At a Glance
Wegovy (semaglutide) is FDA‑approved for chronic weight management in adults and in children 12 years and older with obesity, as an adjunct to reduced-calorie diet and increased physical activity.
This is a brand drug (Wegovy) with no generic or biosimilar.
Active ingredient: Semaglutide.
Administration route: Subcutaneous.
Wegovy is typically started at 0.25 mg once weekly and increased in steps every 4 weeks to a maintenance dose of 1.7 mg or 2.4 mg once weekly by subcutaneous injection.
How It Works
- Wegovy contains semaglutide, which mimics a natural hormone called GLP-1 that helps control appetite and blood sugar.
- It acts on areas of the brain that regulate hunger and fullness, so you feel less hungry and get full sooner.
- It also slows how quickly food leaves your stomach, which helps you stay full longer and can reduce how much you eat over time.
Treatment and Efficacy
Approved indications
- Wegovy is approved for chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol.
- It is also approved for chronic weight management in children 12 years and older with obesity, used along with reduced-calorie diet and increased physical activity.
Off-label uses and evidence
- Semaglutide is studied for reducing cardiovascular risk and for weight management in broader metabolic conditions; however, certain cardiovascular-risk indications currently apply to a different semaglutide product (Ozempic), and prescribers may use Wegovy off-label based on clinical judgment.
- Evidence from large clinical trials shows substantial and sustained weight loss and improvement in cardiometabolic risk factors, so some clinicians may use it off-label in populations not yet fully reflected in labeling.
Efficacy expectations
- Some appetite reduction and early weight change can appear within the first few weeks, but meaningful weight loss typically builds over several months as the dose is increased and maintained.
- In clinical trials, many patients lost around 10–15% or more of their starting body weight over about 1 year when combined with diet and activity changes, and some achieved greater losses.
- Compared with many older weight-loss medicines, Wegovy and other GLP-1–based drugs generally produce larger average weight loss but may have more gastrointestinal side effects and higher cost.
Dosage and Administration
Typical dosing and how to take it
- Wegovy is given as a once-weekly subcutaneous injection in the abdomen, thigh, or upper arm, with or without food, on the same day each week if possible.
- The usual adult and adolescent dose-escalation schedule starts at 0.25 mg once weekly for 4 weeks, then increases every 4 weeks (0.5 mg, 1 mg, 1.7 mg) to a maintenance dose of 1.7 mg or 2.4 mg once weekly, as tolerated.
- Patients use a prefilled, single-patient-use pen and should be trained on injection technique, rotating injection sites each week.
Special dosing instructions
- If gastrointestinal side effects are troublesome when increasing the dose, clinicians may delay dose escalation or maintain a lower dose for longer.
- Do not share pens between people, even if the needle is changed, to avoid infection risk.
Missed dose guidance
- If a dose is missed and the next scheduled dose is more than 2 days (48 hours) away, take the missed dose as soon as possible; otherwise, skip the missed dose and take the next dose on the regular day.
- Do not take an extra dose or increase the amount to make up for a missed injection.
Overdose
- In case of overdose or if too much Wegovy is injected, contact a health care provider, poison control center, or emergency services; symptoms may include severe nausea, vomiting, or low blood sugar, especially if used with other glucose-lowering medicines.
Safety and Side Effects
Common side effects
- Very common effects include nausea, vomiting, diarrhea, constipation, abdominal pain, and decreased appetite; these are most likely when starting treatment or after dose increases and often lessen over time.
- Other common effects can include headache, fatigue, indigestion, belching, and mild injection-site reactions such as redness or soreness.
Serious or rare adverse effects
- Seek urgent medical attention for signs of pancreatitis (severe, persistent abdominal pain that may spread to the back, with or without vomiting), severe allergic reaction (swelling of face or throat, trouble breathing, severe rash), or possible gallbladder disease (upper right abdominal pain, fever, yellowing of skin or eyes, clay-colored stools).
- Wegovy may cause or worsen dehydration from vomiting or diarrhea, which can lead to kidney problems; severe or persistent gastrointestinal symptoms should be reported promptly.
- Like other GLP-1 agonists, there is a warning about thyroid C-cell tumors seen in rodent studies; patients should report neck masses, hoarseness, trouble swallowing, or shortness of breath.
