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Your label comes first.
How to use compounded semaglutide and tirzepatide: first dose, storage, missed doses and travel
By the NexLife Medical Team · Medically reviewed by Adam Kennah, MD · Updated
Follow your label and prescriber first: refrigerate the vial at 36°F to 46°F, and use it within 28 days of opening, or by its beyond-use date if sooner.
- 36°F to 46°F in the fridge, never frozen
- 28 days once opened, or the beyond-use date if sooner
- NexLife patients: call or text (949) 818-8000, 24/7
Your instructions, at a glance
- Storage
- 36°F to 46°F, in the fridge and in its box; never frozen
- Opened vial
- 28 days after first use, or the beyond-use date if sooner
- Missed dose
- Prescriber first; the makers’ 4-day and 2-day rules are below
- Arrived warm
- Don’t use it; NexLife patients, call or text (949) 818-8000
NexLife patients: questions come to us 24/7, never to the pharmacy. Call or text (949) 818-8000.
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Key takeaways
- Your label comes first. Your pharmacy’s label and your prescriber’s instructions outrank any general guide, including this one.
- Keep it cold. 36°F to 46°F in the fridge, in its box, unless your label says otherwise. Never let it freeze.
- Count 28 days. Throw out an opened vial 28 days after first use, or by its beyond-use date if that comes first.
- Missed a dose? Prescriber first. Zepbound’s maker says take it within 4 days; Wegovy’s, only if your next dose is over 2 days away.
- Needles go in a sharps container, never loose in the trash or recycling, and never down the toilet.
- Arrived warm? Don’t use it. NexLife patients: keep the vial and the box, and call or text (949) 818-8000, 24/7.
Free tool
Which instructions do you need?
Pick your medicine, the pharmacy named on your label and what you need help with: your first dose, storage, a missed dose, travel or used needles.
General steps, not your prescription: your label and your prescriber come first, and the missed-dose rules are the makers’ rules for Zepbound and Wegovy. An opened vial also has a 28-day limit (see storage below). NexLife patients: whichever pharmacy is on your label, or if you’re not sure, call or text us at (949) 818-8000.
Your first dose
How do you get ready for your first dose?
Check your vial’s label against your prescription, work out your units, and read the injection steps before the day you need them.
- Check the label. Your name, the medicine, its strength in mg per mL, your dose and the beyond-use date. Semaglutide should say semaglutide, not semaglutide sodium or acetate.
- Look at the liquid. Don’t use it if it’s cloudy, has particles or has ever been frozen. Added vitamin B12 can tint a vial pink or red; color doesn’t tell you the strength.
- Work out your units. Units = your dose in mg ÷ the strength in mg/mL × 100. The dosage calculator does the math; compare it with your instructions.
- Set out your supplies. A new U-100 insulin syringe for every dose, alcohol swabs, gauze or a cotton ball, and a sharps container.
- Know where it goes. Under the skin of your stomach (at least 2 inches from your belly button) or thigh, at a new spot each time. A helper can use the back of your upper arm.
Every step, from wiping the rubber top to the sharps container: how to inject tirzepatide and how to inject semaglutide from a vial.
When to get help right away
- Swelling of your face, lips, tongue or throat, or trouble breathing or swallowing: these can be signs of a serious allergic reaction. Get medical help right away: call 911.
- Severe stomach pain that won’t go away, with or without vomiting: the Zepbound and Wegovy Medication Guides say to stop the medicine and call your provider right away. It can be a sign of pancreatitis.
- Think you injected too much? Call your provider or Poison Help at 1-800-222-1222, or go to the nearest emergency room right away, as the Zepbound Medication Guide says.
Step by step
How do you take a dose from a compounded vial, step by step?
Six steps, the same every week. The full how-to, with each draw and injection step, is on the tirzepatide and semaglutide injection pages.
- Check the label. The right medicine, the strength in mg per mL, your dose and the beyond-use date. More than 28 days since its first dose? Don’t use it.
- Work out your units. Units = your dose in mg ÷ the strength in mg/mL × 100. If the answer doesn’t match your instructions, ask before you draw.
