What is the starting dose of compounded semaglutide?

There is no FDA-approved starting dose for a compounded product, because compounded semaglutide is not FDA-approved and carries no FDA-reviewed label. The reference point a prescriber works from is the approved Wegovy label's starting dose — 0.25 mg subcutaneously once weekly for four weeks, an initiation dose only. What that 0.25 mg comes out to in a specific compounded vial's mL or syringe units depends entirely on that vial's own concentration, not a number the label sets.

Off the FDA label · Checked live August 2026

Semaglutide dosage chart: three ladders, one molecule

The FDA-approved starting dose of semaglutide (Wegovy injection) is 0.25 mg subcutaneously once weekly, for four weeks. There is no separate FDA-approved starting dose for a compounded product — compounded semaglutide carries no FDA-reviewed label of its own, so 0.25 mg is the reference point a prescriber works from, not a rule the vial itself states. Semaglutide also has two OTHER current ladders on different products — Wegovy tablets and Ozempic — tabled below, because confusing them is the single most common charting error on this molecule.

This page states what each label specifies. It does not recommend a dose, and the mg/mL arithmetic below does not verify what any specific compounded vial contains. For the full evidence discussion — trial data, the switching protocol between injection and tablet, and a four-question FAQ — see our complete semaglutide dosing reference.

Three labels, three ladders

A chart that gives one number for “semaglutide maintenance dose” is describing exactly one of these three and silently contradicting the other two.

Product	Ladder	Maintenance
Wegovy injection	0.25 → 0.5 → 1 → 1.7 → 2.4 mg, 4-week steps	2.4 mg (recommended) or 1.7 mg; up to 7.2 mg for weight reduction after ≥4 wks at 2.4 mg
Wegovy tablets	1.5 → 4 → 9 → 25 mg, 30-day steps	25 mg once daily
Ozempic	0.25 → 0.5 → 1 → 2 mg, ≥4-week steps	0.5, 1 or 2 mg — 2 mg is the hard maximum

Read directly off the current Wegovy and Ozempic prescribing information. All three ramps exist, in the labels' own words, to reduce the risk of gastrointestinal adverse reactions.

Missed a dose? It depends which product

Wegovy injection: take the missed dose if the next scheduled one is more than two days away; otherwise skip it. Miss two or more doses in a row and the label says to restart the escalation ladder at a lower dose.
Wegovy tablets: skip the missed dose and take the next one the following day.
Ozempic: take it within five days of the missed dose; past that, skip it and resume on the regular day.

None of these windows match tirzepatide's. See the tirzepatide dosage chart before carrying a rule across molecules.

Milligrams on the label, milliliters in the syringe

Approved semaglutide injections span roughly a 5-fold concentration range on their own — wider once tirzepatide's 25 mg/mL vials enter the comparison. A compounded vial has one fixed concentration, so a syringe-units figure only means something once you know that specific vial's number.

Approved product	Concentration	Note
Ozempic pens	0.68 / 1.34 / 2.68 mg/mL	Three separate pen strengths (2, 4, 8 mg per 3 mL)
Wegovy single-dose pens	0.5–3.2 mg/mL range	Fixed volume per strength, 0.25 mg/0.5 mL up to 7.2 mg/0.75 mL
Wegovy FlexTouch (multi-dose)	3.2 mg/mL	Delivers 2.4 mg per 0.75 mL dose

The rule behind every row: volume (mL) = dose (mg) ÷ concentration (mg/mL), and on a U-100 insulin syringe, units = mL × 100. Check it against Wegovy's own numbers: the FlexTouch delivers 2.4 mg at 3.2 mg/mL, which is 2.4 ÷ 3.2 = 0.75 mL — matching the label's stated dose volume exactly. Run the same arithmetic on your own vial's printed concentration — not a number from a different vial — with our semaglutide reconstitution calculator. Given a units reading and want the mg instead? Our units-to-mg converter runs it the other way.

FDA has received “multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products.” Source below.

Sources, checked live

All three confirmed live and current on August 2026. Labels change; verify the current version before relying on a printed copy.

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Medical disclaimer: This content is for general educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional before starting, stopping, or changing any treatment.