Semaglutide/B12
A GLP-1 receptor agonist that reduces appetite and slows gastric emptying, combined with vitamin B12.
Medically reviewed by Dr. Jonathan Snipes, MD. Last reviewed May 6, 2026.What It Is
Semaglutide is a GLP-1 receptor agonist. The same class of medication as Ozempic® and Wegovy®. Our compounded version pairs it with B12 to support energy levels during weight loss.
How It Works
It mimics the GLP-1 hormone your body naturally produces after eating. This tells your brain you're full, slows digestion, and helps regulate blood sugar. Leading to steady, sustainable weight loss.
Who It's For
Adults with a BMI over 27 looking for pharmaceutical support alongside diet and exercise. Especially effective for those who struggle with portion control and cravings.
Who Should Avoid It
Not for those with personal/family history of thyroid cancer (MTC), MEN2 syndrome, active pancreatitis, or severe gastroparesis. Not suitable during pregnancy.
Protocol & Pricing
OBP Pharmacy Price
From $25/1.2mg
You pay pharmacy price. No markup.
Starting Dose
25 units (0.15mg) twice weekly
Form
Injectable vial (2mL, 0.6mg/mL, 1.2mg total. Starter concentration; titration vials up to 30mg available)
Dosing Protocol
25 units subcutaneous injection twice weekly. Titrate up concentration as tolerated. 25 units = 0.25mL × 0.6mg/mL = 0.15mg per injection (starter vial). Hold or step back dose if nausea. Hydration & protein mitigate side effects. Full dose ladder (pharmacy passthrough at OBP wholesale, no markup): 1.2mg vial $25 · 2.4mg $30 · 4.4mg $42.68 · 6.8mg $65.96 · 8.2mg $79.54 · 11.2mg $108.64 · 12.5mg $121.25 · 15mg $145.50 · 20mg $194 · 30mg $291.
Beyond Use Date
Up to 120 Days from compounding (USP <797>)
Use within this window from the date your vial is compounded. BUD is set per USP <797> sterile compounding standards and printed on every label.
Stacking Guide
Stacks Well With
Do Not Combine With
Related Peptides
Lipo-B (Cyanocobalamin/MIC)
A lipotropic injection combining cyanocobalamin (B12) with methionine, inositol, and choline for fat metabolism.
From $30/10mlLipo-C (Cyanocobalamin/MIC/L-Carnitine)
Enhanced lipotropic injection adding L-carnitine to cyanocobalamin and MIC for improved energy and fat transport.
From $35/10mlAOD-9604
A modified fragment of human growth hormone that targets fat metabolism without growth effects.
$80/6mgIndependently tested
Semaglutide/B12 lab test reports
Every Semaglutide/B12 batch dispensed by Optimal Balance Pharmacy is independently tested by Eagle Analytical Services (FDA-registered, A2LA ISO 17025 accredited) for sterility (ScanRDI) and bacterial endotoxin (USP <85>). The 5 most recent reports of 11 on file:
| Submission | Lot | Sample | Sterility | Endotoxin | |
|---|---|---|---|---|---|
| ETX-260325-0188 | 032426-04 | Semaglutide/Cyanocobalamin 3.4mg/500mcg/ml (2ml vial) S3.4 | Pass | Pass <2 EU/mL / 350 EU/mL | Download |
| ETX-260325-0683 | 032626-03 | Semaglutide/Cyanocobalamin 2.5mg/500mcg/ml (5ml vial) | Pass | Pass <2 EU/mL / 400 EU/mL | Download |
| ETX-260325-0685 | 032626-04 | Semaglutide/Cyanocobalamin 5mg/0.5mg/ml 2.5ml vial | Pass | Pass <2 EU/mL / 375 EU/mL | Download |
| ETX-260320-0122 | LG342006539 | Semaglutide/Cyanocobalamin 2.5mg/500mcg/ml (5ml vial) | Pass | Pass <2 EU/mL / 400 EU/mL | Download |
| ETX-260320-0144 | 031926-05 | Semaglutide/Cyanocobalamin 5mg/500mcg/ml (3ml vial) S53 | Pass | Pass <2 EU/mL / 375 EU/mL | Download |
Eagle Analytical Services is an independent FDA-registered laboratory, A2LA accredited to ISO 17025, based in Houston, Texas. They have no commercial relationship with PeptideRx. PeptideRx prescribes; Optimal Balance Pharmacy compounds and dispenses; Eagle tests every batch. Three separate companies. Browse our full quality program on the quality page.
Why this is legal in 2026
Compounded semaglutide is dispensed under Section 503A of the Federal Food, Drug, and Cosmetic Act, which authorizes a state-licensed pharmacy to compound a drug for an identified individual patient with documented medical need. Each prescription is patient-specific, written by a licensed nurse practitioner or physician assistant after a documented telehealth visit, and dispensed by Optimal Balance Pharmacy in Texas.
The FDA enforcement-discretion period that allowed mass compounding during the tirzepatide shortage ended on March 19, 2025 for 503B outsourcing facilities and February 18, 2025 for 503A pharmacies. The 503A patient-specific exception is statutory and was not affected by either deadline.
Full breakdown of the pathway, the regulatory citations, and the documented medical-need criteria PeptideRx providers use is on our compounded tirzepatide legality page.
