Complete Peptide Reconstitution & Dosing Guide: NAD+, Semaglutide, Tirzepatide, Retatrutide (2026)
Step-by-step reconstitution charts for NAD+ (100-500mg), semaglutide (0.25-5mg), tirzepatide (1.5-30mg) & retatrutide (20mg). BAC water volumes, injection amounts & titration schedules.
Written by
Glunova Medical Team
Clinical Research & Health Content
Editorially reviewed by
Glunova Medical Review Board
Medical Advisory Panel
Why Proper Peptide Reconstitution Matters
Reconstituting lyophilized peptide powder is the critical first step before any subcutaneous injection. Get it wrong, and you risk inaccurate dosing, contamination, or degraded product that simply does not work. Whether you are a clinician preparing semaglutide, tirzepatide, NAD+, or retatrutide, this guide consolidates every dosing table and titration schedule you need in one place.
This comprehensive reference covers four of the most commonly compounded peptides in aesthetic and weight management clinics. Each section includes exact BAC water volumes, resulting concentrations, injection volumes for every standard dose, and the clinically recommended titration protocol.
Supplies You Will Need
Before reconstituting any peptide, gather the following supplies:
- Bacteriostatic water (BAC water) - Contains 0.9% benzyl alcohol as a preservative. Essential for multi-dose vials. See our complete BAC water guide for sourcing and storage details.
- Sterile syringe with needle (18-21G) - For drawing BAC water from the vial and transferring it to the peptide vial.
- Insulin syringe (U-100, 29-31G) - For measuring and administering the injection dose. On a U-100 syringe: 100 units = 1.0 mL, 50 units = 0.5 mL, 10 units = 0.1 mL.
- Alcohol swabs - For sterilizing vial stoppers and injection sites.
- Sharps container - For safe disposal of used needles and syringes.
Step-by-Step Reconstitution Process
Follow these nine steps every time you reconstitute a new vial. This process applies to all four peptides covered in this guide.
- Bring to room temperature. Remove the peptide vial and BAC water from the refrigerator. Let both sit at room temperature for 15-30 minutes.
- Wash hands thoroughly with soap and water, or use alcohol-based hand sanitizer.
- Sterilize stoppers. Swab the rubber stoppers of both the peptide vial and BAC water vial with alcohol. Let air dry completely.
- Draw BAC water. Using a sterile syringe (18-21G), draw the specified volume of BAC water for your vial size (see tables below).
- Inject BAC water into peptide vial. Insert the needle at a 45-degree angle and inject the water slowly along the inner glass wall. Do NOT spray directly onto the powder - this can damage delicate peptide bonds.
- Gently swirl. Roll the vial between your palms or swirl gently until the powder is fully dissolved. Do NOT shake vigorously - this can denature the protein.
- Inspect the solution. It should be completely clear and colorless. If cloudy or containing particles, discard and start over.
- Label the vial. Write the product name, concentration (mg/mL), date reconstituted, and beyond-use date (28 days from today).
- Refrigerate immediately at 2-8 degrees C (36-46 degrees F).
Syringe conversion formula: Units to draw = (Desired dose in mg / Concentration in mg/mL) x 100
NAD+ (Nicotinamide Adenine Dinucleotide) Reconstitution & Dosing
NAD+ is administered via subcutaneous injection for cellular energy support, anti-aging protocols, and neurological health. It is available in three common vial sizes. For detailed storage instructions, see our NAD+ reconstitution and storage guide.
NAD+ Reconstitution Chart
| Vial Size | BAC Water | Concentration | 25 mg Dose | 50 mg Dose | 100 mg Dose | Doses per Vial (at 50 mg) |
|---|---|---|---|---|---|---|
| 100 mg | 1.0 mL | 100 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 1.00 mL (100 units) | 2 doses |
| 200 mg | 2.0 mL | 100 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 1.00 mL (100 units) | 4 doses |
| 500 mg | 5.0 mL | 100 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 1.00 mL (100 units) | 10 doses |
NAD+ Dosing Protocol
- Initiation: 50 mg daily or 50 mg 3x/week for the first 1-2 weeks
- Titration: Increase by 25 mg per week as tolerated
- Daily maintenance: 50-100 mg once daily subcutaneously
- 3x/week maintenance: 100-200 mg per injection, 3 times per week
- Weekly total: 200-500 mg total per week (divided across injections)
- Maximum single dose: 100 mg per injection site - split larger doses across two sites
- Cycle duration: 8-16 weeks, then reassess with your provider
NAD+ Injection Tips
Inject into the lower abdomen (at least 2 inches from the navel), outer thigh, back of the upper arm, or love handle area. Rotate injection sites with each dose. Use a 45-degree angle and inject slowly over 30-60 seconds to minimize flushing and nausea, which are the most common side effects at higher doses.
