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Monograph
FDA APPROVEDP-014
Metabolic

Semaglutide

Long-acting GLP-1 receptor agonist. GLP1R variants (rs6923761) modulate weight-loss response.

EstablishedMetabolic
Typical dose0.25-2.4 mg
Frequencyweekly, subcutaneous
Half-life168h
Citations indexed312
DeliveryInjectable
Half-life~7d
EvidenceEstablished
Citations312
Synergy checkCompareReconstitution calc
Mechanism

Modified GLP-1(7-37) with fatty-acid acylation for albumin binding (≈1 week half-life). STEP trials show 15-17% body weight reduction at 68 weeks. SELECT trial extends evidence to cardiovascular outcomes in non-diabetics.

Specifics
Weight / fat lossAppetite controlInsulin sensitivity
Caveats

Compounded semaglutide (gray market) is no longer permitted by FDA after the shortage ended (2024). Verify your source's legal posture. Same GI titration requirement as tirzepatide.

sequence · 31 aa
HXEGTFTSDVSSYLEGQAAKEFIAWLVRGRG

Aib at position 2; C18 fatty acid conjugated at K20 via γGlu-2×OEG linker.

Evidence levelEstablished
Regulatory statusFDA approved (Ozempic / Wegovy)
DNA / pharmacogenomicsDocumented — Same GLP1R variant context as tirzepatide. Real PG signal.
Pairs & ConflictsCheck full stack →
Avoid stacking

Known risk or pharmacological conflict.

TirzepatideRetatrutideLiraglutideDulaglutideExenatide
Where the experts disagree

Stack doesn't rank peptides — we surface the diversity of opinion. Each card paraphrases a public-record stance from a named source. Where they conflict is where you should slow down and read both.

RCT / meta-analysisSTEP + SELECT trial programs (Novo Nordisk), 2021-2024

STEP showed 14.9% weight loss at 68 weeks in obesity. SELECT showed 20% reduction in major adverse cardiovascular events in patients with overweight/obesity + established CVD — the first weight-loss drug with proven CV outcome data.

Source →
ClinicianDr. Robert Lustig, pediatric endocrinologist (UCSF emeritus)

Useful tool for the metabolic-syndrome end of obesity but argues GLP-1s shouldn't substitute for fixing the food environment. Concerned about long-term dependence and post-discontinuation rebound. Critical of telehealth chains that prescribed without metabolic workup.

Claims & evidence

Per-claim grading. Each claim is graded independently — same peptide, different claims can carry different grades.

  • AStrong evidence

    Semaglutide produces ~15% mean body weight reduction at 68 weeks (vs ~2% placebo) in adults with obesity

    1 supporting referencesVerified 5d ago
  • AStrong evidence

    Semaglutide reduces major adverse cardiovascular events in adults with overweight/obesity and CV disease

    1 supporting referencesVerified 5d ago
  • AStrong evidence

    Semaglutide reduces HbA1c by ~1.5-1.8% in adults with type 2 diabetes

    1 supporting referencesVerified 5d ago
References

External links to PubMed searches, ClinicalTrials.gov, and FDA materials. We do not host papers — we point at canonical sources.

  • RegulatoryEN
    REGULATORYFunding undisclosedVerified 5d ago
    FDA Wegovy label
  • ReviewEN
    RCTIndustry-fundedVerified 5d ago
    STEP trials review
  • RegulatoryEU
    REGULATORYFunding undisclosedVerified 5d ago
    EMA Wegovy EPAR (European Medicines Agency)
  • ReviewES
    REVIEWFunding undisclosedVerified 5d ago
    SciELO — semaglutida (Latin American clinical literature)
Reconstitution calculatorSemaglutide

Pre-filled with this compound's published dose range: 0.25-2.4 mg · weekly, subcutaneous

Concentration2.50 mg/mL
Draw volume0.530 mL
Insulin syringe53.0 u
Doses per vial3
U-100 syringe — fill to indicatorU-100 · 1 mL
0u25u50u75u100u

Calculator is a discussion tool. Verify reconstitution + dosing with a qualified provider. Stack is not a prescription source. Use sterile technique and inspect every vial.

First cycle costCheapest legal from $40

How much a first cycle actually costs across the channels people use. Pick the protocol length you're considering — Stack multiplies the monthly band by cycle weeks. Same caveats apply: ranges are facts, quality varies, this is not legal advice.

Research grey$40–$120
MX pharmacy (brand)$180–$320
FDA-approved brand$499–$1349

Numbers reflect publicly-advertised price ranges, not vendor quotes. Insurance, prescription costs, and shipping aren't included. Channels marked unavailable are filtered out.

See pharmacies for this compound →
Price across channelsRange $40–$1349/mo

Approximate monthly cost across the channels users actually consider — brand FDA-approved retail, US 503A compounding, Mexican pharmacies, MX farmacias magistrales, and the research-grey market. Stack lists ranges, not vendor names. Quality varies wildly across channels — see each band's note.

