Most compounded semaglutide prescriptions mirror the Wegovy label: 0.25, 0.5, 1 and 1.7 mg weekly, each for four weeks, then 2.4 mg. The units you draw depend on the vial's concentration. At 2.5 mg/mL, 0.25 mg is 10 units on a U-100 syringe; at 5 mg/mL it is 5 units. Your prescriber and pharmacy set the actual dose and strength.[1]
Branded Wegovy comes in pens that deliver a fixed dose with a click. Compounded semaglutide usually comes in a multi-dose vial, and you draw each dose with an insulin syringe. That single difference turns a dosing question into an arithmetic question, and the FDA has documented what happens when the arithmetic goes wrong.[5] This page gives you the FDA-labeled schedule the compounded ladder is based on, a units chart for the three most common vial strengths, and the rules for missed doses and maintenance. It is a reference for checking your own prescription, not a substitute for it.
What is the standard semaglutide titration schedule?
The FDA-approved schedule is the one on the Wegovy label. Each step lasts four weeks, and the dose climbs slowly to reduce nausea and other stomach side effects. For weight reduction in adults, the label allows a maintenance dose of 1.7 mg or 2.4 mg, with 2.4 mg recommended.[1] The current label (revised June 2026) also allows a further step to 7.2 mg weekly (sold as Wegovy HD) for patients who have tolerated 2.4 mg for at least four weeks and need more weight reduction.[1] Compounded charts generally stop at 2.4 mg.
| Weeks | Weekly dose (Wegovy label) | Purpose |
|---|---|---|
| 1–4 | 0.25 mg | Starting dose |
| 5–8 | 0.5 mg | Escalation |
| 9–12 | 1 mg | Escalation |
| 13–16 | 1.7 mg | Escalation |
| 17 onward | 2.4 mg (recommended) or 1.7 mg | Maintenance |
| After ≥4 weeks at 2.4 mg, if needed | Up to 7.2 mg (Wegovy HD only) | Optional higher maintenance |
Two notes on this schedule. The 0.25, 0.5 and 1 mg steps are for getting used to the drug; the label does not treat them as maintenance doses for weight loss. And the four-week pace is a minimum, not a deadline. If a dose is not tolerated, the label says to consider delaying the next step by four weeks.[1] Our GLP-1 dose ladder tool shows the branded schedules for Wegovy, Ozempic, Zepbound and Mounjaro side by side.
How many units is each dose at 1, 2.5 and 5 mg/mL?
The rule is simple: divide the dose in milligrams by the vial's concentration in mg/mL to get milliliters, then multiply by 100 to get units on a U-100 insulin syringe. For example, 0.25 mg ÷ 2.5 mg/mL = 0.1 mL = 10 units. The chart below applies that rule to each Wegovy-schedule step. Check which concentration is printed on your vial label before using it.
| Weekly dose | 1 mg/mL vial | 2.5 mg/mL vial | 5 mg/mL vial |
|---|---|---|---|
| 0.25 mg | 0.25 mL = 25 units | 0.10 mL = 10 units | 0.05 mL = 5 units |
| 0.5 mg | 0.50 mL = 50 units | 0.20 mL = 20 units | 0.10 mL = 10 units |
| 1 mg | 1.00 mL = 100 units | 0.40 mL = 40 units | 0.20 mL = 20 units |
| 1.7 mg | 1.70 mL = 170 units* | 0.68 mL = 68 units | 0.34 mL = 34 units |
| 2.4 mg | 2.40 mL = 240 units* | 0.96 mL = 96 units | 0.48 mL = 48 units |
Notice that at 5 mg/mL the starting dose is just 5 units, a very small mark on a 100-unit syringe. That is why the syringe size matters (see below). If your vial comes as a powder you mix yourself, the concentration depends on how much diluent you add, and the reconstitution calculator works it out.
Why do compounded vials differ, and what dosing errors has the FDA seen?
