Compounded semaglutide dosing math changed in 2026 after the FDA declared the shortage over and most 503A compounding access ended. For patients who still have access through narrow clinical exceptions — or for research contexts — this page covers the exact vial-to-syringe math for the standard titration doses (0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg). Pre-filled free calculator link below.
Key Takeaways
- —Compounded semaglutide typically shipped in 5 mg or 10 mg vials pre-shortage-ending. 2 mL BAC water is the standard diluent.
- —At 5 mg + 2 mL, the concentration is 2.5 mg/mL (2,500 mcg/mL). The 0.25 mg starting dose = 0.1 mL = 10 units on a U-100 insulin syringe.
- —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 semaglutide compounding in February 2026. Most 2026 access is via NovoCare direct (~$499/month) or full-price Wegovy/Ozempic (details).
- —Both compounded semaglutide and Wegovy/Ozempic use the same pharmacology — the dose math is equivalent if you can access one instead of 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 |
The 5 mg + 2 mL reconstitution is the most common compounded protocol because it produces clean syringe marks for all five titration doses.
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 for 2.4 mg, the dose fills nearly the entire U-100 syringe. Some practitioners switch to a 1 mL tuberculin syringe at this dose to avoid incomplete draws.
For the 10 mg / 2 mL (5,000 mcg/mL) variant, halve every unit count above: 0.25 mg = 5 units, 2.4 mg = 48 units.
Two things that trip up patients switching between the compounds:
The calculator handles both automatically when you update the vial mass input.
Compounded semaglutide 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 titration weeks (~5 mg through the first 16 weeks) to get the full first-year count.
Click any of these to open the dosing calculator pre-filled for the relevant dose:
For a 5 mg vial reconstituted with 2 mL BAC water (2,500 mcg/mL): 0.25 mg = 0.1 mL = 10 units on a U-100 insulin syringe. The titration then doubles each cycle: 0.5 mg = 20 units, 1.0 mg = 40 units.
28 days at 2–8 °C refrigerated, consistent with other peptide reconstitutions. Branded pens have manufacturer-specific stability labels — consult prescribing information. Never freeze.
If you have Wegovy/Ozempic access, the pen is the simpler option — doses are pre-measured and the injection is single-action. Vial-and-syringe math only applies to compounded semaglutide, which is mostly restricted in 2026. See the where-to-buy guide for current access options.
Semaglutide is a single-receptor GLP-1 agonist; tirzepatide is a dual GIP/GLP-1 agonist. Tirzepatide's weight-loss efficacy per mg is lower, so clinically effective doses are higher (2.5–15 mg vs 0.25–2.4 mg). The mechanism difference, not dose equivalence, drives the difference. Details in the tirzepatide vs semaglutide comparison.
Highly restricted. The FDA declared the shortage over in February 2026, ending broad 503A compounding. Limited clinical-exception compounding remains. For cash-pay patients, NovoCare offers semaglutide 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.
Peptide reconstitution errors are the most common dosing mistake. Free calculator covering insulin syringe units, BAC water volumes, and vial concentration math.
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