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Semaglutide (Wegovy, Ozempic, Rybelsus)

FDA approved GLP-1 agonist with about 15% average weight loss in a 68 week RCT and proven cardiovascular benefit.

By the PeptideAgent Editorial Team. Draft, pending editorial review.  Last verified

At a glance

Semaglutide (GLP-1 receptor agonist (31 amino acid analog of human GLP-1, acylated for once weekly dosing)). Semaglutide is an FDA approved GLP-1 receptor agonist sold as Ozempic (type 2 diabetes, weekly injection or daily tablet), Wegovy (chronic weight management and cardiovascular risk reduction, weekly injection or daily tablet), and Rybelsus (daily tablet for type 2 diabetes). In the 68 week STEP 1 trial, adults with obesity lost 14.9% of body weight on Wegovy's 2.4 mg weekly dose versus 2.4% on placebo. Compounded versions were lawful only during the FDA declared shortage, which ended in February 2025.

Evidence: Human RCT evidenceRegulatory: FDA approvedWADA: Not WADA prohibitedVerified: Verified Sep 27, 2026
Compounding
FDA approved products (Ozempic 2017, Rybelsus 2019, Wegovy 2021). FDA removed semaglutide from the drug shortage list on February 21, 2025; compounding by 503A pharmacies had to stop by April 22, 2025 and by 503B outsourcing facilities by May 22, 2025, except for a documented patient specific clinical need. FDA has warned about unapproved compounded and counterfeit GLP-1 products and salt forms (semaglutide sodium, semaglutide acetate) that are not the approved active ingredient. On April 30, 2026 FDA proposed not to include semaglutide on the 503B bulks list; that proposal was not final as of September 2026. Adding a vitamin such as B12 or niacinamide does not by itself make a compounded GLP-1 different from the approved drug. Under FDA's April 1, 2026 policy update, such a combination may be treated as essentially a copy when the strengths are within 10% of approved products and the route is the same, unless a prescriber documents a real difference for the individual patient. A September 2026 FDA warning letter applied this to semaglutide and tirzepatide vitamin combinations, said high production volume suggested the claimed differences were a pretext, and questioned significant-difference statements picked from preset menus on prescribing platforms.
Typical cost
Manufacturer list price is 1,349.02 USD per month for Wegovy and 1,027.51 USD for Ozempic (checked 2026-09-22), falling to 675 USD for both on January 1, 2027. Manufacturer self-pay prices run 149 to 499 USD per month by product and dose, with the Wegovy pen at 349 USD. With commercial insurance the manufacturer savings offer can bring a covered prescription to 25 USD per month, and eligible Medicare Part D enrollees pay 50 USD per month for Wegovy under the Medicare GLP-1 Bridge (July 2026 to December 2027). A 2024 study found compounded semaglutide at a median 231 USD for the first month during the shortage; compounding is now limited to patient specific needs.
Access path
  1. Prescription from a licensed provider (in person or telehealth) filled at a retail pharmacy as Ozempic, Wegovy, or Rybelsus.
  2. FDA's Drug Shortages database lists Rybelsus 3 mg, 7 mg, and 14 mg tablets as To Be Discontinued, posted June 4, 2026; ask the prescriber or pharmacy which oral semaglutide product replaces them.
  3. Manufacturer direct-to-consumer cash pay program for Wegovy.
  4. Compounded semaglutide is no longer lawful for routine dispensing after the 2025 shortage resolution; ask any provider offering it what the documented clinical need is.

Legal status: FDA approved; the approved product is lawful with a prescription. Not WADA prohibited. See legal status

Summary

Semaglutide is an FDA approved GLP-1 receptor agonist sold as Ozempic (type 2 diabetes, weekly injection or daily tablet), Wegovy (chronic weight management and cardiovascular risk reduction, weekly injection or daily tablet), and Rybelsus (daily tablet for type 2 diabetes). In the 68 week STEP 1 trial, adults with obesity lost 14.9% of body weight on Wegovy's 2.4 mg weekly dose versus 2.4% on placebo. Compounded versions were lawful only during the FDA declared shortage, which ended in February 2025.

