Semaglutide Microdose
Compounded semaglutide with vitamin B12, a GLP-1 receptor agonist, delivered at a fraction of the standard weekly dose.
Medically reviewed by Dr. Jonathan Snipes, MD. Last reviewed May 6, 2026.
What It Is
This is compounded semaglutide, not pure semaglutide. Optimal Balance Pharmacy compounds it as semaglutide co-formulated with cyanocobalamin (vitamin B12) in the same vial, so every injection contains both. Semaglutide is a GLP-1 receptor agonist, the same active ingredient as Ozempic® and Wegovy®. It is the identical vial we dispense as Semaglutide/B12, just drawn at a much smaller dose, so the vial lasts longer than standard dosing.
How It Works
It mimics the GLP-1 hormone your body makes after eating, telling your brain you're full and slowing digestion. At microdose levels the effect is milder and slower, which suits people who want to ease in or who are side-effect sensitive. The B12 is a carrier that supports energy levels during weight loss. It does not change how semaglutide works and does not add to weight loss on its own.
Who It's For
Adults who want a gentle entry to GLP-1 therapy, are sensitive to side effects, or are microdosing for appetite and metabolic support alongside diet and exercise. Not for patients with a known B12 sensitivity, who should ask their provider about the B6/glycine formulation instead.
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. Also avoid if you have reacted to cyanocobalamin (B12), since it is compounded into this vial.
Protocol & Pricing
OBP Pharmacy Price
$25/1.2mg
You pay pharmacy price. No markup.
Starting Dose
20 units once weekly (0.12mg microdose; range 0.1 to 0.25 mg/week)
Form
Injectable vial (2mL, 0.6mg/mL, 1.2mg total. Compounded semaglutide + B12, not pure semaglutide)
Dosing Protocol
20 units subcutaneous injection once weekly. Titrate up as tolerated per provider. 20 units = 0.2mL × 0.6mg/mL = 0.12mg per injection (gentle microdose; range 0.1 to 0.25mg/week). Hold or step back dose if nausea. Hydration & protein mitigate side effects.
Beyond Use Date
90 Days from compounding (USP <797>)
Optimal Balance Pharmacy assigns this date and prints it on your vial label. Always follow the label. Once a multi-dose vial is punctured, the in-use date on the label is shorter than the compounding date shown here.
Stacking Guide
Do Not Combine With
How to get Semaglutide Microdose prescribed online
Semaglutide Microdose is available by prescription through a licensed telehealth visit and dispensed for human use by a named 503A pharmacy. That is what separates it from research-use-only vials sold without a prescription. There is no subscription and no membership, just a one-time visit fee.
- 1
Complete a $39 medical visit. Answer a short intake about your health history and your goals for Semaglutide Microdose. The $39 fee is the only charge RxPepsDirect collects, paid once, not a recurring subscription.
- 2
A licensed provider reviews it. A US-licensed nurse practitioner or physician reviews your intake and, if Semaglutide Microdose is appropriate for you, writes a patient-specific prescription. The starting dose is typically 20 units once weekly (0.12mg microdose; range 0.1 to 0.25 mg/week).
- 3
The pharmacy compounds and ships it. Optimal Balance Pharmacy, a 503A pharmacy in Texas, compounds Semaglutide Microdose and ships it pre-reconstituted by FedEx overnight in a reusable cooled case. Your fill is Injectable vial (2mL, 0.6mg/mL, 1.2mg total. Compounded semaglutide + B12, not pure semaglutide), and you pay the pharmacy $25/1.2mg at wholesale, with no clinic markup, plus a $15 flat FedEx overnight shipping fee charged by the pharmacy.
RxPepsDirect prescribes Semaglutide Microdose in the 29 jurisdictions its medical team is licensed in. Start a $39 visit or browse the full Weight Loss & Metabolic range. Comparing services first? See how RxPepsDirect stacks up against seven other providers in our best telehealth for compounded peptides comparison.
Common questions about Semaglutide Microdose
- What is in the Semaglutide Microdose vial?
- Each vial contains compounded semaglutide co-formulated with cyanocobalamin (vitamin B12), suspended together in the same solution. It is not pure semaglutide and it is not a research-use vial. Optimal Balance Pharmacy compounds it under a 503A patient-specific prescription, and the label lists both ingredients. The vial is 2 mL at 0.6 mg/mL (1.2 mg total) for $25, plus a flat $39 medical visit fee. Every batch is tested by Eagle Analytical Services for sterility and bacterial endotoxin (USP <85>); the Certificate of Analysis is published on this page.
- Is this pure semaglutide?
- No. This is a compounded medication, which means the pharmacy prepares semaglutide together with vitamin B12 in one vial rather than dispensing the semaglutide molecule on its own. Anyone selling a vial labeled pure semaglutide for human use outside a compounding pharmacy is selling a research-use product without a prescription. The semaglutide in this vial is the same active ingredient as Ozempic and Wegovy, and the B12 does not change how it binds the GLP-1 receptor.
- How is this different from the standard Semaglutide/B12 vial?
- It is the same vial. Same pharmacy, same 0.6 mg/mL concentration, same 1.2 mg total, same $25 price. The only difference is the dose your provider writes: the microdose protocol is 20 units (0.12 mg) once weekly, where the standard protocol starts at 25 units (0.15 mg) twice weekly, roughly 0.3 mg per week. Because you draw less and inject less often, a single vial lasts considerably longer.
- Why is vitamin B12 in a weight loss injection?
- Cyanocobalamin is a stable form of vitamin B12 that acts as a soluble carrier in the formulation and 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, so it does not add to your weight loss results. The B12 carrier is a formulation choice by Optimal Balance Pharmacy, not by RxPepsDirect.
- What if I cannot tolerate B12?
- Tell your provider during the intake. Patients with a documented B12 sensitivity, an MTHFR methylation variant, or a history of reacting to cyanocobalamin should ask about the Semaglutide/B6 + Glycine formulation instead, which uses glycine and vitamin B6 as the carrier and contains no B12. It is the same semaglutide active ingredient. Do not order this microdose vial if you have reacted to B12 before.
- What is the starting dose for the semaglutide microdose protocol?
- 20 units on a U-100 insulin syringe, injected subcutaneously once weekly. On the 0.6 mg/mL vial, 20 units equals 0.2 mL, which is 0.12 mg per injection. The microdose range is roughly 0.1 to 0.25 mg per week. For comparison, the standard RxPepsDirect protocol is 0.15 mg twice weekly and branded Wegovy starts at 0.25 mg once weekly. Your provider confirms or adjusts the units at review and titrates up as tolerated. Always verify the concentration printed on your vial before drawing.
- How long does a microdose vial last?
- At the 20 unit once-weekly dose, a 1.2 mg vial holds more than the standard protocol would use in the same period, but the Beyond Use Date governs how long you can actually use it. The BUD is 90 days from compounding under USP <797> sterile compounding standards and is printed on every vial label. Once the vial is punctured, follow the shorter in-use BUD on your label, typically 28 days refrigerated. Refrigerate at 36 to 46 degrees Fahrenheit and do not freeze. Discard at the BUD even if solution remains.