- Draw with a new syringe. Wash your hands, wipe the rubber top with a fresh alcohol swab, and draw your units with a new U-100 insulin syringe. Never leave a needle in the vial.
- Inject at a new spot. Under the skin of your stomach or thigh, away from last week’s spot; a helper can use the back of your upper arm.
- Use the sharps container. Put the syringe straight in, without recapping the needle. Never loose in the trash or recycling.
- Put the vial back in the fridge. At 36°F to 46°F, in its box, unless your label says otherwise. Note the date and your units, and call or text NexLife at (949) 818-8000 with questions.
Storage
How do you store a compounded GLP-1 vial?
In the fridge at 36°F to 46°F (2°C to 8°C), in its box and never frozen, unless your label says otherwise; once opened, use it within 28 days or by its beyond-use date, whichever comes first.
Before first use
In the fridge, until the beyond-use date on your label.
After first use
Up to 28 days, or until the beyond-use date if that’s sooner, even with medicine left. Write the first-use date on the cap or the box.
Out of the fridge
Only if your label allows it. Zepbound’s and Wegovy’s room-temperature rules were tested for those products, not for compounded vials.
Frozen, cloudy or particles
Don’t use it, even if a frozen vial has thawed.
What’s a beyond-use date? It’s the date on your pharmacy label after which the vial shouldn’t be used, opened or not, and it already accounts for how the vial was prepared. It isn’t the 28-day clock, which starts with your first dose from the vial: go by whichever date comes first.
If a delivery arrives warm
Don’t use it. The FDA recommends not using any injectable GLP-1 that arrives warm or without enough refrigeration. Keep the vial and the box, and contact the program that prescribed it.
At NexLife, orders ship with cold packs, and the partner pharmacy usually ships within 1 to 2 business days. A box that arrives warm shouldn’t be used: call or text (949) 818-8000, 24/7. Questions come to us, never to the pharmacy.
The fridge setup, the 28-day rule in real dates and what to do when a vial looks wrong: compounded tirzepatide storage and compounded semaglutide storage.
Missed a dose
What should you do if you miss a dose?
Follow your prescriber’s instructions first; for comparison, here are the rules the makers give for the FDA-approved medicines, Zepbound and Wegovy.
| If you miss a dose | Tirzepatide (Lilly, for Zepbound) | Semaglutide (Novo Nordisk, for Wegovy) |
|---|---|---|
| Take it | As soon as possible, within 4 days (96 hours) of the missed dose | As soon as possible, if your next dose is more than 2 days away |
| Skip it | If more than 4 days have passed; then take your next dose on your regular day | If your next dose is less than 2 days away; then take your next dose on your regular day |
Changing your dose day? For Zepbound, Lilly says the weekly day can be changed if necessary, as long as the two doses are at least 3 days (72 hours) apart. Ask your prescriber before you move a dose.
Missed 2 weeks or more? For Wegovy, Novo Nordisk says to talk with your healthcare professional about how to restart. For either medicine, don’t restart on your own: your prescriber decides the dose. More: restarting tirzepatide and restarting semaglutide after a break.
Compounded tirzepatide and semaglutide aren’t FDA-approved, and your dose and schedule may differ from these labels. If your instructions differ from these rules, follow your instructions, and ask if you’re unsure. NexLife patients: call or text (949) 818-8000, 24/7.
Traveling
How do you travel with a GLP-1 vial?
In your carry-on, cold in an insulated bag with cold packs, and declared to the officer at security screening.
- Carry-on, never checked. Cargo holds can get cold enough to freeze a vial, and checked bags get lost.
- Insulated, with cold packs. The TSA allows medically necessary gel ice packs in reasonable amounts, even when they’re melted or slushy.
- Declared at screening. The TSA allows larger amounts of medically necessary liquids, but you must declare them at the checkpoint.
- Label and supplies. Keep the vial with its pharmacy label, and pack enough new syringes, alcohol swabs and a travel sharps container.
- Back in a fridge on arrival. Keep it out of hot cars and direct sun on the way. Hotel minibars can run warm or freeze things.