What is Semaglutide?

Semaglutide is a GLP-1 receptor agonist (31 amino acid analog of human GLP-1, acylated for once weekly dosing). It is also known as Ozempic, Wegovy, Rybelsus, NN9535, compounded semaglutide, Wegovy pill, Ozempic tablets.

How does it work?

Semaglutide binds and activates the GLP-1 receptor. This increases glucose dependent insulin secretion, suppresses glucagon, slows gastric emptying, and acts on hypothalamic and brainstem appetite centers to reduce hunger and food intake. A fatty acid side chain binds albumin, giving a half life of about one week.

Key facts
ClusterGLP-1 and incretin agonists
RoutesSubcutaneous injection once weekly (Ozempic, Wegovy); Oral tablet once daily (Wegovy tablets, Ozempic tablets, Rybelsus)
Conditions studiedObesity and chronic weight management; Type 2 diabetes; Longevity and healthy aging; Cardiovascular risk reduction; Chronic kidney disease; Fatty liver disease (MASLD and MASH); Fat loss and body composition; Osteoarthritis
Recordv3, draft, verified Sep 27, 2026

What does the evidence say about Semaglutide?

Evidence: Human RCT evidenceGrade assigned per the methodology.

Multiple large randomized controlled trials. STEP 1 (n = 1,961) showed 14.9% mean weight loss at 68 weeks versus 2.4% with placebo. SUSTAIN-6 (n = 3,297) showed a 26% relative reduction in major adverse cardiovascular events in type 2 diabetes. SELECT (n = 17,604) showed a 20% relative reduction in major adverse cardiovascular events in adults with obesity and cardiovascular disease but without diabetes.

Indexed studies by evidence grade
Evidence typeIndexed studiesParticipants (human)
Human randomized trials424741
Human observational studies0n/a
Animal studies0n/a
All indexed studies424,741

Human evidence

STEP 1: 1,961 adults with BMI 30 or higher (or 27 with a comorbidity), 2.4 mg weekly for 68 weeks, mean weight change of minus 14.9% versus minus 2.4% on placebo; 86.4% of the semaglutide group lost at least 5% of body weight. SUSTAIN-6: 3,297 adults with type 2 diabetes, hazard ratio 0.74 for major adverse cardiovascular events over about 2 years. SELECT: 17,604 adults with overweight or obesity and established cardiovascular disease, hazard ratio 0.80 for major adverse cardiovascular events over a mean 40 months.

Animal evidence

Preclinical rodent and primate studies established GLP-1 receptor mediated reductions in food intake and body weight and informed the human dose. Rodent studies also showed thyroid C cell tumors, which is the basis of the boxed warning; this finding has not been reproduced in humans.

Key studies

Indexed studies of Semaglutide
StudyDesign and populationOutcomeGrade
Once-weekly semaglutide in adults with overweight or obesity (STEP 1)2021 PMID 33567185Randomized, double blind, placebo controlled trial, 68 weeksn = 1,961 Adults with BMI 30 or higher, or 27 or higher with at least one weight related comorbidity, without diabetesMean weight change minus 14.9% with semaglutide 2.4 mg versus minus 2.4% with placebo; 86.4% versus 31.5% achieved at least 5% weight lossEvidence: Human RCT evidence
Semaglutide and cardiovascular outcomes in patients with type 2 diabetes (SUSTAIN-6)2016 PMID 27633186Randomized, double blind, placebo controlled cardiovascular outcomes trial, median 2.1 yearsn = 3,297 Adults with type 2 diabetes at high cardiovascular riskMajor adverse cardiovascular events hazard ratio 0.74 (95% CI 0.58 to 0.95) versus placeboEvidence: Human RCT evidence
Semaglutide and cardiovascular outcomes in obesity without diabetes (SELECT)2023 PMID 37952131Randomized, double blind, placebo controlled cardiovascular outcomes trial, mean follow up 39.8 monthsn = 17,604 Adults 45 and older with BMI 27 or higher and established cardiovascular disease, without diabetesMajor adverse cardiovascular events hazard ratio 0.80 (95% CI 0.72 to 0.90) versus placeboEvidence: Human RCT evidence
Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2)2021 PMID 34170647Randomized, open label, active comparator trial, 40 weeksn = 1,879 Adults with type 2 diabetes on metforminTirzepatide 5, 10, and 15 mg lowered HbA1c and body weight more than semaglutide 1 mg (weight minus 7.6 to minus 11.2 kg versus minus 5.7 kg)Evidence: Human RCT evidence

