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The FDA does note that during a drug shortage, compounded versions can be produced if they meet Federal Food, Drug and Cosmetic Act requirements, but urged caution

Interestingly, even in obese swine, GLP-1R activation can improve cardiac function and augment cardiac output after MI [75]

The sNDA was based on results from the Phase 3, double-blind, parallel-group, placebo-controlled cardiovascular outcomes trial, SOUL. The trial reported a 14% reduction in the risk of MACE compared to placebo when added to standard of care in patients with T2DM and established CVD and/or CKD

Since semaglutide is a prescription medication, a qualified healthcare provider must assess if it will be useful and if so, write a prescription

And if you are curious about how long peptides last in powder form before reconstitution, that comparison helps frame why the reconstituted state is so much more fragile