Semaglutide (Wegovy, Ozempic)
Semaglutide is the GLP-1 medication behind Wegovy and Ozempic. It is FDA-approved, backed by large trials, and now available as a weekly injection or a daily pill.
- Legal lane: FDA-approved, prescription only
- Evidence grade: A
- Forms: weekly injection under the skin; daily tablet
- Brands: Wegovy (weight), Ozempic and Rybelsus (type 2 diabetes)
- Self-pay cost: from $149 a month
What it is
Semaglutide mimics GLP-1, a hormone your gut releases after eating. It slows stomach emptying and acts on appetite signals in the brain, so people feel full sooner and eat less.
What the evidence shows
In its main weight-loss trial, adults on the 2.4 mg weekly injection lost an average of 14.9% of their body weight over 68 weeks. In the main trial of the 25 mg daily pill, the average was 13.6%. Results vary from person to person, and weight tends to return when treatment stops.
Dosing on the FDA label
These schedules come from the Wegovy prescribing information. The dose rises in steps to reduce stomach side effects. A prescriber may slow the schedule if a step is not tolerated.
Weekly injection
| Weeks | Dose, once a week | Stage |
|---|---|---|
| 1 to 4 | 0.25 mg | Starting dose |
| 5 to 8 | 0.5 mg | Step up |
| 9 to 12 | 1 mg | Step up |
| 13 to 16 | 1.7 mg | Step up |
| 17 onward | 2.4 mg (or 1.7 mg) | Maintenance |
For weight loss in adults, the label allows an increase to 7.2 mg once a week for people who have tolerated 2.4 mg for at least four weeks and need more weight reduction. That is the maximum dose.
Daily tablet
| Days | Dose, once a day | Stage |
|---|---|---|
| 1 to 30 | 1.5 mg | Starting dose |
| 31 to 60 | 4 mg | Step up |
| 61 to 90 | 9 mg | Step up |
| 91 onward | 25 mg | Maintenance |
The tablet is swallowed whole with plain water only, no more than 4 ounces, and never more than one tablet a day.
Ozempic, the diabetes brand, uses a different schedule. Do not use one brand's schedule for another.
Side effects and warnings
- The most common side effects are in the gut: nausea, diarrhea, vomiting and constipation, especially while the dose is rising.
- The label carries a boxed warning about thyroid C-cell tumors, seen in rodent studies. It should not be used by people with a personal or family history of medullary thyroid cancer or MEN 2.
- The full label lists other serious risks. Read the Medication Guide that comes with the prescription and raise your history with the prescriber.
What it costs without insurance
| Product | Manufacturer self-pay price, per month |
|---|---|
| Wegovy pill | $149 (1.5 mg), $199 (4 mg), $299 (9 mg and 25 mg) |
| Wegovy pen | $199 for the first two fills for new patients, then $349 |
Prices were checked in October 2026 and change often. The $199 pen price is an introductory offer listed through December 31, 2026. People with commercial insurance may pay less with a manufacturer savings card.
Compounded semaglutide
Some telehealth companies sell semaglutide made by compounding pharmacies. It is not FDA-approved and the agency has not reviewed it for safety, effectiveness or quality. Since the shortage ended in February 2025, compounding is allowed only in narrow, patient-specific cases. The FDA had received 990 adverse event reports linked to compounded semaglutide as of May 31, 2026. If you are offered a compounded version, ask which pharmacy makes it and why you need it in place of the approved drug.
Sources
- Wegovy prescribing information (Novo Nordisk)
- Wegovy label, FDA, 2026
- Wegovy dosing schedule (Novo Nordisk)
- Trial results summary
- Self-pay price tracker
- Compounded GLP-1 rules and adverse event counts
Choosing between the two approved options? See semaglutide vs tirzepatide.