Conditions studied

Conditions with evidence for Semaglutide
ConditionGradeNote
Obesity and chronic weight managementEvidence: Human RCT evidence14.9% mean weight loss at 2.4 mg over 68 weeks in STEP 1 (n = 1,961); FDA approved as Wegovy.
Type 2 diabetesEvidence: Human RCT evidence26% relative reduction in major adverse cardiovascular events in SUSTAIN-6; FDA approved as Ozempic and Rybelsus.
Longevity and healthy agingEvidence: Human RCT evidence20% relative reduction in major adverse cardiovascular events in SELECT; no lifespan trial.
Cardiovascular risk reductionEvidence: Human RCT evidenceSELECT (n = 17,604) found a 20% relative reduction in major adverse cardiovascular events in adults with overweight or obesity and established cardiovascular disease without diabetes; Wegovy is FDA labeled for this use.
Chronic kidney diseaseEvidence: Human RCT evidenceFLOW (n = 3,533) stopped early for efficacy with a 24% lower risk of kidney failure, sustained eGFR decline, or kidney or cardiovascular death; Ozempic is FDA labeled for this use in type 2 diabetes.
Fatty liver disease (MASLD and MASH)Evidence: Human RCT evidenceESSENCE phase 3: fibrosis improved without worsening steatohepatitis in 36.8% versus 22.4% on placebo; FDA approved as Wegovy for noncirrhotic MASH with F2 to F3 fibrosis.
Fat loss and body compositionEvidence: Human RCT evidenceSTEP 1: 14.9% mean weight loss with 2.4 mg over 68 weeks versus 2.4% on placebo; FDA approved as Wegovy for chronic weight management.
OsteoarthritisEvidence: Human RCT evidenceSTEP 9 (n = 407): WOMAC pain score fell 41.7 points versus 27.5 on placebo over 68 weeks in knee osteoarthritis with obesity; not labeled for osteoarthritis.

Is Semaglutide legal in the United States?

Regulatory: FDA approvedWADA: Not WADA prohibited

FDA and compounding status

FDA approved products (Ozempic 2017, Rybelsus 2019, Wegovy 2021). FDA removed semaglutide from the drug shortage list on February 21, 2025; compounding by 503A pharmacies had to stop by April 22, 2025 and by 503B outsourcing facilities by May 22, 2025, except for a documented patient specific clinical need. FDA has warned about unapproved compounded and counterfeit GLP-1 products and salt forms (semaglutide sodium, semaglutide acetate) that are not the approved active ingredient. On April 30, 2026 FDA proposed not to include semaglutide on the 503B bulks list; that proposal was not final as of September 2026. Adding a vitamin such as B12 or niacinamide does not by itself make a compounded GLP-1 different from the approved drug. Under FDA's April 1, 2026 policy update, such a combination may be treated as essentially a copy when the strengths are within 10% of approved products and the route is the same, unless a prescriber documents a real difference for the individual patient. A September 2026 FDA warning letter applied this to semaglutide and tirzepatide vitamin combinations, said high production volume suggested the claimed differences were a pretext, and questioned significant-difference statements picked from preset menus on prescribing platforms.

WADA status

Not WADA prohibited. Not named on the current prohibited list. Athletes should still confirm against the list in force for their season.

Regulatory timeline

  1. FDA

    FDA warning letter treats GLP-1 plus vitamin combinations as essentially copies

    In a warning letter dated September 18, 2026 and posted September 22, FDA said compounded tirzepatide with niacinamide and semaglutide with cyanocobalamin (vitamin B12) appeared to be essentially copies of approved drugs, that the volume produced suggested the claimed differences were a pretext, and that significant-difference statements were repeated verbatim across many records or chosen from preset menus on prescribing platforms. The letter's findings are specific to one pharmacy, but they apply FDA's April 1, 2026 policy that a combination within 10% of approved strengths by the same route may be treated as essentially a copy without a documented prescriber determination.

