Semaglutide/B6 + Glycine
Same GLP-1 receptor agonist mechanism as standard semaglutide, formulated with glycine and B6 instead of B12 as the carrier.
Medically reviewed by Dr. Jonathan Snipes, MD. Last reviewed May 6, 2026.Select vial size
Checking your status…
What It Is
Semaglutide compounded with B6 and glycine instead of B12. Identical active ingredient and weight-loss mechanism as Semaglutide/B12. Chosen when a patient has reacted to B12 or when a provider wants a cleaner cofactor profile.
How It Works
Same as Semaglutide/B12: mimics the GLP-1 hormone, suppresses appetite, slows gastric emptying. The B6/glycine carrier is pharmacologically inert with respect to weight loss.
Who It's For
Adults indicated for compounded semaglutide who have a known B12 sensitivity or whose provider has specifically requested the glycine formulation.
Who Should Avoid It
Same as Semaglutide/B12: avoid with thyroid cancer history, MEN2, pancreatitis, gastroparesis, or pregnancy.
Protocol & Pricing
OBP Pharmacy Price
From $175/10mg
You pay pharmacy price. No markup.
Glycine carrier: reserved for patients with B-12 sensitivity, methylation issues, or histamine reactions. Higher carrier cost reflects formulation complexity, not the peptide itself.
Starting Dose
Per provider. Formulation reserved for B12-sensitive patients
Form
Injectable vial (10mg or 30mg total at 5mg-2.5mg/mL. Semaglutide + B6/glycine)
Dosing Protocol
Dosing matches standard semaglutide. Provider titrates per patient response. Two vial sizes: 5mg/2.5mg/mL × 2mL = 10mg total ($175) and 5mg/2.5mg/mL × 6mL = 30mg total ($425).
Beyond Use Date
90 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.
Titration Schedule & Pricing
B12-sensitive formulation. Dosing matches standard semaglutide; provider titrates per patient response. Two vial sizes available.
| Month | Vial | Price | Access |
|---|---|---|---|
| Starter | 10mg | $175 | Active Rx Required |
| Refill | 30mg | $425 | Active Rx Required |
Month Starter: Provider must confirm B12 sensitivity, methylation, or histamine reactions
Month Refill: Bulk refill
All prices are pharmacy passthrough at Optimal Balance Pharmacy wholesale, no markup. Add the flat $39 medical visit fee on your first order. Titration schedule above reflects the standard RxPepsDirect protocol; your provider may adjust based on tolerance and clinical response.
Medical Records & Prescription Verification
Required for any Semaglutide/B6 + Glycine order beyond Month 1.
Why this is required
Unlike other peptides we prescribe, GLP-1 medications (semaglutide and tirzepatide) carry real medical risk when titration is not supervised by a physician. Over-dosing or skipping titration steps can cause severe nausea, dehydration, gastroparesis (delayed stomach emptying), and in rare cases pancreatitis or hypoglycemic events.
People with a personal or family history of medullary thyroid carcinoma, MEN2 syndrome, active pancreatitis, or severe gastroparesis should not take GLP-1 agonists at all. These are decisions that have to be made between a patient and their provider — not by a website.
For these reasons, the FDA-approved versions (Ozempic®, Wegovy®, Mounjaro®, Zepbound®) require a prescription. Our compounded versions follow the same standard. The starter vial (Month 1) is dispensed after your initial RxPepsDirect medical visit. Every subsequent vial — whether you titrate up with us or refill at a maintenance dose — requires us to verify that you are under active medical care for this medication.
What you can upload
- A copy of your current prescription (PDF or photo)
- A medical record or chart note from your prescribing provider showing the active medication and dose
- A pharmacy printout or label from your most recent fill
- A recent lab result with your provider's name and the medication noted
Existing RxPepsDirect patients on Sema or Tirz: we'll auto-match your email to your prior approved visit. No additional upload required for routine ladder step-ups.
When you'll upload
You'll upload your documentation during onboarding — after you complete the intake form and the contraindication review, just before consent. Existing RxPepsDirect patients are auto-verified by email match and skip this step.
Begin onboarding →Stacking Guide
Stacks Well With
Do Not Combine With
GLP-1 protocol guide
Read the Semaglutide/B6 + Glycine protocol guide
Microdosing semaglutide or tirzepatide means running them below the FDA-approved starter dose. The vial-duration math, the published evidence, and how to start with a provider.
