What you need to know first
Compounded semaglutide from telehealth platforms is typically supplied as a multi-dose vial with separate syringes and needles — unlike brand-name auto-injector pens. The injection is subcutaneous (under the skin, not into muscle), using a very small needle. Most patients describe the sensation as a minor pinch lasting 1–2 seconds.
Your telehealth provider will give you specific instructions for your formulation and dose. This guide covers the general technique that applies to subcutaneous injection of compounded semaglutide. Always follow your provider's specific instructions if they differ from what's below.
What you'll need
- Semaglutide vial (refrigerated, brought to room temperature for 30 minutes before injecting)
- Insulin syringe with needle (your provider will specify gauge and length — typically 28–31G, 4–6mm)
- Alcohol swabs (2 — one for the vial top, one for your skin)
- Sharps disposal container (required — never put needles in regular trash)
- Optional: gauze or cotton ball
Step-by-step injection guide
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1
Prepare your supplies
Wash your hands thoroughly with soap and water for at least 20 seconds. Take the vial out of the refrigerator 30 minutes before injecting — room temperature medication is more comfortable than cold. Gather your syringe, alcohol swabs, and sharps container.
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2
Inspect the medication
Look at the semaglutide in the vial. It should be clear and colorless or very slightly yellow. Do not use it if you see particles, cloudiness, or discoloration. Check the expiration date. Wipe the rubber top of the vial with an alcohol swab and let it air dry for 10 seconds.
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3
Draw the correct dose
Remove the needle cap and pull the plunger back to draw air equal to your prescribed dose (e.g., if your dose is 0.25ml, pull back to 0.25ml). Insert the needle into the vial's rubber top, push the air in, then invert the vial. Draw back the plunger to pull out slightly more than your dose, then gently push to the exact dose mark to remove air bubbles. Remove the needle from the vial.
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4
Choose and prepare your injection site
The three recommended sites for subcutaneous injection are the abdomen (2 inches from navel), outer thigh, or outer upper arm. The abdomen is usually easiest for self-injection. Rotate sites with each injection — same site repeatedly can cause lumps. Clean the chosen area with an alcohol swab and let it air dry fully (10–15 seconds).
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5
Inject
Pinch a fold of skin 1–2 inches wide at your chosen site. Hold the syringe like a pencil at a 45–90 degree angle (90 degrees if you have more body fat, 45 if leaner). In one smooth motion, insert the needle fully. Release the skin pinch. Slowly push the plunger all the way down over 5–10 seconds. Hold for 5 seconds before removing. Withdraw the needle at the same angle it entered.
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6
After the injection
Do not rub the injection site — this can cause irritation. If there's a small drop of blood, apply light pressure with gauze or cotton. Dispose of the needle immediately in your sharps container — never recap or reuse needles. Store the remaining vial in the refrigerator.
Best injection sites
Abdomen
2 inches from your navel in any direction. Avoid the belly button itself.
Outer thigh
Middle outer portion of the thigh. Avoid the inner thigh and kneecap area.
Upper arm
Back of the upper arm, outer portion. Easier with help from another person.
Storage instructions
Compounded semaglutide vials must be refrigerated at 36–46°F (2–8°C). Do not freeze. Keep away from direct light. Once opened, most compounded vials are stable for 28–56 days refrigerated — check your specific product labeling. Do not use if the medication has been accidentally frozen or left unrefrigerated for more than a few hours.
When traveling, use an insulated cooler or travel case with an ice pack. Do not check medication in airplane luggage — keep it in your carry-on.
Contact your provider if you experience:
- Severe pain, significant swelling, warmth, or redness at the injection site (signs of infection)
- Hard lumps or thickened skin where you've been injecting repeatedly (lipohypertrophy — rotate sites)
- Severe allergic reaction (hives, difficulty breathing, swelling of face or throat)
- Severe abdominal pain that doesn't resolve within a few hours
- Visual changes or persistent headache after injection
Common questions about injecting
What if I see a bubble in the syringe? Small air bubbles are not dangerous subcutaneously, but you should try to remove them. Tap the syringe gently and push the plunger slightly to move bubbles to the top, then push them out before injecting.
What if I bleed more than a small drop? Apply firm pressure with gauze for 2–3 minutes. A little bleeding is normal and not a concern. If bleeding is significant or doesn't stop, contact your provider.
Can I inject through clothing? No — always inject directly into clean, exposed skin.
What if I miss my weekly injection? If it's been less than 5 days since your scheduled dose, inject as soon as you remember. If more than 5 days, skip it and resume your regular weekly schedule. Never double-dose.
Get started with compounded semaglutide
DirectMeds provides complete injection instructions with every order, plus ongoing physician access if you have questions. Starting from ~$99/month.
Check eligibility at DirectMeds →