More on flying with a vial: compounded semaglutide storage and travel.
Used needles
How do you throw away used needles and syringes?
Right away, in an FDA-cleared sharps disposal container; never put loose needles in the trash or recycling, and never flush them.
- Straight in, uncapped. Don’t recap the needle: recapping can stick you.
- No FDA-cleared container? The FDA notes that some community guidelines recommend a heavy-duty plastic household container, such as a laundry detergent container.
- Make it a safe one. Heavy-duty plastic with a tight-fitting, puncture-resistant lid, upright and stable, leak-resistant, and labeled as hazardous waste.
- About three-quarters full? Follow your community’s rules. Drop-off sites can include pharmacies, doctors’ offices, hospitals and health departments, and some areas have mail-back programs.
- Not sure what your area allows? The FDA points to Safe Needle Disposal: 1-800-643-1643.
In their words
What do the FDA, TSA and drugmakers say about GLP-1 injections at home?
Their own words on missed doses, travel, used needles and warm deliveries; for a compounded medicine, your prescriber’s instructions still come first.
For a missed dose of Zepbound, the FDA-approved tirzepatide, Lilly’s medical information team says:
“If a dose is missed, it should be administered as soon as possible within 4 days.”
Eli Lilly and Company (Lilly Medical), What should a patient do if they miss a dose of Zepbound (tirzepatide)?, last reviewed January 29, 2026
For Wegovy, Novo Nordisk’s advice after 2 or more weeks (14 days) without a dose:
“talk with your healthcare professional about how to restart your treatment”
Novo Nordisk, Wegovy dosing schedule
At the airport, the TSA’s rule covers liquid medicines such as a GLP-1 vial:
“TSA allows larger amounts of medically necessary liquids, gels, and aerosols in reasonable quantities for your trip, but you must declare them to security officers at the checkpoint for inspection.”
Transportation Security Administration, Liquid medications
For used needles, the FDA’s first rule:
“The FDA recommends that used needles and other sharps be immediately placed in FDA-cleared sharps disposal containers.”
U.S. Food and Drug Administration, Sharps Disposal Containers
And why the warm-box rule exists, in the FDA’s words:
“FDA has received complaints that certain compounded GLP-1 drugs have arrived warm or with inadequate ice packs to keep the drug at recommended storage temperatures.”
U.S. Food and Drug Administration, FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss
Vial math
How many units is your tirzepatide or semaglutide dose?
On a compounded vial, the units depend on its strength. Here are the label doses at example strengths, with the math to check your own.
Tirzepatide
| Dose | mL at 25 mg/mL | Units (U-100) | On the label |
|---|---|---|---|
| 2.5 mg | 0.1 mL | 10 units | Starting dose, for 4 weeks |
| 5 mg | 0.2 mL | 20 units | A maintenance dose |
| 7.5 mg | 0.3 mL | 30 units | A step up |
| 10 mg | 0.4 mL | 40 units | A maintenance dose |
| 12.5 mg | 0.5 mL | 50 units | A step up |
| 15 mg | 0.6 mL | 60 units | The maximum, and a maintenance dose |
The math: mL = dose ÷ strength (mg per mL), and units = mL × 100. At 25 mg/mL, 10 mg is 10 ÷ 25 = 0.4 mL, or 40 units.
Semaglutide
| Weeks | Weekly dose | At 2.5 mg/mL | At 5 mg/mL |
|---|---|---|---|
| 1 to 4 | 0.25 mg | 0.1 mL (10 units) | 0.05 mL (5 units) |
| 5 to 8 | 0.5 mg | 0.2 mL (20 units) | 0.1 mL (10 units) |
| 9 to 12 | 1 mg | 0.4 mL (40 units) | 0.2 mL (20 units) |
| 13 to 16 | 1.7 mg | 0.68 mL (68 units) | 0.34 mL (34 units) |
| 17 onward | 2.4 mg | 0.96 mL (96 units) | 0.48 mL (48 units) |
The math: mL = dose ÷ strength (mg per mL); units = mL × 100. At 2.5 mg/mL, 1 mg is 1 ÷ 2.5 = 0.4 mL, or 40 units. At 5 mg/mL, the same 1 mg is 0.2 mL, or 20 units.
