Semaglutide.

Compounded semaglutide is prepared by a state-licensed 503A pharmacy to a custom formula, using the same active ingredient (semaglutide) as brand-name versions. Compounded medications are not FDA-approved. Your provider reviews your health history to determine whether it is appropriate for you.

Most patients see meaningful appetite reduction within the first 2 weeks. Visible weight loss typically begins by week 4 to 6. The most significant results come over 6 to 12 months of consistent treatment combined with sustainable eating and movement habits.

The most common side effects are gastrointestinal: nausea, diarrhea, constipation, and reduced appetite. These usually peak in the first 2 weeks of each dose increase and subside as your body adjusts. Less common but serious side effects include pancreatitis, gallbladder issues, and (in rare cases) thyroid tumors in patients with a personal or family history of medullary thyroid cancer or MEN-2.

Anyone with a personal or family history of medullary thyroid carcinoma or MEN-2, severe gastroparesis, active pancreatitis, or a history of severe allergic reaction to semaglutide. Pregnant or breastfeeding women should also avoid it. Your provider will screen for all of these at consultation.

Semaglutide can interact with insulin and sulfonylureas (raising hypoglycemia risk), oral contraceptives (slowing absorption due to delayed gastric emptying), and warfarin. Always tell your provider everything you take, including over-the-counter and supplements.

Without ongoing treatment, appetite typically returns and most patients regain weight unless they have built sustainable habits. Many patients use semaglutide as a long-term tool combined with lifestyle changes. Your provider can also help you taper safely if you choose to stop.

Both are GLP-1 medications. Tirzepatide is a dual GLP-1 and GIP agonist, and semaglutide is a GLP-1 agonist. Semaglutide has a long track record and is often a starting point. Your provider will discuss your goals, medical history, and budget to recommend the best fit.