GLP-1 medications are compounded semaglutide or tirzepatide. Compounded versions are not the same as branded Ozempic®, Wegovy®, Mounjaro®, or Zepbound®. Compounded medications are prepared by licensed pharmacies and are not FDA-approved drug products.
Common questions about Semaglutide/B12
- What is Semaglutide/B12 from PeptideRx?
- Semaglutide/B12 is a compounded injectable that pairs semaglutide, a GLP-1 receptor agonist, with cyanocobalamin (vitamin B12). Semaglutide is the same active ingredient as Ozempic and Wegovy. Vial sizes start at $25 for the 1.2 mg starter and ladder up through 6.4 mg vials, with a flat $39 medical visit fee. Optimal Balance Pharmacy dispenses the prescription under Section 503A and Eagle Analytical Services tests every batch for sterility and bacterial endotoxin. The Certificate of Analysis for your lot is published on this page.
- Does compounded semaglutide work the same as Ozempic or Wegovy?
- Compounded semaglutide uses the same active ingredient as Ozempic and Wegovy: semaglutide. The pharmacology, dose-response, and weight-loss mechanism are identical because the molecule is the same. The compounded version Optimal Balance Pharmacy dispenses is co-formulated with cyanocobalamin (B12) for energy support during caloric deficit; B12 has no effect on GLP-1 receptor activation. The pivotal STEP-1 trial reported approximately 14.9 percent mean body weight loss at 68 weeks on semaglutide; that data applies because the active is the same.
- What is the starting dose of compounded semaglutide?
- The PeptideRx starting dose is 25 units (0.15 mg) on a U-100 insulin syringe, taken subcutaneously twice weekly. Your provider may adjust based on your medical history. The full dose ladder includes 1.2 mg, 2.2 mg, 2.5 mg, 3.4 mg, 5 mg, and 6.4 mg vials at Optimal Balance Pharmacy wholesale pricing. Titration is typically every 4 weeks if tolerated, mirroring the manufacturer-recommended Wegovy schedule.
- How many units is 0.25 mg of semaglutide on a U-100 syringe?
- On a U-100 (insulin) syringe, 0.25 mg of semaglutide drawn from a 1 mg/mL starter vial equals 25 units (0.25 mL). The unit conversion depends on your specific vial concentration; always verify the concentration printed on your label before drawing. Optimal Balance Pharmacy ships multiple concentrations across the titration ladder for PeptideRx prescriptions, and your shipment includes a per-vial unit conversion table for safety.
- Why does the formulation include cyanocobalamin (B12)?
- Cyanocobalamin is a stable form of vitamin B12 that supports red blood cell production and energy metabolism during caloric restriction. The 0.5 mg/mL inclusion is below any clinical toxicity threshold and has no effect on semaglutide's GLP-1 receptor binding. Patients with documented B12 sensitivity or MTHFR methylation variants can ask their provider about the Semaglutide/Glycine variant, which uses glycine and B6 as the carrier instead.
- Where should I inject semaglutide?
- Semaglutide is injected subcutaneously into the abdomen, the upper outer thigh, or the back of the upper arm. Rotate sites between injections to avoid lipohypertrophy. Use a 31-gauge, 5/16-inch (8 mm) needle on a U-100 insulin syringe; sterile syringes are included with every PeptideRx shipment. Pinch the skin lightly and inject at a 90-degree angle. For step-by-step technique, see the PeptideRx injection guide.
- How long does semaglutide stay in the system?
- Semaglutide has a long half-life of approximately 165 hours (about 7 days). After your last dose, semaglutide remains pharmacologically active for roughly 3 to 5 weeks as the body clears it. This long half-life is why semaglutide is dosed once or twice weekly depending on the protocol step. If you discontinue semaglutide, expect appetite to begin returning to baseline around week 3 post-discontinuation.
- Does semaglutide cause hair loss?
- Hair shedding is reported in approximately 3 percent of semaglutide users in clinical trial data. The mechanism is most often telogen effluvium tied to rapid weight loss rather than a direct semaglutide effect, similar to what occurs after any aggressive caloric deficit. Most cases resolve within 3 to 6 months as weight stabilizes. Adequate protein intake (at least 1 gram per kilogram body weight per day) and complete-micronutrient coverage during weight loss reduce risk.
- Does compounded semaglutide expire?
- Yes. Every compounded semaglutide vial from Optimal Balance Pharmacy carries a Beyond Use Date (BUD) printed on the vial label per USP <797> sterile compounding standards. Unopened vials should be refrigerated at 36 to 46 degrees Fahrenheit and used by the printed BUD. Once a vial is punctured for first use, the in-use BUD on the label applies, typically 28 days. Do not use any vial past the printed BUD and do not freeze.
- Can I switch between Ozempic and PeptideRx-prescribed compounded semaglutide?
- Switching is a clinical decision your provider makes based on your current dose, titration step, and reason for switching. The active ingredient is identical, so the dose translates directly. Tell your PeptideRx provider your current Ozempic dose in mg per week and they will match the dose on the compounded ladder dispensed by Optimal Balance Pharmacy. Do not stack Ozempic and compounded semaglutide; they are the same active ingredient and stacking causes overdose.