Semaglutide
Metabolic / GLP-1
Status & caution. FDA-approved for type 2 diabetes (Ozempic/Rybelsus) and chronic weight management (Wegovy). Compounded copies were widely sold during the 2022-2024 shortage; semaglutide was removed from the FDA shortage list, so routine compounding of copies is now generally not permitted. Among the best-studied peptides here, but not benign. Grey-market and compounded versions vary in purity and concentration.
At a glance
Indications & what it's studied for
Type 2 diabetes; chronic weight management; under study for cardiovascular risk reduction, MASH/fatty liver, and more. A GLP-1 receptor agonist that increases glucose-dependent insulin secretion, slows gastric emptying, and reduces appetite.
Contraindications & cautions
Personal/family history of medullary thyroid carcinoma or MEN-2; known hypersensitivity. Caution in pancreatitis history, gastroparesis, diabetic retinopathy, and during pregnancy/breastfeeding.
Commonly reported dosing
Reported, not recommended. The following describes what appears in research literature and community use. It is not a protocol, and unapproved peptides have no validated human dosing.
Approved products titrate slowly (e.g. Wegovy 0.25 mg weekly, stepping up over months to 2.4 mg) specifically to limit GI side effects. Aggressive grey-market dosing is a common cause of severe nausea, vomiting, and dehydration.
Routes of administration
Subcutaneous injection weekly (Ozempic/Wegovy); oral tablet daily (Rybelsus).
Don't combine with
Other GLP-1/GIP agonists (additive GI effects); insulin/sulfonylureas without dose adjustment (hypoglycaemia risk); drugs that depend on predictable gastric emptying.
Reported to stack with
Sometimes paired clinically with lifestyle programs; community 'stacks' with other agonists raise the side-effect ceiling and are not established as safe.
Note: "stacking" combines multiple agents and multiplies unknowns; popularity of a combination is not evidence of its safety
What the research actually shows
Large multi-phase trials (STEP, SUSTAIN, SELECT) underpin its approvals, including a cardiovascular-benefit signal. This is the depth of evidence most peptides on this site do NOT have.
Before acting on anything here, see Safety & the grey market and how to read a COA.