Compounded semaglutide is not FDA-approved, and there is no single standard product. Each compounding pharmacy chooses its own concentration, vial size and sometimes added ingredients. Compounding was widely allowed while semaglutide was in shortage. The FDA declared that shortage resolved on February 21, 2025, and its grace period for compounders ended in April 2025 for 503A pharmacies and May 2025 for 503B outsourcing facilities.[6] In February 2026 the FDA said it intends to act against mass-marketed, non-approved GLP-1 drugs.[7] Our compounded vs branded GLP-1 guide explains where that leaves patients.
The FDA's July 2024 alert describes two kinds of error. Some patients drawing their own doses took 5 to 20 times the intended amount. Some clinicians miscalculated unit conversions, leading to doses 5 to 10 times too high. In one pattern, patients told to inject 5 units drew 50 units instead. Reported effects included stomach and bowel symptoms, fainting, headache, dehydration, acute pancreatitis and gallstones, and some patients were hospitalized.[5]
How do I read a U-100 insulin syringe?
A U-100 syringe is marked in units, where 100 units equals 1 mL. They come in three common sizes: 0.3 mL (30 units), 0.5 mL (50 units) and 1 mL (100 units). On many 0.3 mL and 0.5 mL syringes each line is 1 unit, which makes a 5- or 10-unit dose easier to see. On a 1 mL syringe each line is often 2 units. Read the dose at the edge of the plunger's stopper nearest the needle. Remove air bubbles before you check the line. Our step-by-step semaglutide injection guide covers technique, sites and needle disposal.
What if I miss a dose or need to step back down?
The Wegovy label gives clear rules. If you miss one dose and the next scheduled dose is more than 2 days away, take it as soon as you can. If the next dose is less than 2 days away, skip the missed dose and take the next one on schedule. If you miss two or more doses in a row, the label says to restart titration at a lower dose to reduce the risk of stomach side effects.[1] How much lower is a decision for your prescriber. If a step causes side effects you cannot manage, the label suggests waiting four more weeks before moving up.[1] Some people take lower doses on purpose for longer; our GLP-1 microdosing review covers what is known about that.
What is the maintenance dose?
On the label, maintenance for weight reduction is 2.4 mg weekly (recommended) or 1.7 mg, with the option to go to 7.2 mg on Wegovy HD.[1] The trial evidence is for 2.4 mg. In STEP 1, 1,961 adults without diabetes took 2.4 mg weekly or placebo for 68 weeks. Mean weight change was −14.9% versus −2.4% (difference −12.4 percentage points; 95% CI −13.4 to −11.5).[2]
Staying on the dose matters. In STEP 4, people who reached 2.4 mg and kept taking it lost a further 7.9% over 48 weeks, while those switched to placebo regained 6.9%.[3] In the STEP 1 extension, people who stopped regained about two-thirds of the weight they had lost within a year.[4] For how long results take to show, see our semaglutide results timeline; for choosing between 1.7 and 2.4 mg, see GLP-1 maintenance dose. For the tirzepatide version of this chart, see the compounded tirzepatide dosage chart.
Where do providers we review sell compounded semaglutide, and at what price?
Prices change often, and many providers charge more as the dose rises. We list current prices, read from each company's public website, on two pages. The semaglutide provider list compares services on care model, transparency and price, with partners listed first. The cheapest semaglutide providers page sorts by published starting price. When you compare, ask what the price is at your dose, not just the starting dose, and which pharmacy compounds the vial. For pharmacy-direct options, see compounding pharmacy semaglutide.
The bottom line
The milligram schedule for compounded semaglutide is borrowed from the Wegovy label: four-week steps from 0.25 mg up to 2.4 mg. The number of units depends entirely on your vial's concentration, and that is where the documented errors happen. Treat this chart as a way to check your instructions, not to replace them. If the units on your syringe do not match the arithmetic for your dose and vial, stop and call your pharmacy before you inject.