Compounded Semaglutide Side Effects: What to Watch For

Compounded* semaglutide may cause similar side effects to brand name versions like Ozempic or Wegovy, including nausea, diarrhoea, constipation and fatigue. In this article, we’ll unpack what compounded semaglutide works and how to manage side effects.

Article Summary

• Compounded semaglutide is a GLP-1 medication designed to support weight loss or blood sugar management, prepared by a compounding pharmacy to meet individual patient needs.
• Common side effects of compounded semaglutide include nausea, vomiting, diarrhoea, constipation and stomach pain.
• More serious side effects of compounded semaglutide, such as signs of pancreatitis, anaphylaxis and gallbladder issues.

What is Compounded Medication?

Compounded medication is a custom-made version of a drug prepared by a licensed pharmacist. Compounded medications are used for a whole range of reasons like personalizing the dose or removing allergens. In the case of semaglutide, compounded versions may be used when the brand-name option is unavailable or not covered by insurance.

At ZipHealth, we are state-licensed and LegitScript-certified, ensuring strict compliance with both FDA and state regulations. Our pharmacy undergoes regular inspections to maintain the highest standards of quality and safety. Our medications are subjected to rigorous testing, encompassing potency, pH levels, sterility, and endotoxicity checks to ensure efficacy and safety.

What is Compounded* Semaglutide?

As a glucagon-like peptide-1 receptor agonist, compounded* semaglutide works in the same way as brand name versions of semaglutide like Wegovy and Ozempic. 

Like brand name alternatives, it works by mimicking the naturally occurring GLP-1 gut hormone in your body that is released after you eat. In clinical trials, patients taking semaglutide experienced an average weight loss of approximately 15% over 68 weeks. [1]

Here’s how semaglutide promotes weight loss in your body:

• Acts on the reward center in the brain (the hypothalamus) to reduce your appetite and increase feelings of fullness. [1]
• Slows down the rate at which food leaves your stomach, helping you stay fuller for longer. [1]
• Enhances insulin secretion from your pancreas, helping to control blood sugar levels. [1]

Side Effects of Compounded* Semaglutide

Nausea, vomiting, diarrhoea, constipation and stomach pain are the most common side effects of GLP-1 medications. These symptoms often appear when you first start treatment or increase your dose, but usually improve as your body adjusts to the medication. [1]

Below, we’ve included tips for managing some of the most common digestive side effects of semaglutide.

Nausea

• Stay hydrated and drink plenty of fluids (cold water, herbal teas)
• Get lots of fresh air
• Eat smaller meals more frequently
• Avoid foods high in sugar and fat or spicy or strong-smelling foods

Constipation

• Drink plenty of fluids (water, herbal teas) to stay hydrated
• Eat high-fiber foods such as prunes, figs, and oats 
• Take regular walks as exercise can stimulate bowel movements

Indigestion

• Reduce your caffeine intake
• Don’t eat too close to bedtime
• Avoid rich, spicy or fatty foods 
• Try over-the-counter heartburn medication

Diarrhoea

• Stay hydrated by drinking plenty of fluids (water, herbal teas)
• Eat small and frequent meals
• Rest. Take it easy and allow your body to recover
• Consider over-the-counter options like oral rehydration salts to replace lost electrolytes and acetaminophen for pain relief

Vomiting

• Stay hydrated by taking small sips of water.
• Try drinking herbal teas such as ginger and peppermint.
• Eat small and frequent meals to keep your energy levels up. 
• Stick to a bland diet that is easy on your stomach, such as toast, rice and bananas.

Serious Side Effects

Serious side effects of GLP-1 treatments are rare but require urgent medical attention. Stop taking your medication and call 911 or go to the emergency department if you experience any of the following: 

• Severe, persistent stomach pain that may radiate to your back (especially with vomiting), as this could indicate pancreatitis.
• Difficulty breathing or swelling of the lips, tongue, or throat, which may signal a severe allergic reaction (anaphylaxis).
• Severe pain under your right ribcage that spreads to your shoulder or back, which could suggest gallbladder problems.

Dosing, Storage and Administration

Unlike standardised pre-filled pens used for Ozempic or Wegovy, compounded versions may come in vials requiring manual measurement and injection. Compounded* Semaglutide is administered via subcutaneous injection once daily, which simply means injecting the medication just under the skin using a disposable needle.

Here’s how to inject Compounded* Semaglutide:

1. Start by washing your hands.
2. Gather your medication vial, alcohol swab, disposable needle and sharps bin on a clean surface. 
3. Check your medication for signs of damage or expiration.
4. Choose an injection site (abdomen, thigh, or upper arm) and clean the area with an alcohol swab. Remember to choose a new injection site each time you inject to prevent skin irritation at the injection site.
5. Remove the needle cap and draw up the prescribed dose into the syringe. 
6. Remove any air bubbles by gently tapping the syringe.
7. Inject the medication by inserting the needle into your injection site at a 90-degree angle and slowly pushing the plunger down while counting to 5.
8. Dispose of the needle in a rigid, plastic container.

It’s important that you follow correct injection and dosing guidelines to minimize side effects.

Ready to Start Your Weight Loss Journey?

At ZipHealth, we’re here to support you through your whole weight loss journey. If you’re thinking about getting started, complete a consultation on our website.

*Compounded drugs are permitted to be prescribed under federal law but are not FDA-approved and do not undergo FDA review for safety, effectiveness, or quality.

References:

1. Wilding JPH, Batterham RL, Calanna S. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine [Internet]. 2021 Feb 10;384(11):989–1002. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183