Compounded semaglutide is made by a pharmacy to a prescriber’s order, not to an FDA label. That means there’s no official maximum dose for it. The only official ceilings belong to the approved semaglutide injections, Ozempic and Wegovy [2] [1]. Those labels are the reference your prescriber works from, and FDA has warned about compounded doses that go past them [3].
Compounded semaglutide has no official maximum because it has no label
A maximum dose is something FDA approves on a drug’s label, and compounded drugs have no FDA label. FDA says compounded drugs “are not FDA approved,” so the agency “does not review compounded drugs for safety, effectiveness or quality before they are marketed” [3].
A compounded product copies the active ingredient, semaglutide. The dosing comes from your prescriber. So when a program quotes a “max dose,” it’s quoting either the brand labels or its own protocol, and it’s worth asking which.
The two semaglutide injection labels set the reference points
Both labels start at 0.25 mg once a week. Ozempic’s label maximum is 2 mg a week [2]. Wegovy’s label maximum is 7.2 mg a week, sold as Wegovy HD, but only for some people already on 2.4 mg [1].
| Reference point | Wegovy injection | Ozempic |
|---|---|---|
| Labeled use | Weight management; heart-risk reduction; MASH | Type 2 diabetes; heart and kidney risk reduction |
| Starting dose | 0.25 mg once weekly | 0.25 mg once weekly |
| Maintenance dose for weight | 1.7 mg or 2.4 mg (2.4 mg recommended) | Not approved for weight loss |
| Label maximum | 7.2 mg once weekly | 2 mg once weekly |
| Condition for the maximum | Tolerating 2.4 mg for at least 4 weeks, and more weight loss is clinically indicated | More blood-sugar control is needed |
Milligrams once weekly, as labeled [1] [2]. Compounded products have no label; your prescriber sets the dose. The dose steps between start and maintenance are set by the label and your prescriber, and aren’t listed here.
Wegovy’s label maximum is 7.2 mg, with a trade-off
Wegovy’s usual maintenance dose for weight is 1.7 or 2.4 mg a week, and the label recommends 2.4 mg. For people who tolerate 2.4 mg for at least 4 weeks, the label says that when “additional weight reduction is clinically indicated, the dosage may be increased to a maximum dosage of 7.2 mg subcutaneously once weekly” [1].
The higher dose came with more side effects in trials. Dysesthesia, an unusual or burning skin sensation, was reported by 22% of people on 7.2 mg, against 6% on 2.4 mg and 0.3% on placebo [1].
Wegovy is approved to lower the risk of heart attack, stroke and heart-related death in adults with established heart disease and obesity or overweight. It’s also approved for long-term weight management and, under accelerated approval, for a form of fatty liver disease called MASH with moderate to advanced scarring [1]. More on the brand is on the Wegovy page.
Ozempic’s label maximum is 2 mg, for type 2 diabetes
Ozempic’s label says “the maximum recommended dosage is 2 mg once weekly” [2]. It’s approved to improve blood sugar in adults with type 2 diabetes, and to lower heart and kidney risks in adults with type 2 diabetes who have heart or kidney disease. It isn’t approved for weight loss, so a weight-loss program that quotes Ozempic’s 2 mg ceiling is borrowing a diabetes label.
FDA has seen problems with compounded doses above the label
FDA’s adverse-event files include reports possibly linked to compounded semaglutide or tirzepatide prescribed “in doses beyond what is in the FDA-approved drug label” [3]. The agency spells out what that means: “using more product in a single dose, taking doses more frequently or increasing the amount more quickly.”
Some of those events were serious, with people seeking medical help for stomach symptoms ranging from nausea to constipation [3]. FDA has separate reports, some requiring hospitalization, tied to dosing errors with compounded injectable semaglutide. Those errors came from patients measuring wrong doses and, in some cases, from clinicians miscalculating them.
Prescribers move up only when the current dose works and is tolerated
Both labels are written the same way: a higher dose is for someone who tolerates the current one and needs more effect. Wegovy’s label tells prescribers to “consider treatment response and tolerability when selecting the maintenance dosage” [1]. Staying on is part of the plan too: in the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they had lost within a year [4].
That’s also why a compounded program’s dose list isn’t a menu. Your prescriber decides when, and whether, to change your dose. If side effects are hard to live with, raise it with them before your next dose, not after.
Questions to ask about your compounded dose
Ask your prescriber which label dose yours corresponds to, and have your pharmacist check the milligram dose on your vial’s label.
- Which Wegovy or Ozempic label dose does my dose correspond to?
- Is my dose, or my schedule for changing it, different from the label? If so, why?
- What dose in milligrams is printed on my vial’s label, and does it match my prescription?
- Which side effects should make me call before my next dose?
- When does my vial need to be thrown away?
The vial question matters because FDA advises discarding multi-dose vials 28 days after first use [3]; storage is covered in compounded semaglutide fridge rules. Doses below the label’s starting point are covered in microdosing GLP-1s. The tirzepatide version of the dose question is compounded tirzepatide starting dose. Risks are in is compounded semaglutide safe, and prices are in compounded semaglutide cost.
If you’re comparing programs, look for one that names its pharmacy. Eden, Midi Health and Embody do so on their own pages. Programs are scored on the compounded semaglutide scores, and the molecule is explained on the semaglutide page.