Is compounded semaglutide the same as Ozempic?

If you’ve been looking into Ozempic or Wegovy for weight loss or type 2 diabetes, you may have come across compounded semaglutide. 

Compounded semaglutide is a custom-made version of semaglutide tailored to meet the needs of an individual patient or a copy version to help meet supply needs during a shortage. While certain compounding pharmacies may use the same active pharmaceutical ingredient as Ozempic and Wegovy to prepare compounded semaglutide, it’s not accurate to say compounded semaglutide is the same as Ozempic.

Read on as we explore the differences between compounded semaglutide and Ozempic, so you can make an informed decision about your treatment options.

This question is difficult to answer, in part due to the drug compounding process. Because drug compounding is often done to meet the needs of individual patients, there can be a lot of variability in the final product. One person may be allergic to one of the inactive ingredients in Ozempic, so a compounding pharmacy may make a version of the drug without that ingredient in it. Some people may be unable to administer injectable medications, so a compounding pharmacy could prepare compounded semaglutide in another form.

Dr. Beverly Tchang, MD, an endocrinologist who treats patients with obesity, and an advisor to Ro, summed this up well: “‘Compounded semaglutide’ is not standardized—one compounded semaglutide is not the same as another compounded semaglutide, and none of them have been tested in clinical trials for safety or efficacy.”

Compounding pharmacies also prepare compounded semaglutide to meet demand and patient needs during drug shortages, which have affected Ozempic and Wegovy on an on-and-off basis since March 2022. Compounded semaglutide prepared by reputable compounding pharmacies will include semaglutide base, which is the same active ingredient used in Ozempic and Wegovy. However, the FDA has warned that some compounding pharmacies are using semaglutide salts instead, which is not the same active ingredient that Ozempic and Wegovy contain.

At a basic level, compounded semaglutide cannot be exactly the same as Ozempic, simply because it’s not made by Novo Nordisk, which is the only company that has received approval for medications that contain semaglutide: Ozempic, Wegovy, and Rybelsus. Here’s a quick breakdown of the other key differences between compounded semaglutide vs. Ozempic:

• Who makes it: Ozempic is produced and manufactured by the pharmaceutical company Novo Nordisk, while compounded semaglutide may be produced by various compounding pharmacies and other compounding facilities. 

• How it’s administered: Ozempic comes in injectable prescription pens. Each pen contains between 4–8 doses of the medication. You’ll need to attach a new needle for each injection. Injectable compounded semaglutide typically comes in small glass vials. You’ll use a syringe and draw up your own dose for each injection.

• What it contains: Some forms of compounded semaglutide, like those offered by Ro, use semaglutide base, which is the same active ingredient as Ozempic. Other forms may use semaglutide salts, which are not the same active ingredient. 

• How much it costs: The cost of brand-name Ozempic is high, around $1,000. Compounded semaglutide tends to be more affordable, depending on where you fill your medication. For some people, compounded semaglutide may be a more affordable way to get semaglutide for weight loss until Novo Nordisk’s patent expires and a generic form of Ozempic becomes available. However, Ozempic and Wegovy have gone through the FDA approval process, whereas compounded semaglutide is not FDA approved and does not undergo safety, effectiveness, or manufacturing review by FDA.

The answer to this is that we do not know for sure, said Dr. Tchang. “We do not know since compounded semaglutide has not been tested in clinical trials for safety or efficacy.” 

To date, research on semaglutide is conducted using versions of semaglutide prepared by Novo Nordisk. Given the use case of drug compounding—to meet the needs of an individual patient or boost supply during a drug shortage—clinical trials are not performed with compounded drugs. 

So, even when compounded semaglutide contains the same active ingredient as Ozempic, semaglutide base, and is prepared by a state-licensed compounding pharmacy, we cannot say with certainty that it is as effective as Ozempic or Wegovy simply because it has not been studied and gone through FDA approval process.

Again, because compounded semaglutide has not been tested in clinical trials, we don’t know if compounded semaglutide is safe or effective, said Dr. Tchang. The FDA has received reports of people experiencing side effects after using compounded semaglutide. They’ve also warned that some compounding pharmacies are using the salt forms of semaglutide, which include semaglutide sodium and semaglutide acetate. These semaglutide salts are different active ingredients than those in Ozempic and Wegovy, which use the base form of semaglutide.

Compounded drugs do not undergo the same amount of testing for safety, effectiveness, and quality that FDA-approved drugs do, so they naturally pose a higher risk to people taking them. Having said that, compounded semaglutide can be a helpful option during Ozempic and Wegovy shortages, as well as for people who cannot take Ozempic and Wegovy in their standard form. In addition, drug compounding is subject to federal and state requirements, including sterile compounding standards.  

There are steps you can take to help ensure you are getting compounded semaglutide from a reputable compounder who uses semaglutide base, not salts. For example, Ro only works with state-licensed compounding pharmacies to produce compounded semaglutide, and each batch of medication undergoes quality checks by an accredited third-party lab. Ro’s compounded product only uses semaglutide base, which is the same active ingredient in Ozempic and Wegovy, and not semaglutide salts.

How do you know if compounded semaglutide is a good option for you? “This should be a discussion between a patient and their doctor since it deserves a full assessment of the risks, benefits, and alternatives to compounded semaglutide,” said Dr. Tchang. 

Below we answer a few more common questions people have about compounded semaglutide.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

October 22, 2024

Written by

Amelia Willson

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.