NAD+ Storage
- Lyophilized powder: Store at -20 degrees C (-4 degrees F) or 2-8 degrees C (36-46 degrees F) per manufacturer label. Protect from light.
- Reconstituted solution: Refrigerate at 2-8 degrees C (36-46 degrees F). Use within 28 days.
Semaglutide (GLP-1 Receptor Agonist) Reconstitution & Dosing
Semaglutide is a once-weekly GLP-1 receptor agonist used for weight management (Wegovy, up to 2.4 mg/week) and type 2 diabetes (Ozempic, up to 2.0 mg/week). Compounded semaglutide arrives as lyophilized powder requiring reconstitution. For cost comparisons and vial sizing guidance, see our semaglutide cost and pricing guide.
Semaglutide Reconstitution Chart
| Vial Size | BAC Water | Concentration | 0.25 mg | 0.50 mg | 1.0 mg | 1.7 mg | 2.4 mg | Doses at 0.5 mg |
|---|---|---|---|---|---|---|---|---|
| 0.25 mg | 0.25 mL | 1.0 mg/mL | 0.25 mL (25 units) | - | - | - | - | Single dose |
| 0.5 mg | 0.5 mL | 1.0 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | - | - | - | 1 dose |
| 1.0 mg | 0.5 mL | 2.0 mg/mL | 0.125 mL (12.5 units) | 0.25 mL (25 units) | 0.50 mL (50 units) | - | - | 2 doses |
| 2.5 mg | 1.0 mL | 2.5 mg/mL | 0.10 mL (10 units) | 0.20 mL (20 units) | 0.40 mL (40 units) | 0.68 mL (68 units) | 0.96 mL (96 units) | 5 doses |
| 5.0 mg | 2.0 mL | 2.5 mg/mL | 0.10 mL (10 units) | 0.20 mL (20 units) | 0.40 mL (40 units) | 0.68 mL (68 units) | 0.96 mL (96 units) | 10 doses |
Note: The 5.0 mg vial can alternatively be reconstituted with 1.0 mL BAC water for a 5.0 mg/mL concentration. This reduces injection volumes but requires more precise measurement.
Semaglutide Titration Schedule (Wegovy Protocol)
| Phase | Weeks | Weekly Dose | Purpose |
|---|---|---|---|
| 1 | 1-4 | 0.25 mg | GI adaptation; minimal weight loss expected |
| 2 | 5-8 | 0.50 mg | Appetite reduction begins |
| 3 | 9-12 | 1.0 mg | Significant weight loss typically begins |
| 4 | 13-16 | 1.7 mg | Continued escalation toward maintenance |
| 5 | 17+ | 2.4 mg | Maximum maintenance dose |
Each dose level should be maintained for at least 4 weeks before escalating. If you do not tolerate a dose increase, return to the previous dose for 4 additional weeks before re-attempting. For a detailed week-by-week breakdown, see our semaglutide dosing schedule guide.
The Ozempic maximum is 2.0 mg/week (type 2 diabetes indication). The Wegovy maximum is 2.4 mg/week (weight management indication). Not every patient needs to reach the maximum dose.
Semaglutide Injection Sites & Storage
Inject into the abdomen, outer thigh, or upper arm. Rotate sites weekly. For a complete injection technique tutorial, see our step-by-step semaglutide injection guide.
- Lyophilized powder: Store at 2-8 degrees C (36-46 degrees F). Protect from light.
- Reconstituted solution: Refrigerate at 2-8 degrees C (36-46 degrees F). Use within 28 days. Do not freeze.
Tirzepatide (GIP/GLP-1 Dual Agonist) Reconstitution & Dosing
Tirzepatide is a once-weekly dual GIP/GLP-1 receptor agonist available as Mounjaro (type 2 diabetes) and Zepbound (weight management). The FDA-approved dose range is 2.5-15 mg weekly. For a head-to-head comparison with semaglutide, see our tirzepatide vs semaglutide guide.