    Source: FDA warning letter to a compounding pharmacy on semaglutide and tirzepatide vitamin combinations (September 18, 2026)
  2. FDA

    FDA proposes to keep semaglutide, tirzepatide and liraglutide off the 503B bulks list

    FDA proposed not to include semaglutide, tirzepatide or liraglutide on the 503B bulks list, after tentatively finding no clinical need for outsourcing facilities to compound them from bulk. The notice was published May 1, 2026, and the comment period was extended to July 30, 2026. The proposal was not final as of September 2026. It does not change the 503A rules for patient specific compounding.

    Source: Federal Register 2026-08552: List of Bulk Drug Substances for Which There Is a Clinical Need Under Section 503B
  3. FDA

    FDA approves a 7.2 mg Wegovy dose for chronic weight management

    FDA approved a higher 7.2 mg dose of Wegovy (semaglutide) injection, marketed as Wegovy HD, for weight loss and long-term maintenance of weight loss in certain adults.

    Regulatory: FDA approvedSource: FDA press release: FDA approves fourth product under national priority voucher program, higher dose semaglutide (March 19, 2026)
  4. FDA

    FDA approves oral semaglutide (Wegovy tablets) for weight management

    In December 2025 FDA approved a once-daily oral formulation of semaglutide for chronic weight management, the first oral GLP-1 receptor agonist approved for obesity.

    Regulatory: FDA approvedSource: Drugs@FDA: Wegovy (semaglutide) NDA 215256
  5. FDA

    FDA grants accelerated approval of Wegovy for MASH with fibrosis

    FDA granted accelerated approval of Wegovy (semaglutide 2.4 mg) for adults with noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver fibrosis, based on histologic endpoints from the ESSENCE trial.

    Regulatory: FDA approvedSource: Drugs@FDA: Wegovy (semaglutide) NDA 215256
  6. FDA

    503B grace period for compounded semaglutide ends

    FDA's enforcement discretion for 503B outsourcing facilities compounding semaglutide ended, closing the shortage-based pathway for compounded semaglutide.

    Source: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (Wayback Machine capture of the FDA page, March 13, 2026)
  7. FDA

    503A grace period for compounded semaglutide ends

    FDA's enforcement discretion for 503A pharmacies compounding semaglutide ended. After this date 503A pharmacies may not compound copies of Ozempic or Wegovy on shortage grounds.

    Source: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (Wayback Machine capture of the FDA page, March 13, 2026)
  8. FDA

    FDA declares the semaglutide shortage resolved

    FDA announced that the shortage of semaglutide injection (Ozempic and Wegovy) was resolved and set enforcement discretion periods: 503A pharmacies until April 22, 2025 and 503B outsourcing facilities until May 22, 2025.

    Source: FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize (Wayback Machine capture of the FDA page, March 13, 2026)
  9. FDA

    FDA approves Ozempic for chronic kidney disease in type 2 diabetes

    FDA approved Ozempic (semaglutide) to reduce the risk of kidney disease worsening, kidney failure, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease, based on the FLOW trial.

    Regulatory: FDA approvedSource: Drugs@FDA: Ozempic (semaglutide) NDA 209637
  10. FDA

    FDA approves Wegovy to reduce cardiovascular risk in adults with obesity

    FDA approved a new indication for Wegovy (semaglutide 2.4 mg) to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and obesity or overweight, based on the SELECT trial.

    Regulatory: FDA approvedSource: FDA approves first treatment to reduce risk of serious heart problems specifically in adults with obesity or overweight
  11. FDA

    FDA warns about compounded semaglutide made with salt forms

    In May 2023 FDA published its concerns about compounded semaglutide, stating it had received adverse event reports and that products made with semaglutide sodium or semaglutide acetate salts are not the same active ingredient as the approved drugs and do not meet the compounding exemption requirements.

