The shortage situation is a mess. Here's what I've gathered from the last few weeks:

• 0.25mg and 0.5mg: Generally available — these are the starter doses and demand is lower because people titrate through them quickly
• 1.0mg: Spotty — available at some pharmacies, not others
• 1.7mg: Very hard to find — this is the dose most people settle on and the biggest bottleneck
• 2.4mg: Also tight but slightly better availability than 1.7mg in my area

Tips that helped me find stock:

1. Call pharmacies early in the morning on Tuesdays and Thursdays — that's when most receive shipments
2. Try smaller independent pharmacies, not just the big chains
3. Ask your pharmacy to do a "nationwide search" in their system — many chains can check all locations
4. Consider a specialty pharmacy — they often have better access to supply

I found stock at a Costco pharmacy last week when nowhere else had it. Worth trying if you have a membership (and you don't actually need a membership to use Costco pharmacy in most states).

Two important things if you're going without your dose:

1. You won't lose all your progress in 2-3 weeks. Semaglutide has a half-life of ~168 hours (7 days). After missing one dose, you still have 50% of your steady-state levels. After two weeks, you're at about 25%. The drug doesn't just vanish — it takes several weeks to fully clear your system. So while you'll notice some return of appetite, you're not starting from zero.

2. When you get your pen, DO NOT skip ahead in dosing. If you've been off for 2+ weeks, you may want to consider restarting at your current dose rather than jumping to a higher one. If you've been off for 4+ weeks, talk to your doctor about whether to go back a dose level to avoid severe nausea.

The FDA still has semaglutide listed on their Drug Shortage Database as of this month. Novo Nordisk has been increasing manufacturing capacity but demand continues to outpace supply globally.

From a clinical standpoint, options if you can't find your dose:

• Dose-splitting from a higher strength: NOT recommended with Wegovy pens because the autoinjector delivers a fixed dose. But Ozempic pens can technically be dialed to custom doses. Talk to your prescriber about temporarily switching to Ozempic for more dosing flexibility.
• Compounded semaglutide: Available from compounding pharmacies without the supply constraints of brand products. The FDA's position on this is evolving, so discuss with your provider.
• Temporary switch to liraglutide (Saxenda): Same drug class, different molecule, much better availability. Won't be exactly the same but covers the mechanism while you wait for sema supply.

I know none of these are ideal but going without any GLP-1 therapy for an extended period increases the risk of weight regain.