Tirzepatide Reconstitution Chart
| Vial Size | BAC Water | Concentration | 2.5 mg | 5.0 mg | 7.5 mg | 10 mg | 12.5 mg | 15 mg | Doses at 5 mg |
|---|---|---|---|---|---|---|---|---|---|
| 1.5 mg | 0.3 mL | 5.0 mg/mL | - | - | - | - | - | - | Single dose (1.5 mg) |
| 2.5 mg | 0.5 mL | 5.0 mg/mL | 0.50 mL (50 units) | - | - | - | - | - | Single dose |
| 5.0 mg | 1.0 mL | 5.0 mg/mL | 0.50 mL (50 units) | 1.00 mL (100 units) | - | - | - | - | 1 dose |
| 7.5 mg | 1.5 mL | 5.0 mg/mL | 0.50 mL (50 units) | 1.00 mL (100 units) | 1.50 mL (150 units)* | - | - | - | 1 dose |
| 15 mg | 1.5 mL | 10.0 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 0.75 mL (75 units) | 1.00 mL (100 units) | - | 1.50 mL (150 units) | 3 doses |
| 20 mg | 2.0 mL | 10.0 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 0.75 mL (75 units) | 1.00 mL (100 units) | - | 1.50 mL (150 units) | 4 doses |
| 30 mg | 3.0 mL | 10.0 mg/mL | 0.25 mL (25 units) | 0.50 mL (50 units) | 0.75 mL (75 units) | 1.00 mL (100 units) | 1.25 mL (125 units) | 1.50 mL (150 units) | 6 doses |
*For injection volumes exceeding 1.0 mL, consider splitting across two injection sites.
The 30 mg vial is the most popular multi-dose option. Reconstituting with 3.0 mL BAC water gives a clean 10 mg/mL concentration for easy dose calculation.
Tirzepatide Titration Schedule (Mounjaro/Zepbound Protocol)
| Weeks | Weekly Dose | Purpose |
|---|---|---|
| 1-4 | 2.5 mg | Initiation dose; GI adaptation (not a therapeutic dose for glycemic control) |
| 5-8 | 5.0 mg | First therapeutic dose level |
| 9-12 | 7.5 mg | Continued escalation |
| 13-16 | 10.0 mg | Continued escalation |
| 17-20 | 12.5 mg | Continued escalation |
| 21+ | 15.0 mg | Maximum approved maintenance dose |
The 2.5 mg dose is for initiation only. Each dose should be maintained for at least 4 weeks before escalating. If tolerability is poor, extend to 6-8 weeks per dose level. Some patients achieve adequate response at 5 mg or 10 mg and do not need to reach 15 mg. For the complete dosing breakdown, see our tirzepatide dosing schedule guide.
Tirzepatide Storage
- Lyophilized powder: Store at 2-8 degrees C (36-46 degrees F). Protect from light.
- Reconstituted solution: Refrigerate at 2-8 degrees C (36-46 degrees F). Use within 28 days. Do not freeze.
Retatrutide (GIP/GLP-1/Glucagon Triple Agonist) Reconstitution & Dosing
Retatrutide (Eli Lilly, LY3437943) is an investigational triple-hormone receptor agonist targeting GIP, GLP-1, and glucagon receptors simultaneously. It is not yet FDA-approved. Phase 3 trials are ongoing. The Phase 2 data published in the New England Journal of Medicine showed the most impressive weight loss results of any single-agent therapy to date. For more details, see our retatrutide reconstitution guide and dosing protocol guide.
Retatrutide Reconstitution Chart
| Vial Size | BAC Water | Concentration | 2 mg | 4 mg | 6 mg | 8 mg | 10 mg | 12 mg | Doses at 4 mg |
|---|---|---|---|---|---|---|---|---|---|
| 20 mg | 2.0 mL | 10.0 mg/mL | 0.20 mL (20 units) | 0.40 mL (40 units) | 0.60 mL (60 units) | 0.80 mL (80 units) | 1.00 mL (100 units) | 1.20 mL (120 units)* | 5 doses |
*For the 12 mg dose, the injection volume exceeds 1.0 mL. Split into two separate 60-unit injections at different sites.