    Source: FDA's concerns with unapproved GLP-1 drugs used for weight loss
  12. FDA

    FDA expands Wegovy to adolescents aged 12 and older

    FDA approved Wegovy (semaglutide 2.4 mg) for chronic weight management in pediatric patients aged 12 years and older with obesity, based on the STEP TEENS trial.

    Regulatory: FDA approvedSource: Drugs@FDA: Wegovy (semaglutide) NDA 215256
  13. FDA

    FDA lists semaglutide injection on the drug shortage list

    In March 2022 FDA added semaglutide injection to its drug shortage list as demand for Wegovy and Ozempic outpaced supply. While a drug is in shortage, 503A and 503B compounders may prepare essentially a copy under FDA's shortage-related compounding policies.

    Source: FDA drug shortages database
  14. FDA

    FDA approves Wegovy (semaglutide 2.4 mg) for chronic weight management

    FDA approved once-weekly semaglutide 2.4 mg injection (Wegovy) for chronic weight management in adults with obesity or overweight with at least one weight-related condition, the first new weight-management drug approved since 2014.

    Regulatory: FDA approvedSource: Drugs@FDA: Wegovy (semaglutide) NDA 215256
  15. FDA

    FDA adds cardiovascular risk reduction to the Ozempic label

    FDA approved a label expansion for Ozempic (semaglutide) to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, based on the SUSTAIN-6 trial.

    Regulatory: FDA approvedSource: Drugs@FDA: Ozempic (semaglutide) NDA 209637
  16. FDA

    FDA approves Rybelsus, the first oral GLP-1 receptor agonist

    FDA approved oral semaglutide tablets (Rybelsus) for adults with type 2 diabetes, the first GLP-1 receptor agonist available in a pill rather than an injection.

    Regulatory: FDA approvedSource: Drugs@FDA: Rybelsus (semaglutide tablets) NDA 213051
  17. FDA

    FDA approves Ozempic (semaglutide) for type 2 diabetes

    FDA approved once-weekly semaglutide injection (Ozempic) to improve glycemic control in adults with type 2 diabetes, the first semaglutide product to reach the US market.

    Regulatory: FDA approvedSource: Drugs@FDA: Ozempic (semaglutide) NDA 209637

Full tracker for Semaglutide or the category-wide tracker.

Semaglutide dose schedule on the FDA label

Doses below are quoted from the FDA label for its approved uses, plus the doses used in the pivotal trials where noted. The prescriber sets the dose; PeptideAgent does not recommend doses or protocols.

Weight management (STEP 1 and Wegovy label): start 0.25 mg subcutaneously once weekly, increase every 4 weeks through 0.5, 1.0, and 1.7 mg to a maintenance dose of 2.4 mg weekly. The Wegovy label also allows 1.7 mg as a maintenance dose and, for adults who tolerate 2.4 mg for at least 4 weeks, an increase to a 7.2 mg maximum for more weight reduction. Wegovy tablets: 1.5 mg daily for 30 days, then 4 mg and 9 mg, with 25 mg daily as maintenance. Type 2 diabetes (Ozempic label): 0.25 mg weekly for 4 weeks, then 0.5 mg, with optional increases to 1 mg and 2 mg weekly. Oral (Rybelsus label): 3 mg daily for 30 days then 7 mg, up to 14 mg.

Routes reported

Routes of administration reported for Semaglutide
#Route
1Subcutaneous injection once weekly (Ozempic, Wegovy)
2Oral tablet once daily (Wegovy tablets, Ozempic tablets, Rybelsus)

Wegovy and Ozempic side effects in trials

Side effects

Side effects reported for Semaglutide
#Reported side effect
1Nausea (44% in STEP 1 versus 16% placebo)
2Diarrhea (32% versus 16%)
3Vomiting (24% versus 6%)
4Constipation (24% versus 11%)
5Gallbladder disease including gallstones
6Pancreatitis (rare)
7Hypoglycemia when combined with insulin or sulfonylureas
8Boxed warning for thyroid C cell tumors based on rodent data
9Reports of ileus and, rarely, non-arteritic anterior ischemic optic neuropathy under investigation

