When Washington's medical commission withdrew its 2021 telemedicine policy in 2024, its staff said the state's telehealth law includes all of the policy's positions, without naming them; the policy had said an online questionnaire is not an acceptable medical interview and the standard of care requires direct interaction with a licensed practitioner, so your doctor may ask you to book a video visit.
Our drops cost $112 to $258 a month, depending on the daily dose your doctor prescribes.
At 2–4 mg/day:
Gentle Health
$112/mo
Wegovy pill directwithout doctor support
$199/mo
Hims / Ro
$348/mo
At >4–8 mg/day:
Gentle Health
$189/mo
Wegovy pill directwithout doctor support
$299/mo
Hims / Ro
$448/mo
At >8–12 mg/day:
Gentle Health
$258/mo
Wegovy pill directwithout doctor support
$299/mo
Hims / Ro
$448/mo
What each price is made of
Gentle Health
Medication, doctor reviews and dose decisions, unlimited messaging and video visits, refrigerated delivery and licenses.
Brand direct
Medication. New patients: the 1.5 mg first-month tablet costs less.
Hims / Ro
The brand price for medication, plus a $149 monthly membership for access to a prescriber, messaging with a care team, and dose and side-effect support. New members: $39 for the first month. Hims publishes only a starting price.
Rows line up by treatment stage, not milligrams: drop and tablet doses are not comparable.
A doctor can check whether semaglutide is safe for you, whether daily drops or a weekly injection fits you better, and whether you need medication in the first place.
Complete the intake and I’ll review your history. Message me with any questions, or book a video visit if you’d like one. The intake and my first review are free.
James Simmons, MD · Medical Director, board-certified in emergency medicine
Not tested in people yet. In rats, drops under the tongue got 5.5 times as much semaglutide into the blood as the same dose of tablet given by mouth.
Drops under the tonguemade from tablets, rats
0.34%of the dose
Drops under the tonguemade from powder, rats
0.29%of the dose
Tablet by mouth20 times the dose, rats
0.16%of the dose
Tablet by mouthsame dose, rats
0.06%of the dose
5.5% to 11%of a drop’s dose may reach the blood in people: a rough estimate scaled up from these rats, not measured in people
How this was studied · rat study · 30 rats · one dose · vs injection and tablet
Who took part
Rats (young male Sprague-Dawley lab rats), not people
How many animals
30 rats, 6 in each of 5 groups
How long
One dose, with blood samples taken over the next 24 hours
What they got
Semaglutide drops held under the tongue (1 mg per kg of body weight) in SubMagna SL HMW (the base our pharmacy also uses), made up by PCCA from crushed Rybelsus tablets (one group) or semaglutide powder (another). The rats were put under anesthesia and kept face down so they could not swallow. Not the drops we dispense.
Compared with
A semaglutide injection under the skin (Ozempic, at a much smaller dose), and Rybelsus tablets mixed into water and given by mouth, at the same dose as the drops and at 20 times that dose
What was measured
How much semaglutide reached the blood over 24 hours after one dose
Our estimate
Drops got 5.5 times as much semaglutide into the blood as the tablet given by mouth (0.336% against 0.061%, each measured against an injection). The tablet gets 1–2% in, in people; if the same ratio held, drops would get roughly 5.5% to 11% in. Rats can differ from people, so this is a guess to test, not a result.
What it did not test
Weight loss, or what dose people would need
Who paid for it
The paper has no funding statement. All 6 authors work for PCCA, the company that makes the SubMagna base, and one of them is credited with getting the funding.
Yes. In the main trial of semaglutide tablets, people on 25 mg a day lost 13.6% of their body weight on average over 64 weeks, against 2.4% on placebo.
Lost 5% or moreof body weight, by week 64
76.3%
on placebo31.3%
Lost 10% or moreof body weight, by week 64
59.8%
on placebo14.4%
Lost 15% or moreof body weight, by week 64
47%
on placebo5.5%
Lost 20% or moreof body weight, by week 64
27.9%
on placebo3.1%
On semaglutide tabletsOn placebo
How this was studied · OASIS 4 trial · 307 people · 64 weeks · vs placebo
Who took part
Adults without diabetes who had obesity (BMI 30 or more), or overweight (BMI 27 or more) plus a weight-related condition such as high blood pressure or high cholesterol. 79% were women.
