GLP-1 & incretin
Semaglutide
GLP-1 receptor agonist with large randomized human trials behind it and FDA approval for type 2 diabetes and weight management under brand names.
Also known as Ozempic · Wegovy
At a glance
Dose summary
Reconstitution
What to draw, at the usual vial
A 5 mg vial reconstituted with 2 mL of bacteriostatic water gives 2.50 mg/mL. A typical 1 mg dose is 0.400 mL — pull the plunger to 40 units on a U-100 syringe.
Same dose, other vial sizes
| Vial | Water | Concentration | Draw | Units | Doses |
|---|---|---|---|---|---|
| 2 mg | 2 mL | 1.00 mg/mL | 1.000 mL | 100 units | 2 |
| 5 mg | 2 mL | 2.50 mg/mL | 0.400 mL | 40 units | 5 |
| 10 mg | 2 mL | 5.00 mg/mL | 0.200 mL | 20 units | 10 |
The highlighted row is the one quoted above: the smallest listed vial that holds at least four typical doses. Change any of it — a different vial, more or less water, a different dose — on the reconstitution calculator, which draws the syringe to true U-100 graduations.
Titration
Step-up ladder
This compound is escalated rather than held flat. Each step is a fixed number of weeks before the next increase — the side effects cluster in the days after a step, not at the top of the ladder.
| Step | Weeks | Dose | Note |
|---|---|---|---|
| 1 | 1–4 | 250 mcg | starting dose |
| 2 | 5–8 | 500 mcg | — |
| 3 | 9–12 | 1 mg | — |
| 4 | 13–16 | 1.7 mg | — |
| 5 | 17–20 | 2.4 mg | maintenance |
Full ladder: 20 weeks from the starting dose to the top step.
Mechanism & evidence
What it is, and what is known
GLP-1 receptor agonist with large randomized human trials behind it and FDA approval for type 2 diabetes and weight management under brand names.
Tolerability
Reported side effects
- Nausea, especially in the days after a dose increase
- Constipation or diarrhoea
- Reduced appetite and early satiety
- Fatigue during titration
Hard stops
Do not use this if
- Pregnancy, possible pregnancy, or breastfeeding
- Personal or family history of medullary thyroid carcinoma, or MEN2
- History of pancreatitis
- Existing thyroid disease
These are flags, not a screening. They do not replace a conversation with a clinician who knows your history.
Handling
Storage
Keep it cold, keep it dark, and label the vial with the date you mixed it. Discard anything cloudy or past the window above.
References
Sources
Educational information only, not medical advice. Talk to a licensed clinician before starting, changing, or stopping anything.