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/B6 + Glycine lab test reports
Every Semaglutide/B6 + Glycine 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 2 most recent reports:
| Submission | Lot | Sample | Sterility | Endotoxin | |
|---|---|---|---|---|---|
| ETX-260325-0675 | 032626-01 | Semaglutide/Glycine 5mg/2.5mg/ml (6ml) | Pass | Pass <2 EU/mL / 400 EU/mL | Download |
| ETX-260325-0677 | 032626-02 | Semaglutide/Glycine 5mg/2.5mg/ml (2ml) | 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 RxPepsDirect. RxPepsDirect 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 RxPepsDirect 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/B6 + Glycine
- What is Semaglutide/Glycine from RxPepsDirect?
- Semaglutide/Glycine is the same GLP-1 receptor agonist as Semaglutide/B12, formulated with glycine and vitamin B6 instead of cyanocobalamin (B12) as the carrier. The starter vial is $175 for 10 mg total, with a flat $39 medical visit fee. Optimal Balance Pharmacy compounds it 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. The active ingredient (semaglutide) and clinical effect are identical to the B12 variant; only the carrier differs.
- How is the Glycine variant different from the B12 variant?
- The active ingredient (semaglutide) is identical, so weight-loss mechanism, dose response, and side-effect profile from the active are the same. The difference is only in the carrier solvent: cyanocobalamin (B12) in the standard formulation versus glycine with vitamin B6 in the Glycine variant. The Glycine variant is typically prescribed for patients with documented B12 sensitivity, MTHFR methylation variants, or whose provider has specifically requested the alternate buffer.
- Why is glycine in the formulation?
- Glycine is a simple amino acid included as a stabilizing buffer. It also has a documented role in glutathione synthesis and hepatic phase-II detoxification, which makes it a clean cofactor in patients undergoing rapid weight loss. Glycine is pharmacologically inert with respect to GLP-1 receptor activation; the amount included as a buffer is well below typical dietary glycine intake. The B6 (pyridoxine) supports homocysteine metabolism.
- Is the dose ladder the same as the B12 variant?
- Dosing matches standard semaglutide because the molecule is the same. Your provider titrates per your response and tolerance, typically starting at 0.15 mg twice weekly and stepping up every 4 weeks if tolerated. The Glycine variant starter is the 10 mg total vial at $175.
- How long is the Glycine variant stable in the fridge after first use?
- Semaglutide/Glycine vials carry a Beyond Use Date (BUD) printed on the vial label per USP <797>. Refrigerate unopened vials at 36 to 46 degrees Fahrenheit. Once punctured for first use, follow the in-use BUD printed on your specific label (typically 28 days at refrigerator temperature). Do not freeze.
- Does Semaglutide/Glycine cause less nausea than other compounded semaglutide?
- There is no large-scale trial data comparing the Glycine carrier head-to-head with the B12 carrier for nausea outcomes. Anecdotally, some patients with documented B12 reactions report better tolerability on the Glycine variant. Most nausea on semaglutide is tied to the active mechanism (slowed gastric emptying), which is identical regardless of carrier. The most reliable nausea-mitigation strategies are slow titration, smaller and more frequent meals, hydration, and using ondansetron PRN if your provider prescribes it.
- How is Semaglutide/Glycine made and tested?
- Optimal Balance Pharmacy compounds Semaglutide/Glycine in a USP <797>-compliant sterile cleanroom under a 503A patient-specific prescription. Every batch is tested before release by Eagle Analytical Services, an FDA-registered, A2LA ISO 17025-accredited independent laboratory. Sterility is tested using the ScanRDI or Celsis platform; bacterial endotoxin is tested under USP <85>. The Certificate of Analysis for the specific lot you receive is published on this page.
- Can I take Semaglutide/Glycine alongside other GLP-1s?
- No. Do not stack Semaglutide/Glycine with semaglutide from any other source (Ozempic, Wegovy, or other compounded semaglutide); they are the same active ingredient and stacking causes overdose. Do not stack with tirzepatide or other GLP-1-class medications such as liraglutide (Saxenda). Your RxPepsDirect provider verifies your current medications during intake and will block any conflicting prescriptions.
- What side effects should I expect on Semaglutide/Glycine?
- The side-effect profile mirrors standard semaglutide: nausea (most common during titration), reduced appetite, constipation, occasional reflux, fatigue in the first 4 to 6 weeks, and rare hair shedding tied to rapid weight loss. Most side effects diminish after 4 to 6 weeks once your body adapts. Severe or persistent symptoms warrant a message to your provider through the dashboard for a protocol review.
- Is the Glycine formulation more expensive than the B12 formulation?
- Yes. The Glycine variant is priced higher per mg of active ingredient than the B12 variant ($175 starter vs $25 for the comparable B12 starter), because the glycine and B6 raw materials and the alternate compounding workflow cost more to produce. RxPepsDirect passes Optimal Balance Pharmacy's wholesale pricing through with no markup and adds a flat $39 medical visit fee. The Glycine variant is typically reserved for patients with documented B12 sensitivity rather than as a default.