How many people
205 on the tablet and 102 on placebo
How long
64 weeks on treatment: 12 weeks of stepping up the dose, then a year at 25 mg a day
What they got
Wegovy 25 mg tablets, swallowed once a day, plus diet and activity counseling.
Compared with
Dummy tablets with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Average change in body weight after 64 weeks, and the share who lost 5% or more: the trial’s two main results (primary endpoints). Everyone assigned a group was counted, including people who stopped taking it.
What it did not test
Drops under the tongue: everyone swallowed tablets.
You will probably regain most of the weight. People who stopped weekly semaglutide shots regained two-thirds of what they had lost within a year; stopping tablets or drops is untested.
How this was studied · STEP 1 extension · 327 people · 68 weeks on, then a year off · vs placebo
Who took part
STEP 1 participants (adults with obesity, or overweight plus a weight-related condition, and no diabetes) who finished all 68 weeks of their shots, at selected sites in Canada, Germany, Japan, the UK and the US
How many people
228 who had been on semaglutide and 99 who had been on placebo
How long
68 weeks on the shots (16 weeks of stepping up the dose, then a year at 2.4 mg), then a year off the study shots
What they got
Weekly Wegovy shots, up to 2.4 mg, plus diet and activity advice
Compared with
Dummy shots with no medicine (placebo), plus the same advice. Nobody knew which they had, even during the year off.
What was measured
Change in weight against each person’s starting weight, up to a year after stopping. This follow-up was an extra, exploratory analysis, not the trial’s main result.
What it did not test
Stopping the pill or the drops: these people took weekly shots. Diet and activity support stopped at the same time as the drug.
All three contain semaglutide, and all are legal. Only the Wegovy pill and Rybelsus are FDA-approved: the Wegovy pill for weight loss, Rybelsus for type 2 diabetes.
Wegovy pillRybelsusDropsActive ingredientsemaglutidesemaglutidesemaglutideLegalYesYesYesHow you take itSwallowedSwallowedUnder the tongueTested in peopleYesYesNoFDA-approved forWeight lossType 2 diabetes– not FDA-approved
How this was studied · OASIS 4 trial · 307 people · 64 weeks · vs placebo
Who took part
Adults without diabetes who had obesity (BMI 30 or more), or overweight (BMI 27 or more) plus a weight-related condition such as high blood pressure or high cholesterol
How many people
205 assigned to the tablet (204 of them took it) and 102 to placebo
How long
Up to 64 weeks on treatment, then 7 weeks off the drug
What they got
Wegovy tablets, swallowed once a day, stepped up over 12 weeks to 25 mg, plus diet and activity counseling.
Compared with
Dummy tablets with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Whether each person had a side effect at any point. This was a secondary result; the trial’s main result (primary endpoint) was weight loss.
What it did not test
Drops under the tongue (sublingual semaglutide). No study has reported their side effects in people, including what they do in the mouth.
Every 30 days on the semaglutide tablet’s label, or slower if a step is hard to tolerate. For drops, your doctor sets the steps: tablet milligrams don’t convert to drops.
Yes, for one patient whose doctor documents why an FDA-approved product won’t do, such as needing a dose it doesn’t come in.
Counts as a reasonA dose or form no approved semaglutide comes in, written up by the doctor for that patient
Doesn’t countRoutine copies of an approved product, or calling the result a generic or clinically proven
How we got here · the FDA’s shortage rules
Feb 21, 2025
The FDA declared the semaglutide shortage over, ending the exception that let pharmacies make copies
Apr 2025
The grace period for state-licensed pharmacies ended
Feb 6, 2026
The FDA said companies may not call compounded semaglutide a generic, the same as an FDA-approved drug, or clinically proven
Compounding lets me prescribe the dose a patient needs instead of limiting them to the fixed strengths available in brand products. That flexibility can matter when someone needs to increase more slowly or stay at a lower dose.
James Simmons, MD · Medical Director, board-certified in emergency medicine
Educational only, not medical advice: talk to a doctor about your own history before starting or stopping anything.
Every trial cited here studied a branded, FDA-approved semaglutide product. The compounded sublingual drops we dispense are not FDA-approved, have never been trialed on their own, and have no measured absorption in people.
Step 1Fill in the intakeTell us about your health and goals
Step 2Request careAn online request, a message or a video visit
Step 3Doctor reviewa doctor licensed in Washington decides whether it’s right for you
Step 4SubscribeIf prescribed, start your plan and we order your medicine
Step 5Get your medicineA licensed pharmacy ships it to your door