GLP-1 Semaglutide 30mg (10mg/1mL)

Route: Subcutaneous (SC) injection, once weekly.

Administer using a small-gauge needle (27–31G) into the subcutaneous tissue of the abdomen, outer thigh, or upper arm. Rotate injection sites within the same body region between doses. Avoid injecting into the same exact spot consecutively. Do not administer intravenously or intramuscularly. Do not mix with insulin in the same syringe. Inspect the solution before each use — discard if cloudy, discolored, or particulate matter is observed. As a multi-dose vial, draw only the prescribed volume per weekly dose using an appropriate syringe.

All dosing is prescriber-determined. The 30 mg/3 mL multi-dose vial accommodates extended titration or maintenance at prescriber-directed weekly doses. Standard titration framework (per FDA-approved product precedent):

• Initial: 0.25 mg SC once weekly × 4 weeks (GI tolerability phase).
• Escalation: Increase by 0.25–0.5 mg every 4 weeks as tolerated.
• Maintenance target (prescriber-determined): Typically 0.5 mg to 2.4 mg weekly depending on indication and tolerability.
• This vial volume supports multiple weeks of use at titration-range doses; prescriber specifies dose volume per injection.
• Do not escalate during significant GI adverse events; hold dose and reassess with the prescriber.

• Semaglutide: Activates the GLP-1 receptor (GLP-1R), a Gs-coupled GPCR, increasing intracellular cAMP in target cells. In pancreatic β-cells: glucose-dependent insulin secretion enhancement and β-cell proliferation stimulation with simultaneous α-cell glucagon suppression. In the GI tract: delayed gastric emptying reducing postprandial glucose excursions. In the hypothalamus: appetite suppression, food craving reduction, and satiety enhancement via GLP-1R signaling in arcuate and paraventricular nuclei. Semaglutide's fatty diacid C18 modification enables reversible albumin binding (extending plasma half-life to ~7 days via reduced renal clearance), and Aib substitution at position 8 renders it resistant to DPP-4 enzymatic cleavage — the primary degradation pathway for endogenous GLP-1.

Clinical Context: The 30 mg vial format is suited for prescribers directing semaglutide for chronic weight management or type 2 diabetes glycemic control, providing an extended supply that reduces dispensing frequency. Clinical evidence supporting semaglutide in these contexts includes significant HbA1c reduction in T2DM and mean body weight reduction of ~15% in the STEP-1 trial for obesity management. Prescribers should remain aware of all monitoring requirements and contraindications applicable to semaglutide regardless of vial size.

Monitoring Considerations:

• HbA1c and fasting glucose (T2DM); body weight and BMI (weight management) at each encounter.
• Renal function — particularly during periods of GI-related dehydration.
• Thyroid exam and patient education regarding MTC risk (black box warning).
• Retinal examination in patients with diabetic retinopathy prior to initiation and during rapid glycemic improvement.
• Gallbladder imaging if clinical symptoms of biliary disease develop.
• Reassess cardiovascular risk reduction benefit, consistent with SUSTAIN-6 trial evidence, in T2DM patients with established cardiovascular disease.

Contraindications:

• Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN2).
• Type 1 diabetes mellitus.
• Known hypersensitivity to semaglutide or excipients.

Warnings & Precautions:

• Black Box Warning — Thyroid C-cell tumors: Dose-dependent thyroid C-cell tumors in rodents; human risk unknown. Contraindicated with MTC or MEN2 history. Counsel all patients.
• Pancreatitis: discontinue if suspected.
• Cholelithiasis and cholecystitis: monitor for biliary symptoms.
• Acute kidney injury secondary to dehydration from GI adverse effects.
• Diabetic retinopathy worsening with rapid glycemic improvement.
• Suicidal ideation: monitor for mood/behavioral changes.
• Rebound weight gain upon discontinuation: approximately two-thirds of weight regained within 12 months.
• Multi-dose vial integrity: maintain aseptic technique each time the vial is accessed; vial sharing is prohibited.

Drug Interactions:

• Insulin, sulfonylureas: increased hypoglycemia risk; reduce doses of these agents at semaglutide initiation.
• Oral medications with narrow therapeutic windows (warfarin, digoxin, levothyroxine): delayed gastric emptying may affect absorption; monitor clinical parameters.
• Other GLP-1 agonists or tirzepatide: contraindicated in combination.
• Corticosteroids, thiazide diuretics: may attenuate semaglutide's glycemic effect.

Common Side Effects: Nausea, vomiting, diarrhea, constipation, abdominal pain, decreased appetite, dysgeusia, dyspepsia. Injection-site erythema or pain. Fatigue, headache, and alopecia with weight-loss protocols. GI events most prominent during dose escalation.

Store at 2–8°C (36–46°F) under refrigeration. Protect from light — keep vial in the outer carton between uses. Do not freeze. For multi-dose vials, maintain aseptic technique at every access; use a new sterile needle and syringe for each dose. Store the accessed vial refrigerated and use within the beyond-use date (BUD) assigned by Genesis Compounding on the prescription label. Allow the prescribed dose volume to reach room temperature briefly before injection for patient comfort. Discard vial if solution appears cloudy, discolored, or particulate matter is present.

What is the difference between this 30 mg vial and smaller semaglutide vials?

This vial contains 30 mg of semaglutide (10 mg/mL, 3 mL) — a multi-dose vial intended to provide a longer supply within a single prescription. The active drug and mechanism of action are identical regardless of vial size. Your prescriber determines the specific weekly dose to draw from this vial based on your titration protocol.

How long will this vial last?

At a 0.25 mg weekly starting dose, the 30 mg vial contains enough drug for approximately 4 months. At a maintenance dose of 1 mg/week, it contains approximately 30 weeks' supply. Your prescriber will specify the dose volume per injection and the frequency of refills.

Can I share this vial with someone else?

No. This is a prescription-only, patient-specific compounded preparation. Vial sharing is prohibited and unsafe. Each patient must have their own prescription and vial.

What should I do if I accidentally get a higher dose?

Contact your prescriber or seek medical attention if you have drawn and administered significantly more than the prescribed dose. Excess semaglutide may cause severe nausea, vomiting, hypoglycemia (especially if on insulin or sulfonylureas), and dehydration.

Do I need to use this for the rest of my life?

Duration of therapy is prescriber-determined based on your condition (T2DM management vs. weight management). For weight management, long-term use is typically required; discontinuation is associated with significant weight regain. Your prescriber will guide ongoing treatment planning.