| Name | Compounded Semaglutide & Branded Semaglutide (Ozempic®, Wegovy®) |
| Uses | Adjunct to diet and exercise for chronic weight management in adults with obesity or overweight with weight-related conditions; type 2 diabetes management. |
| Route Of Administration | Subcutaneous (SC) injection. |
| Frequency Of Use | Once weekly, on the same day each week, at any time of day, with or without food. |
| Concentration(s) | Compounded: 1 mg/mL, 2 mg/mL, 5 mg/mL; Branded: 0.25 mg, 0.5 mg, 1 mg, 2 mg per dose. |
| Maximum Dosage (Day, Wk) | Max dose: 2.4 mg SC once weekly (Wegovy®) or 2 mg SC once weekly (Ozempic®). |
| Contraindications | Personal or family history of medullary thyroid carcinoma (MTC), multiple endocrine neoplasia syndrome type 2 (MEN 2), severe hypersensitivity to semaglutide or excipients. |
| Possible Side Effects | Common: nausea, vomiting, diarrhea, constipation, decreased appetite. Rare: pancreatitis, gallbladder disease, thyroid tumors, severe allergic reaction. |
| Compatibility With Other Treatments/Drugs | Use caution with insulin or sulfonylureas due to hypoglycemia risk. Avoid with other GLP-1 receptor agonists. |
| Allergies | Assess for hypersensitivity to semaglutide, preservatives, or stabilizing agents in compounded formulations. |
| Administration Time | Once weekly injection, at any time of day, with or without food. |
| Dosing/Settings | Start at 0.25 mg SC once weekly for 4 weeks, then increase to 0.5 mg weekly. Titrate by 0.5 mg every 4 weeks as tolerated, max 2.4 mg weekly. |
| Test Spot Requirement | Not required for semaglutide. |
| Pre-Treatment Guidelines | Assess baseline A1C (if diabetic), renal and hepatic function, weight history, and contraindications. |
| Provider Clearance Guidelines | NP, PA, MD, or DO must approve; confirm absence of contraindications and assess cardiovascular/metabolic risk factors. |
| Pre-Treatment Screening Workflow | 1. Confirm no history of MTC or MEN 2. 2. Review kidney and liver function. 3. Assess for prior pancreatitis or gallbladder disease. |
| What To Do If Adverse Reaction Occurs | For mild GI symptoms: supportive care. For severe reactions: discontinue, initiate emergency response if anaphylaxis or pancreatitis suspected. |
| Clinic Implementation Guidelines | Store at 2-8°C (36-46°F). Do not freeze. Use within stability period per compounding pharmacy or manufacturer guidelines. |
| Photographic Documentation Protocol | Not required for semaglutide therapy. |
| Post-Treatment Care | Monitor for gastrointestinal symptoms, assess for weight loss progress, schedule follow-up in 4-6 weeks. |
| Additional Documentation Requirements | Signed informed consent, treatment logs, patient education on administration and side effects, adverse event documentation if applicable. |