Semaglutide

Ozempic · Wegovy · Rybelsus

FDA-approved GLP-1 receptor agonist for type 2 diabetes, chronic weight management, and cardiovascular risk reduction.

FDA approvedWeight & Metabolism

Overview

Semaglutide is a long-acting GLP-1 analogue given weekly by injection or daily by mouth. It is one of the best-studied peptides in medicine, with large outcome trials in diabetes, obesity, cardiovascular disease, and kidney disease.

Mechanism of action

Activates GLP-1 receptors in the pancreas, gut and brain — increasing glucose-dependent insulin release, suppressing glucagon, slowing gastric emptying, and reducing appetite via hypothalamic signaling.

Benefits & evidence ratings

~15% mean weight loss at 2.4 mg weekly over 68 weeks (STEP 1)A Established / approved

20% relative reduction in major cardiovascular events in obesity without diabetes (SELECT)A Established / approved

HbA1c reduction in type 2 diabetesA Established / approved

Slowing of kidney disease progression in T2D (FLOW)A Established / approved

Dosing

Doses show what has been studied or discussed — not guidance. Always follow your prescriber.

Source	Dose	Frequency	Duration	Route
Wegovy label (weight management) A Established / approved	0.25 mg → titrate every 4 wk to 2.4 mg maintenance	Once weekly	Chronic	Subcutaneous
Ozempic label (T2D) A Established / approved	0.25 mg → 0.5 / 1 / 2 mg	Once weekly	Chronic	Subcutaneous
Rybelsus label (T2D) A Established / approved	3 mg → 7 mg → 14 mg	Once daily, fasting	Chronic	Oral

Clinical trials & studies

Phase 32021
Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1, NEJM)
1,961 adults; −14.9% vs −2.4% placebo at 68 weeks.
Phase 32023
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT, NEJM)
17,604 adults; MACE HR 0.80.
LabelCurrent
Wegovy prescribing information
Official FDA label including boxed warning.

Safety

Side effects

Nausea, vomiting, diarrhea, constipation
Gallbladder disease
Pancreatitis (rare)
Injection-site reactions
Lean-mass loss alongside fat loss

Contraindications

Personal/family history of medullary thyroid carcinoma or MEN2 (boxed warning)
Prior serious hypersensitivity
Pregnancy

Interactions

Insulin/sulfonylureas — hypoglycemia
Oral medications — altered absorption from slowed gastric emptying
Caution around anesthesia (aspiration risk with retained gastric contents)

Long-term safety

Safety data extend several years in large trials. Weight regain is common after discontinuation (STEP 1 extension).

Regulatory status

FDA approved

FDA and EMA approved (Ozempic, Wegovy, Rybelsus). Indications vary by product and region.

FAQ

Commonly discussed alongside

Cagrilintide Tirzepatide

Listing a combination does not mean it has been studied or is safe.

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