Compounded semaglutide

Salt forms are a different active ingredient

This is the sharpest point in the whole semaglutide record, and the one least likely to appear on a page selling the product. Some compounded semaglutide is a salt form — semaglutide sodium or semaglutide acetate. FDA says they are different active ingredients. It has no evidence that they act like the approved form. The agency also says it knows of no lawful basis for using them in compounding.

In FDA’s view a salt form is not a version of the approved ingredient. It is a different ingredient. The agency has also warned ingredient distributors and set up an import alert covering GLP-1 ingredients with possible quality problems.

The dosing-error alert

FDA has published an alert about people taking the wrong amount of compounded semaglutide. The cause is packaging, not chemistry. An approved product comes in a pen that measures the dose for you. Compounded product usually arrives as a vial and a separate syringe, which hands the measuring job to the patient. FDA says many of the people affected had never injected anything before, and that mixing up mL, mg and units was part of it.

Most reports were of people drawing up more than they were prescribed — in some cases five to twenty times more — and some ended in hospital. Reported effects included stomach symptoms, fainting, headache, migraine, dehydration, sudden pancreas inflammation and gallstones. FDA has also received reports of prescriptions written above what the approved label allows. Compounded preparations therefore have no schedule presented as an approved one.

What dose is compounded semaglutide?

No dose schedule exists for compounded semaglutide. Three approved semaglutide products publish one each, they stop at three different ceilings, and none of them was written for a preparation somebody mixed.

Ozempic, Wegovy and the semaglutide tablet contain the same drug. Their labels still cover different people, dose ceilings and missed-dose rules. There is no single semaglutide schedule.

A compounded vial has no fourth answer, because it has no label. FDA has gone further on this molecule than on tirzepatide: it has also received reports of prescriptions written above what any approved label allows.

There is a second problem here that tirzepatide does not have. Some compounded semaglutide was made from a salt form, which FDA says is a different active ingredient from the one in the approved drugs. A schedule borrowed from an approved label would not even be describing the same substance.

Is there a compounded semaglutide dosage chart in units?

The dangerous version of this question is the one asking for units. Units measure the liquid drawn into a syringe, not the drug dissolved in it.

The compounder decides how much liquid the drug is dissolved in, so the same syringe reading means different amounts from different vials. FDA’s alert describes exactly that going wrong: people confusing milliliters, milligrams and units, most of them drawing up more than they were prescribed, some by five to twenty times.

FDA also says many of the people affected had never injected anything before. The measuring job moved from a device to a person, and the reports followed it.

Where the published semaglutide dosing charts actually are

The three approved schedules are shown from their labels. A separate calculator shows how vial strength and water volume change a syringe reading.

• The Wegovy schedule and the Ozempic schedule are two of the three, and they do not meet at either end.
• The semaglutide dosage chart covers the molecule and says what each figure on it rests on.
• The reconstitution calculator turns a vial strength and a volume of water into a syringe reading, which is the arithmetic a chart in units pretends it can skip.
• The dosing-error study compares FDA reports with the device each product uses. It counts submitted reports, never rates.

Is compounded semaglutide the same as Ozempic or Wegovy?

Semaglutide is the drug in all three. The difference is that Ozempic and Wegovy each come with an FDA-approved label, and a compounded vial comes with none.

Those two labels do not even agree with each other. Ozempic stops at 2 mg a week and covers type 2 diabetes. Wegovy runs to 2.4 mg, then to 7.2 mg for weight in adults, and covers nobody for blood sugar. So “the semaglutide dose” is not one number, and a compounded vial sits outside both schedules.

• Wegovy and Ozempic compared line by line — one drug substance, two labels that diverge on almost everything else.
• The Wegovy dose schedule in full is the approved weight-loss schedule, tablet included.
• The semaglutide dosage chart covers the drug itself, and the reconstitution calculator turns a vial and a volume of water into a syringe reading.

What has actually been recalled

FDA has published 43 recall records naming semaglutide, filed by 16 companies, checked 17 August 2026.

FDA writes its own reason on each record. These are its words, counted:

• 27 of 43 recall records naming semaglutide use the word “sterility”.
• 3 of 43 recall records naming semaglutide use the word “temperature”.
• 2 of 43 recall records naming semaglutide use the word “endotoxin”.
• 2 of 43 recall records naming semaglutide use the word “particulate”.

FDA matched 1 of 43 recall records naming semaglutide to an approved product listing. The other 42 name a preparation with no approved product behind it.

These are counts of recall filings, not of problems per batch made. Many small pharmacies file many small recalls; one large manufacturer files few large ones. Nobody publishes how many units either side made, so these counts cannot be read as which is safer.

16 companies filed these recalls. This site does not name pharmacies or outsourcing facilities. FDA does, on the page behind each recall number, and the newest here is D-0471-2026.

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