25 mg per mL is an example only: it’s the strength of the 15 mg multi-dose vial on Zepbound’s label (15 mg per 0.6 mL). Read the strength on your own vial’s label; your provider sets your dose, in steps at least 4 weeks apart. Every step: the tirzepatide dosage chart. Both strengths are examples only. The same dose is a different number of units at a different strength, so read the strength on your own vial’s label. Your prescription sets your dose and schedule, which may differ from these label steps. Every step: the semaglutide dosage chart.
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Prices from each provider’s own site, checked November 1, 2026. Brand-name and compounded medications are different products: compounded medications aren’t FDA-approved, and a provider prescribes one only when it offers a significant difference for you. Price Match Guarantee† terms apply.
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Semaglutide
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GLP-1 instructions questions
Fair questions about NexLife
- Will my price go up with my dose?
- No. You pay the same at every dose.
- What if I’m not prescribed?
- You aren’t charged for medication.
- Can I cancel?
- Yes, by email. It takes effect 30 days after we receive it. Plans renew until you cancel; our cancellation policy has the details.
- Do I need insurance?
- No. Pay with an HSA or FSA card, or with Affirm, Klarna or Afterpay at checkout.
How do you use compounded semaglutide or tirzepatide?
Inject the dose your provider prescribed under the skin, on your label’s schedule, with a new U-100 insulin syringe each time. Keep the vial in the fridge at 36°F to 46°F, and use it within 28 days of first use, or by its beyond-use date if sooner. Your label and prescriber come first.
What if I miss a dose of compounded tirzepatide or semaglutide?
Follow your prescriber’s instructions first. For Zepbound, Lilly says to take a missed dose as soon as possible within 4 days, and to skip it after that. For Wegovy, Novo Nordisk says to take it if your next dose is more than 2 days away, and otherwise to skip it. Unsure? Ask before you inject.
Can I change the day I take my GLP-1 shot?
Ask your prescriber first. For Zepbound, Lilly says the weekly day can be changed if necessary, as long as the two doses are at least 3 days (72 hours) apart. Compounded medicines follow your prescriber’s instructions, which may differ, so don’t move a dose on your own. NexLife patients: call or text (949) 818-8000.
What is a beyond-use date on a compounded vial?
It’s the date on your pharmacy label after which the vial shouldn’t be used, opened or not, and it already accounts for how the vial was prepared. Once you open the vial, the FDA says to discard it within 28 days after the first use. Go by whichever date comes first.
What if I left my vial out of the fridge?
Don’t use it unless your label says it can stay out that long. Zepbound’s and Wegovy’s room-temperature rules were tested for those products, not for compounded vials, so they don’t apply to yours. Keep the vial, and ask before your next dose. NexLife patients: call or text (949) 818-8000, 24/7.
Can you fly with compounded semaglutide or tirzepatide?
Yes. Pack it in your carry-on, never in checked bags, in an insulated bag with cold packs. The TSA allows larger amounts of medically necessary liquids in reasonable quantities, but you must declare them at the checkpoint. Bring a travel sharps container, and put the vial back in a fridge when you arrive.
Can you throw GLP-1 needles in the trash?
Not loose. The FDA says to put used needles straight into an FDA-cleared sharps container, and never to throw loose needles in the trash or recycling or flush them. No container? Some community guidelines recommend a heavy-duty plastic household container with a tight, puncture-resistant lid. When it’s about three-quarters full, follow your community’s rules.
Who do I call with questions about my compounded GLP-1?
NexLife patients: call or text NexLife at (949) 818-8000, 24/7, whichever pharmacy filled your vial. Questions come to us, never to the pharmacy. For signs of a serious allergic reaction, such as swelling of your face or throat or trouble breathing, call 911 right away.
