Semaglutide (obesity)
WEGOVY
Pronunciation: sem-a-GLOO-tide (wee-GOE-vee)
“(Rebel, Olympic, & Wig governor) See my glue tide”
Glasses on the mascots → “see my glue tide”
Rebel saying “You ain’t injectin’ me!” → Rybelsus is oral, unlike Ozempic/Wegovy
What it isGLP-1 receptor agonist formulation for chronic weight management in obesity.
Why this oneUnlike diabetes-branded semaglutide, it is labeled specifically for obesity treatment and cardiovascular risk reduction.
What limits itGI intolerance often limits escalation. Delayed gastric emptying matters before anesthesia; gallbladder disease can end treatment.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Reduce MACE risk (established CVD + obesity/overweight) | Adults | 0.25 mg SC once weekly x4 wk | 2.4 mg (recommended) or 1.7 mg once weekly | 2.4 mg once weekly |
| Chronic weight management (obesity, or overweight with ≥1 comorbidity) | Adults | 0.25 mg SC once weekly, escalate q4wk (0.5 → 1 → 1.7) | 2.4 mg (recommended) or 1.7 mg once weekly | 2.4 mg once weekly |
| Chronic weight management (obesity) | Pediatric ≥12 y | 0.25 mg SC once weekly, escalate q4wk (0.5 → 1 → 1.7) | 2.4 mg once weekly (may reduce to 1.7 mg if intolerant) | 2.4 mg once weekly |
Titration Escalate every 4 weeks (may delay escalation 4 weeks if not tolerated)
Renal No adjustment needed
Hepatic No adjustment needed
Do not coadminister with other semaglutide-containing products or other GLP-1 receptor agonists; once-weekly dosing (missed dose: give if next dose >2 days away)
Instructions
- Inject subcutaneously in abdomen, thigh, or upper arm once weekly, same day each week, any time, with or without meals
- Use in combination with reduced-calorie diet and increased physical activity
- In patients with type 2 diabetes, monitor blood glucose
Available strengths
- inj 0.25, 0.5, 1, 1.7, 2.4, 7.2 mg (SQ)
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Cautions
- Acute pancreatitis
- Acute gallbladder disease
- Hypoglycemia (with insulin or insulin secretagogue)
- Acute kidney injury
- Hypersensitivity reactions
- Diabetic retinopathy complications (type 2 diabetes)
- Heart rate increase
- Suicidal behavior and ideation
Adverse reactions
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Headache
- Fatigue
- Dyspepsia
- Dizziness
Pregnancy May cause fetal harm; weight loss offers no benefit in pregnancy — discontinue when pregnancy recognized; discontinue ≥2 months before a planned pregnancy
Lactation No human data; present in rat milk; consider benefits vs risk
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 0.25 mg | inj | per unit | — | $653.29/mL | not offered |
| 0.5 mg | inj | per unit | — | $653.27/mL | not offered |
| 1 mg | inj | per unit | — | $653.04/mL | not offered |
| 1.7 mg | inj | per unit | — | $435.56/mL | not offered |
| 2.4 mg | inj | per unit | — | $435.53/mL | not offered |
| 7.2 mg | inj | per unit | — | $434.95/mL | not offered |
Other forms: Semaglutide (OZEMPIC, WEGOVY) · Semaglutide oral (RYBELSUS) · Semaglutide oral (obesity) (WEGOVY (oral))
⚠ BOXED WARNING
- Thyroid C-cell tumors in rodents
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.
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