Interactions

Interactions reported for Semaglutide
#Interaction
1Insulin and sulfonylureas: increased risk of hypoglycemia, dose reduction of those agents is usually needed
2Oral medications with a narrow therapeutic window: delayed gastric emptying can change absorption (labels advise monitoring, for example with warfarin)
3Other GLP-1 or GIP/GLP-1 agonists: not studied in combination and not recommended

Contraindications

Contraindications for Semaglutide
#Contraindication
1Personal or family history of medullary thyroid carcinoma
2Multiple endocrine neoplasia syndrome type 2
3Prior serious hypersensitivity to semaglutide
4Pregnancy (discontinue at least 2 months before a planned pregnancy per label)

How do people access Semaglutide legally?

Typical cost: Manufacturer list price is 1,349.02 USD per month for Wegovy and 1,027.51 USD for Ozempic (checked 2026-09-22), falling to 675 USD for both on January 1, 2027. Manufacturer self-pay prices run 149 to 499 USD per month by product and dose, with the Wegovy pen at 349 USD. With commercial insurance the manufacturer savings offer can bring a covered prescription to 25 USD per month, and eligible Medicare Part D enrollees pay 50 USD per month for Wegovy under the Medicare GLP-1 Bridge (July 2026 to December 2027). A 2024 study found compounded semaglutide at a median 231 USD for the first month during the shortage; compounding is now limited to patient specific needs.

Verified access options

  • Step 1

    Prescription from a licensed provider (in person or telehealth) filled at a retail pharmacy as Ozempic, Wegovy, or Rybelsus.

  • Step 2

    FDA's Drug Shortages database lists Rybelsus 3 mg, 7 mg, and 14 mg tablets as To Be Discontinued, posted June 4, 2026; ask the prescriber or pharmacy which oral semaglutide product replaces them.

  • Step 3

    Manufacturer direct-to-consumer cash pay program for Wegovy.

  • Step 4

    Compounded semaglutide is no longer lawful for routine dispensing after the 2025 shortage resolution; ask any provider offering it what the documented clinical need is.

Access paths are verified against public regulatory records and prescriber licensing. We never list unlicensed vendors.

Compare Semaglutide

Frequently asked questions

Is semaglutide (Wegovy, Ozempic) FDA approved and legal?

Yes. Semaglutide is FDA approved as Ozempic (type 2 diabetes, 2017), Rybelsus (oral, type 2 diabetes, 2019), and Wegovy (chronic weight management, 2021). Wegovy's label has since added cardiovascular risk reduction, noncirrhotic MASH with liver fibrosis, and a once daily tablet for weight management, and Ozempic's label covers kidney outcomes in type 2 diabetes with chronic kidney disease. It is available only by prescription. Compounded copies were permitted only while FDA listed the drug as in shortage; that listing ended February 21, 2025. [5] [6] [15]

Is Ozempic a peptide?

Yes. Semaglutide, the active ingredient in Ozempic, Wegovy, and Rybelsus, is a modified version of GLP-1, a 31 amino acid gut hormone. The labels describe a peptide backbone made by yeast fermentation, changed at one position to resist breakdown and linked to a fatty acid that binds albumin, which stretches its half life to about a week. So it is a peptide drug, but unlike peptides sold online as research chemicals it is FDA approved and made under pharmaceutical quality rules. [5] [15]

How much weight do people lose on Wegovy (semaglutide)?

In the STEP 1 randomized trial of 1,961 adults with obesity, the semaglutide 2.4 mg group lost a mean 14.9% of body weight over 68 weeks versus 2.4% on placebo. About 86% of participants lost at least 5% and about a third lost 20% or more. Weight regain is expected after stopping: in the STEP 1 extension, participants regained about two thirds of lost weight within a year off treatment. [1]

What are the side effects of Wegovy and Ozempic?