Warnings and precautions
- Wegovy is not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC) or with multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Use in pregnancy is not recommended for weight loss; patients planning pregnancy are typically advised to stop the drug in advance, and breastfeeding risks/benefits should be discussed with a clinician.
- Caution and possible dose adjustments may be needed in people with kidney or liver disease, history of pancreatitis, gallbladder disease, or severe gastrointestinal disease.
Safety compared with similar drugs
- Compared with older stimulant-type weight-loss medicines, Wegovy has less risk of increased heart rate and blood pressure but more gastrointestinal side effects.
- Long-term cardiovascular outcome data for semaglutide are generally favorable in people with type 2 diabetes, but individual risk–benefit assessment remains important.
Side-effect reporting and safety updates
- Patients can report side effects to their health care provider and directly to the FDA MedWatch program, and can check FDA and manufacturer websites for the latest safety communications and prescribing information.
Interactions and Precautions
Drug and supplement interactions
- Because Wegovy slows stomach emptying, it may affect how quickly some oral medicines are absorbed, though major interactions are uncommon; timing and monitoring may be needed for drugs with a narrow therapeutic index.
- When used with other diabetes medications, especially insulin or sulfonylureas, there is an increased risk of low blood sugar, so dose adjustments of those agents may be needed.
- No specific interactions with most common vitamins or supplements are known, but patients should review all products they take with their clinician.
Food, alcohol, and procedure interactions
- Wegovy can be taken with or without food, but very large or high-fat meals may worsen nausea or other gastrointestinal side effects.
- Alcohol can irritate the stomach and affect blood sugar; use should be moderate and discussed with a clinician, especially in people with diabetes or pancreatitis risk.
- Because semaglutide delays gastric emptying, some anesthesia and endoscopy guidelines recommend special fasting or holding instructions before procedures; patients should inform their surgical or anesthesia team that they use Wegovy.
Precautions and monitoring
- Wegovy should not be used in people with a personal or family history of medullary thyroid carcinoma or MEN 2, and caution is advised in those with pancreatitis, gallbladder disease, or severe gastrointestinal disease.
- Periodic monitoring may include weight, blood pressure, blood sugar or A1c (especially in people with diabetes or prediabetes), kidney function if significant vomiting or diarrhea occurs, and evaluation for gallbladder or pancreatic symptoms.
- Patients should also be monitored for mood changes or suicidal thoughts, as with other weight-management therapies.
Common Questions and Answers
Q: How much weight can I expect to lose with Wegovy?
A: Individual results vary, but in clinical studies many people lost around 10–15% or more of their starting body weight over about a year when Wegovy was combined with a reduced-calorie diet and increased physical activity.
Q: How long does it take for Wegovy to start working?
A: Some people notice reduced appetite within days to weeks, but meaningful weight loss usually builds gradually over several months as the dose is increased to the maintenance level.
Q: Do I have to follow a special diet while taking Wegovy?
A: Wegovy is meant to be used along with a reduced-calorie, healthy eating plan and increased physical activity; choosing smaller portions and balanced meals can improve results and may help reduce stomach-related side effects.
Q: Can I stop Wegovy once I reach my goal weight?
A: Many people regain some weight after stopping, so decisions about continuing, reducing, or stopping Wegovy should be made with your health care provider based on your weight, side effects, and overall health goals.
Q: Is Wegovy the same as Ozempic?
A: Both contain semaglutide, but they have different approved uses, dosing, and brand-specific instructions; Ozempic is approved mainly for type 2 diabetes, while Wegovy is specifically approved for chronic weight management.
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Disposal Guidance
Storage
- Store unused Wegovy pens in the refrigerator (36°F to 46°F / 2°C to 8°C); do not freeze, and discard if the pen has been frozen.
- Protect pens from light by keeping the cap on, and avoid storing near heat sources; if needed, a pen in use may generally be kept at room temperature below 86°F (30°C) for a limited time as specified on the package.
- Keep out of reach of children and pets.
Disposal
- Dispose of used pens and needles right after use in an FDA-cleared sharps container; do not throw loose needles or pens in household trash or recycling.
- Follow local or pharmacy guidance for sharps disposal programs or drop-off sites; when the sharps container is nearly full, follow community rules for proper disposal.