What Is Semaglutide, and How Does It Relate to Ozempic?

Semaglutide is the active pharmaceutical ingredient (API) in both Ozempic and Wegovy — two brand-name GLP-1 receptor agonists made by Novo Nordisk. Ozempic is FDA-approved for type 2 diabetes management, while Wegovy is approved for chronic weight management.

For a period when these drugs faced severe shortages, licensed compounding pharmacies were permitted to compound semaglutide as an alternative. That window has largely closed.

Where Things Stand Now

The FDA removed semaglutide from its official drug shortage list in early 2025. Once a drug is no longer on the shortage list, the legal basis for widespread compounding under shortage provisions no longer applies. The FDA has since taken enforcement action against pharmacies continuing to compound semaglutide outside of permitted conditions.

As of now, compounding pharmacies may only prepare semaglutide for patients with a documented medical necessity — meaning a specific, individualized clinical reason why the commercially available product cannot be used. This is determined by the prescribing physician, not the pharmacy.

What Counts as Medical Necessity?

Medical necessity for a compounded GLP-1 is a high bar. Examples that may qualify include:

• A documented allergy to an inactive ingredient (excipient) in the commercial product
• A need for a specific dose or concentration not available in any FDA-approved product
• A documented clinical reason why the standard delivery form cannot be used

General preference for a lower price or difficulty affording the brand-name product does not qualify as medical necessity under current FDA guidance. Your prescriber must document the specific clinical rationale.

What This Means for Patients

If you were previously using compounded semaglutide obtained through a pharmacy operating under shortage provisions, that pathway is no longer broadly available. Patients seeking semaglutide now generally need to obtain Ozempic or Wegovy through standard channels.

Options for managing cost include manufacturer patient assistance programs (Novo Nordisk offers NovoCare), GoodRx and pharmacy discount cards, and insurance appeals if coverage was previously denied.

What's the Same When You Do Get Compounded Semaglutide

For the subset of patients who do qualify under medical necessity, the pharmacology is identical — compounded semaglutide uses the same active molecule, working through the same GLP-1 receptor mechanism. The practical differences remain: vials instead of a pen injector, and no FDA review of the finished preparation.

Bottom Line

Compounded semaglutide is no longer widely available since the FDA resolved the shortage. Access is now limited to patients with documented medical necessity, as determined by their prescriber. If you believe you may qualify, discuss the specific clinical rationale with your doctor before pursuing a compounded option.

CompoundingFinder connects patients with licensed compounding pharmacies for medications that are legally available to compound. Submit your medication details to see what's available and compare pricing.