Semaglutide is a medication used to manage certain health conditions, primarily type 2 diabetes and chronic weight management. This article provides general information found on semaglutide’s official labeling. This information is for general understanding only and not a substitute for professional medical advice. Always consult your doctor or pharmacist for personalized guidance.
What Semaglutide Is Used For
Semaglutide is approved by the U.S. Food and Drug Administration (FDA) for specific indications, depending on its brand name and formulation.
Ozempic (semaglutide injection) is primarily used, alongside diet and exercise, to improve blood sugar control in adults with type 2 diabetes. It also helps reduce the risk of major cardiovascular events (heart attack, stroke, or death) in adults with type 2 diabetes who have known heart disease. Ozempic can also reduce the risk of worsening kidney disease, kidney failure, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease.
Wegovy (semaglutide injection) is FDA-approved for chronic weight management in adults and children aged 12 years and older. It is used with a reduced-calorie diet and increased physical activity for adults with obesity (Body Mass Index [BMI] of 30 kg/m² or greater) or overweight (BMI of 27 kg/m² or greater) who also have at least one weight-related medical condition. Wegovy also reduces the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease who are obese or overweight.
Rybelsus (oral semaglutide) is an oral tablet formulation approved for adults with type 2 diabetes to improve blood sugar control, alongside diet and exercise. It is the first oral glucagon-like peptide-1 (GLP-1) receptor agonist for type 2 diabetes. While Ozempic and Rybelsus share the same active ingredient, they are approved for different conditions, with Wegovy specifically for weight management.
How to Take Semaglutide
Semaglutide is administered as a subcutaneous injection or an oral tablet.
Injectable forms, such as Ozempic and Wegovy, are typically given once weekly, on the same day each week. The injection can be administered at any time of day, with or without meals. Common injection sites include the abdomen, thigh, or upper arm. Rotate injection sites within the same body region. The initial dose is low and gradually increased by a healthcare provider over several weeks to minimize gastrointestinal side effects.
If a dose of Ozempic is missed, it should be taken as soon as possible within 5 days; if more than 5 days have passed, the missed dose should be skipped, and the regular schedule resumed. For Wegovy, if a dose is missed and the next scheduled dose is more than 2 days away, it should be taken as soon as possible, but if the next dose is less than 2 days away, the missed dose should be skipped.
Oral semaglutide (Rybelsus) is taken once daily. It should be taken with a small sip of water on an empty stomach, and no other food, beverages, or medications should be consumed for at least 30 minutes afterward.
Unused injectable pens should be stored in a refrigerator (2-8°C). Once in use, injectable pens can be stored at room temperature or refrigerated for a specific period (e.g., up to 56 days for Ozempic or 28 days for Wegovy). Oral tablets should be stored at room temperature in their original bottle with the drying agent cap to protect from moisture.
Key Warnings and Precautions
Semaglutide carries a Boxed Warning regarding the risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). Studies in rodents have shown that semaglutide can cause dose-dependent thyroid C-cell tumors. It is currently unknown whether this medication causes such tumors in humans, although cases of MTC have been reported in patients using GLP-1 receptor agonists in the post-marketing period. For this reason, semaglutide is not recommended for individuals with a personal or family history of MTC or those with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a genetic condition that increases the risk of certain tumors. Patients should be counseled about the potential risk of thyroid tumors and informed about symptoms like a mass in the neck, difficulty swallowing, shortness of breath, or persistent hoarseness.
Other serious warnings and precautions are associated with semaglutide use. Acute pancreatitis, an inflammation of the pancreas, has been observed in patients treated with GLP-1 receptor agonists, including semaglutide. If pancreatitis is suspected, semaglutide should be discontinued immediately, and treatment should not be restarted if pancreatitis is confirmed. Gallbladder problems, such as gallstones (cholelithiasis) or inflammation of the gallbladder (cholecystitis), have also been reported. If these conditions are suspected, gallbladder studies are recommended.
Acute kidney injury, in some cases requiring hemodialysis, has been reported in patients taking semaglutide, often linked to gastrointestinal reactions like nausea, vomiting, or diarrhea that can lead to dehydration. Monitoring kidney function is advised, especially during the initiation and dose escalation phases. Patients with a history of diabetic retinopathy, a complication affecting the eyes, should be monitored closely as rapid improvements in blood sugar control can sometimes lead to a temporary worsening of this condition.
Severe gastrointestinal adverse reactions have been associated with semaglutide, and its use is not recommended in patients with severe gastroparesis, a condition that slows stomach emptying. Serious allergic reactions, including anaphylaxis and angioedema (swelling of the face, lips, tongue, or throat), have also been reported, requiring immediate medical attention if they occur. It is also advised that semaglutide pens should never be shared between patients due to the risk of transmitting blood-borne pathogens.
Common and Serious Side Effects
The most frequently reported side effects of semaglutide are gastrointestinal in nature. These commonly include nausea (16-44% of users), vomiting (5-24%), diarrhea (8.5-30%), constipation (up to 25%), and abdominal pain. These symptoms tend to be more pronounced when starting the medication or increasing the dose, but they often lessen over time as the body adjusts.
Serious side effects, though less common, warrant immediate medical attention. Signs and symptoms that should prompt contact with a doctor include severe abdominal pain that does not resolve, which could indicate pancreatitis or gallbladder problems. Vision changes, such as blurred vision, especially for those with a history of diabetic retinopathy, should also be reported. Symptoms of a serious allergic reaction, such as swelling of the face, lips, tongue, or throat, difficulty breathing, severe rash, or itching, require immediate medical help.
Other serious but less frequent side effects include acute kidney injury, which might manifest as decreased urine output, swelling of the face, ankles, or hands, or unusual tiredness. Low blood sugar (hypoglycemia) can occur, particularly if semaglutide is used with other medications that lower blood sugar, like insulin or sulfonylureas. Patients should be aware of symptoms of low blood sugar, such as dizziness, sweating, confusion, or a fast heartbeat. Always contact a healthcare provider if any severe or persistent side effects are experienced.