Long-acting GLP-1 receptor agonist. Active ingredient in Ozempic (T2D + CV), Wegovy (weight + CV), Rybelsus (oral T2D), and compounded preparations. ~7-day half-life enables weekly subcutaneous dosing. Manufacturer (branded): Novo Nordisk.
Pharmacology
Long-acting GLP-1 receptor agonist. Active ingredient in Ozempic (T2D + CV), Wegovy (weight + CV), Rybelsus (oral T2D), and compounded preparations. ~7-day half-life enables weekly subcutaneous dosing. Manufacturer (branded): Novo Nordisk.
FDA-approved indications
- Type 2 diabetes (Ozempic, Rybelsus) — 2017
- CV risk reduction in T2D + CVD (Ozempic) — 2020
- Chronic weight management (Wegovy) — 2021
- CV event reduction in BMI ≥27 + established CVD without diabetes (Wegovy) — March 2024 (first weight-management drug ever approved for CV outcome)
- Pediatric obesity 12+ (Wegovy)
Standard dosing
| Indication | Starting | Titration | Maintenance |
|---|---|---|---|
| T2D (Ozempic) | 0.25 mg/wk × 4 wk | 0.5 → 1.0 → 2.0 mg | 0.5–2.0 mg weekly |
| Weight (Wegovy) | 0.25 mg/wk × 4 wk | 0.5 → 1.0 → 1.7 → 2.4 mg | 2.4 mg weekly |
Side effects
- Common (>10%): nausea, diarrhea, constipation, abdominal pain (dose- and titration-dependent)
- Rare: pancreatitis, gallbladder disease, severe GI events
- Boxed warning: MTC and MEN-2 contraindications
Compounded availability
Compounded semaglutide contains the same active ingredient as branded. Prepared by licensed 503A pharmacies (patient-specific) or 503B outsourcing facilities (regulatory status changed April 2026 — see April 2026 FDA action analysis). Compounded preparations are not FDA-approved as finished products. Cash-pay pricing $145–$215/mo via providers like NexLife.
See also
· Research bibliography · Drug interactions · Where to get it (compounded)