Retatrutide Phase 2 Trial Results
The pivotal Phase 2 trial (Jastreboff et al., NEJM 2023) enrolled 338 participants over 48 weeks and tested six dose arms. Key findings:
| Dose Arm | Weight Loss at 48 Weeks |
|---|---|
| 1 mg (fixed) | -8.7% |
| 4 mg (escalated from 2 mg) | -17.1% |
| 8 mg (escalated from 2 mg) | -22.8% |
| 12 mg (escalated from 2 mg) | -24.2% |
A critical finding: starting from 2 mg had significantly fewer GI side effects than starting from 4 mg, supporting the slower titration approach used in the protocol below.
Retatrutide Dose Escalation Protocol
| Weeks | Weekly Dose | Injection Volume | Syringe Units |
|---|---|---|---|
| 1-4 | 2 mg | 0.20 mL | 20 units |
| 5-8 | 4 mg | 0.40 mL | 40 units |
| 9-12 | 6 mg | 0.60 mL | 60 units |
| 13-16 | 8 mg | 0.80 mL | 80 units |
| 17-20 | 10 mg | 1.00 mL | 100 units |
| 21+ | 12 mg | 1.20 mL | Split: 2 x 60 units |
Retatrutide is injected once weekly on the same day each week. It has an approximate half-life of 6 days. Inject into the abdomen, outer thigh, or upper arm and rotate sites weekly. For a detailed week-by-week chart, see our retatrutide dosage schedule guide.
Retatrutide Storage
- Lyophilized powder: Store at -20 degrees C (-4 degrees F). Stable up to 24 months. Alternatively, store at 2-8 degrees C per manufacturer label.
- Reconstituted solution: Refrigerate at 2-8 degrees C (36-46 degrees F). Use within 28 days.
Storage Guidelines Summary
| Product | Powder Storage | Reconstituted Storage | Beyond-Use Date |
|---|---|---|---|
| NAD+ | -20 degrees C or 2-8 degrees C, protect from light | 2-8 degrees C | 28 days |
| Semaglutide | 2-8 degrees C, protect from light | 2-8 degrees C, do not freeze | 28 days |
| Tirzepatide | 2-8 degrees C, protect from light | 2-8 degrees C, do not freeze | 28 days |
| Retatrutide | -20 degrees C (preferred) or 2-8 degrees C | 2-8 degrees C | 28 days |
Choosing the Right Vial Size for Your Practice
For clinics managing multiple patients, larger multi-dose vials offer significant cost savings per dose:
- NAD+: The 500 mg vial provides 10 doses at 50 mg, making it the most economical choice for clinics with steady patient volume.
- Semaglutide: The 5.0 mg vial provides up to 10 doses at 0.5 mg or roughly 2 full titration cycles at the 2.4 mg maintenance dose.
- Tirzepatide: The 30 mg vial is the most popular multi-dose option, providing 6 doses at 5 mg with a clean 10 mg/mL concentration.
- Retatrutide: The 20 mg vial provides 5 doses at 4 mg, enough for the first month of escalation.
Need help choosing the right vial size for your clinic? Contact our team on WhatsApp for bulk pricing and professional support.
Important Safety Reminders
- Always use a new sterile needle for each injection. Never reuse needles.
- Rotate injection sites to prevent lipodystrophy (hardened tissue under the skin).
- If you experience severe nausea, vomiting, or abdominal pain, contact your healthcare provider before continuing injections.
- Store all reconstituted peptides in the refrigerator and discard after 28 days.
- Keep a sharps container accessible and dispose of it according to local regulations.
Medical Disclaimer
IMPORTANT: This information is provided for educational and reference purposes only and is intended for licensed healthcare professionals, compounding pharmacies, and wholesale distributors. It does not constitute medical advice, diagnosis, or treatment recommendations. All reconstitution and dosing should be performed by or under the supervision of a licensed healthcare provider. Compounded medications are not FDA-approved and may vary between compounding pharmacies. Retatrutide is an investigational compound not yet approved by the FDA or any regulatory agency. Patients should always follow their prescriber's specific instructions. PROST BIOTECH SDN BHD provides these products for professional use only.
Frequently Asked Questions
Related Tools
Sources & References
- 1Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1)
New England Journal of Medicine, 2021
- 2Wegovy (semaglutide) Prescribing Information
U.S. FDA, 2023
- 3Mounjaro (tirzepatide) Prescribing Information
U.S. FDA, 2022
- 4Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial
New England Journal of Medicine, 2023
- 5Empower Pharmacy NAD+ Compounding Protocols
Empower Pharmacy, 2024