Both brands are semaglutide, so the side effects are the same kind, with gastrointestinal effects most common. In STEP 1 (Wegovy 2.4 mg), nausea affected 44% of the semaglutide group versus 16% on placebo, diarrhea 32% versus 16%, vomiting 24% versus 6%, and constipation 24% versus 11%. Most were mild to moderate and eased with time. Less common but serious risks include gallbladder disease, pancreatitis, and hypoglycemia when combined with insulin or sulfonylureas. Both labels carry a boxed warning for thyroid C cell tumors seen in rodents. [1] [5] [15]

What is the Wegovy and Ozempic dose schedule on the FDA label?

Wegovy injection starts at 0.25 mg once weekly for 4 weeks, then rises every 4 weeks to 0.5 mg, 1 mg, and 1.7 mg. The usual maintenance dose is 2.4 mg weekly, and adults who tolerate 2.4 mg for at least 4 weeks may go up to a 7.2 mg maximum. Wegovy tablets start at 1.5 mg daily for 30 days, then 4 mg and 9 mg, with 25 mg daily as maintenance. Ozempic for type 2 diabetes starts at 0.25 mg weekly, then 0.5 mg, with optional steps to 1 mg and 2 mg. Injections go under the skin of the abdomen, thigh, or upper arm. The prescriber sets the dose. [5] [15]

How much do Wegovy and Ozempic cost?

Wegovy's list price is 1,349.02 USD per month and Ozempic's 1,027.51 USD, but few people pay list, and the manufacturer has announced a 675 USD list price for both from January 1, 2027. Manufacturer self-pay prices, checked 2026-09-22, are 149 to 299 USD per month for the tablets and 349 USD for the Wegovy pen (399 USD for the 7.2 mg dose, 199 USD for new patients' first two starting-dose fills). Commercial insurance with the manufacturer savings offer can bring a covered prescription to 25 USD, and eligible Medicare Part D enrollees pay 50 USD per month for Wegovy under the Medicare GLP-1 Bridge through December 31, 2027. [8] [9] [10] [11] [12] [13]

Does semaglutide protect the heart?

Yes, in two large trials. SUSTAIN-6 (3,297 people with type 2 diabetes) found a 26% relative reduction in major adverse cardiovascular events. SELECT (17,604 people with obesity and cardiovascular disease but no diabetes) found a 20% relative reduction over a mean 40 months, which led to the 2024 cardiovascular risk reduction indication for Wegovy. [2] [3] [5]

Wegovy vs Zepbound: which works better?

For weight loss, Zepbound's ingredient tirzepatide won the only direct obesity trial: in SURMOUNT-5, adults lost 20.2% of body weight on tirzepatide versus 13.7% on semaglutide at 72 weeks. In type 2 diabetes, SURPASS-2 also favored tirzepatide over semaglutide 1 mg on HbA1c and weight. Semaglutide has what tirzepatide lacks in obesity: a completed cardiovascular outcomes trial (SELECT) and a tablet form. Both carry the same thyroid boxed warning, and cost and coverage often decide. [3] [4] [17]

Decisions about starting, stopping, or combining any treatment belong with a licensed clinician who knows your history.

From the blog

More on the blog

Sources

Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.

  1. [1]Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021 (STEP 1)PubMed 33567185, 2021
  2. [2]Marso SP et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016 (SUSTAIN-6)PubMed 27633186, 2016
  3. [3]Lincoff AM et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023 (SELECT)PubMed 37952131, 2023
  4. [4]Frias JP et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. N Engl J Med 2021 (SURPASS-2)PubMed 34170647, 2021
  5. [5]FDA prescribing information for Wegovy (semaglutide) injection and tablets, via DailyMedFDA, 2025
  6. [6]FDA: concerns with unapproved GLP-1 drugs used for weight loss, including shortage resolution and compounding deadlinesFDA, 2025
  7. [7]WADA Prohibited ListWADA, 2026
  8. [8]Manufacturer list price (wholesale acquisition cost) page for semaglutide for weight management, accessed 2026-09-222026
  9. [9]Manufacturer list price (wholesale acquisition cost) page for semaglutide for type 2 diabetes, accessed 2026-09-222026
  10. [10]Manufacturer press release: semaglutide list price lowered to 675 USD per month effective January 1, 2027, self-pay prices unchanged (February 24, 2026)2026

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