Dosing assumption: 1.0-1.7 mg weekly (steady-state weight-management dose)

FDA-approved brand$499–$1349/mo

Wegovy (obesity) and Ozempic (T2D). NovoCare direct-pay program at lower bound. Insurance coverage variable.

As of 2026-04
503A compounded (US)Not legally available

Not currently legal in US — FDA declared shortage resolved May 2025.

As of 2026-04
MX pharmacy (brand)$180–$320/mo

Ozempic + Wegovy widely available in COFEPRIS-registered MX pharmacies. Border pharmacies higher counterfeit rate.

As of 2026-04
Research grey$40–$120/mo

Research-grey range. Same caveats as Tirzepatide grey market.

As of 2026-04
Supply chain

Public-source attribution across the production + distribution chain. Stack does not endorse vendors — this is who is in the chain, not which one is best.

API manufacturers
  • Bachem AG

    CH
    VERIFIEDFDA REGISTERED

    Swiss-headquartered global peptide API manufacturer with FDA-registered facilities. Supplies APIs to multiple FDA-approved drug brands.

    Source: Bachem — peptide API drug substance manufacturerVerified 5d ago
  • Enogen

    CN
    VERIFIEDFDA REGISTEREDFDA GREEN LIST

    China-based peptide API maker with semaglutide and tirzepatide listed on US FDA Green List. Also certified by China NMPA, EU EDQM, South Korea MFDS.

    Source: Enogen — peptide API manufacturer (FDA Green List)Verified 5d ago
  • AmbioPharm

    US/CN
    VERIFIEDFDA REGISTERED

    FDA-inspected peptide API manufacturer with US and China facilities. 500+ chemists.

    Source: AmbioPharm — peptide manufacturingVerified 5d ago
Pharma brands (FDA-approved)
  • Ozempic(Novo Nordisk)

    DK
    FDA APPROVED 2017

    Type 2 diabetes (FDA approved 2017)

    Source: Novo Nordisk — OzempicVerified 5d ago
  • Wegovy(Novo Nordisk)

    DK
    FDA APPROVED 2021

    Chronic weight management (FDA approved 2021)

    Source: Novo Nordisk — WegovyVerified 5d ago
503A compounding pharmacies (US)
  • Empower Pharmacy

    US
    VERIFIEDPCAB ACCREDITED

    BPC-157 · TB-500 · Sermorelin · CJC-1295/Ipamorelin · Semaglutide · Tirzepatide

    Houston-based 503A compounding pharmacy, one of the largest in the US peptide compounding market.

    Source: Empower Pharmacy — peptide compoundingVerified 5d ago
Mexico channels
  • Pharma Lab Global Mexico

    distributor
    SELF-REPORTED

    Mexico-side distributor with online storefront. Self-reported COFEPRIS compliance not independently verified by Stack.

    Source: Pharma Lab Global Mexico storefrontVerified 5d ago
FDA APPROVEDP-014

FDA approved (Ozempic / Wegovy)

May 2025USWithdrawal

FDA declares Semaglutide shortage resolved — compounding ends

FDA declared the Semaglutide shortage resolved in May 2025. Compounded Semaglutide (sold as 'Wegovy alternatives' by telehealth chains) is no longer permitted in the US. The shutdown applied to both 503A and 503B pharmacies.

Aug 2024MXGuidance

COFEPRIS issues counterfeit-Ozempic warning amid cross-border GLP-1 demand

COFEPRIS issued formal warnings about counterfeit Ozempic, Wegovy, and Saxenda circulating in Mexican gray markets, particularly in border-state pharmacies catering to US cross-border traffic. Several seizures documented in Tijuana, Juárez, and Reynosa.

Mar 8, 2024USApproval

Semaglutide (Wegovy) approved for cardiovascular risk reduction

FDA approved an expanded label for Semaglutide (Wegovy) to reduce risk of cardiovascular death, heart attack, and stroke in adults with overweight/obesity + established cardiovascular disease. Based on the SELECT trial.

2024MXGuidance

Mexico (COFEPRIS) maintains GLP-1 prescription regime through obesity epidemic

COFEPRIS (Mexican federal health regulator) continued to require physician prescription for GLP-1 agonists through 2023-2024 despite high obesity prevalence and pharmacy-tourism demand from US patients. Compounding less restrictive than US 503A regime.

2024GLOBALGuidance

Argentina (ANMAT), Colombia (INVIMA), Brazil (ANVISA) — LATAM GLP-1 access landscape

ANMAT (Argentina), INVIMA (Colombia), and ANVISA (Brazil) all regulate GLP-1 agonists as prescription drugs. Brazil is the strictest enforcement jurisdiction in LATAM. Argentina has a more porous regime in practice. Colombia sits in the middle. Cross-border GLP-1 supply between LATAM countries is real but not as developed as US-Mexico flow.

Semaglutide0.25-2.4 mg · weekly, subcutaneous
Discussion guide, not prescription

stack is an exploration engine. Output is a discussion guide for a conversation with a licensed provider — never a prescription, dose recommendation, or sourcing instruction. Peptides discussed include compounds with limited human evidence and varying legal status by jurisdiction. Verify everything with a qualified clinician before any decision.

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