Important safety information
Compounded tirzepatide and semaglutide are not FDA-approved, and the FDA hasn’t reviewed them for safety, effectiveness or quality. A provider prescribes them only when they offer a significant difference for you compared with an FDA-approved product. Both medicines may cause thyroid tumors, including cancer: don’t use either if you or a family member has had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
Read the full safety information
In studies with rodents, both medicines caused thyroid tumors; it isn’t known whether they cause them in people. Tell your provider if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath. Serious side effects can include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems from dehydration, severe stomach problems, serious allergic reactions, vision changes in people with type 2 diabetes, and a faster heart rate. Tell your care team before any surgery or procedure that uses anesthesia or deep sedation. Don’t combine either medicine with other
Tirzepatide can make birth control pills less effective: switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after you start and for 4 weeks after each dose increase. Both medicines may harm an unborn baby. Semaglutide should be stopped at least 2 months before a planned pregnancy. Tell your provider right away if you’re pregnant, planning to be, or breastfeeding.
This is a summary, not the complete safety information. Read the full Prescribing Information for FDA-approved tirzepatide (Zepbound) and semaglutide (Wegovy), and talk with your provider. You can report side effects to the FDA at
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About NexLife. NexLife is a telehealth and care-coordination platform. Care is delivered through affiliated, physician-owned medical groups, and licensed providers decide whether treatment is right for you. NexLife doesn’t make or compound medication: state-licensed partner pharmacies fill each prescription, and we coordinate the rest. Available only in states where our affiliated providers are licensed.
“Compounded drugs are not FDA-approved. This means that FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed.”
Who wrote and checked this page
Leads the NexLife Medical Team, which writes and medically reviews NexLife’s guides, including this one.
Checked each step against the Zepbound and Wegovy labels, Lilly’s and Novo Nordisk’s missed-dose guidance, the FDA’s pages on compounded GLP-1s and sharps disposal, and the TSA’s rules for medicines.
- Every fact, sourced. Each price and rule links to the page it comes from.
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Compounded medications aren’t FDA-approved. A provider prescribes one only when it offers a significant difference for you.
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Sources
- Eli Lilly and Company (Lilly Medical). What should a patient do if they miss a dose of Zepbound (tirzepatide)?. Last reviewed January 29, 2026.
- Novo Nordisk. Wegovy dosing schedule. Missed doses and restarting.
- Eli Lilly and Company. Zepbound (tirzepatide) prescribing information. Storage, injection sites.
- Eli Lilly and Company. Zepbound Medication Guide. When to get help right away.
- Novo Nordisk. Wegovy (semaglutide) prescribing information, Medication Guide and Instructions for Use. Storage, injection sites, when to get help.
- U.S. Food and Drug Administration. FDA’s concerns with unapproved GLP-1 drugs used for weight loss. The 28-day rule, refrigeration and warm deliveries.
- U.S. Pharmacopeia. USP General Chapter <797> Pharmaceutical Compounding: Sterile Preparations.
- Centers for Disease Control and Prevention. Preventing unsafe injection practices (multi-dose vials).
- U.S. Food and Drug Administration. Sharps disposal containers.
- U.S. Food and Drug Administration. What to do if you can’t find a sharps disposal container.
- U.S. Food and Drug Administration. The best way to get rid of used needles and other sharps.
- Transportation Security Administration. Liquid medications.
- Transportation Security Administration. What can I bring? Gel ice packs.
- U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers.
- U.S. Food and Drug Administration. MedWatch: The FDA Safety Information and Adverse Event Reporting Program.
- NexLife. Compounded tirzepatide plans.
- NexLife. Compounded semaglutide plans.
- LegitScript. LegitScript certification record for NexLife.us.
- Ro: weight loss program pricing. Checked November 1, 2026.
- Hims: Zepbound KwikPen. Checked November 1, 2026.
- Hims: Wegovy pill and pen, with membership. Checked November 1, 2026.
- Mochi Health: FAQs (membership and medication prices). Checked November 1, 2026.
- Embody: compounded tirzepatide, one-month supply. Checked November 1, 2026.
- Embody: compounded semaglutide, one-month supply. Checked November 1, 2026.