vials |
|---|---|---|---|---|
| 1.0 mg (Ozempic T2D) | 1.0 | ~52 | 11 | 6 |
| 1.7 mg | 1.7 | ~88 | 18 | 9 |
| 2.4 mg (Wegovy obesity) | 2.4 | ~125 | 25 | 13 |
Add the titration weeks (~5 mg burned through the first 16 weeks) to get the full first-year count. Plateaus and dose holds are normal — if the scale stalls and food noise stays quiet, holding the current dose another 4 weeks before stepping up is fine. NSVs (clothes fitting different, sleep apnea easing) often show up before the next scale move anyway.
Click any of these to open the dosing calculator pre-filled for the relevant dose:
For a 5 mg vial reco'd with 2 mL BAC water (2,500 mcg/mL): 0.25 mg = 0.1 mL = 10 units on a U-100 slin pin. The titration then doubles each step: 0.5 mg = 20 units, 1.0 mg = 40 units. Easy to remember, easy to draw.
28 days at 2–8 °C in the fridge, same window as most other peptide recos. Branded pens have manufacturer-specific stability labels — check the prescribing info on those. Never freeze. Date-sticker the vial when you first puncture it and toss at day 28 regardless of how it looks.
If you've got Wegovy/Ozempic access, the pen is simpler — doses are pre-measured, single-action injection, no reco math at all. Vial-and-pin math only applies to compounded sema, which is mostly restricted in 2026 post-shortage. See the where-to-buy guide for current access options.
Sema is a single-receptor GLP-1 agonist; tirz is a dual GIP/GLP-1 agonist. Tirz's per-mg weight-loss efficacy is lower, so clinically effective doses run higher (2.5–15 mg vs 0.25–2.4 mg). The receptor mechanism, not dose equivalence, drives the gap. Details in the tirzepatide vs semaglutide comparison.
Highly restricted. The FDA called the shortage over in February 2026 and broad 503A compounding ended with it. Limited clinical-exception compounding still exists. For cash-pay people, NovoCare offers sema at ~$499/month. Full details in the semaglutide buyer guide.
This article is for research and informational purposes only. Semaglutide is an FDA-regulated prescription medication. Compounded semaglutide access is restricted following the FDA's February 2026 shortage-list removal. Consult a licensed healthcare professional for any semaglutide protocol.
Research Disclaimer. All content on Next Pep is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Consult a licensed healthcare professional before considering any peptide protocol.
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