How to use?

Semaglutide is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm. Do not mix insulin and Semaglutide together in the same injection.

For Weight Management

Indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of ≥30 kg/m2 (obesity) or ≥27 kg/m2 (overweight) in the presence of at least 1 weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, dyslipidemia)

Initiate with low dose and gradually escalate to maintenance dose of 2.4 mg/week SC to minimize GI adverse reactions

If unable to tolerate a dose during escalation, consider delaying dose escalation for 4 weeks

If unable to tolerate maintenance dose of 2.4 mg once-weekly, may temporarily decreased to 1.7 mg once weekly, for a maximum of 4 weeks; after 4 weeks, increase back to maintenance 2.4 mg once-weekly; discontinue if not tolerated after second attempt

In patients with type 2 diabetes, monitor blood glucose before initiating and during treatment

Once weekly SC dose escalation schedule

Weeks 1-4: 0.25 mg

Weeks 5-8: 0.5 mg

Weeks 9-12: 1 mg

Week 13-16: 1.7 mg

Week 17 and onward: 2.4 mg (maintenance)

You should know this:

Semaglutide should not be used in combination with other peptides-containing products, other GLP-1 receptor agonists, or other products intended for weight loss, including prescription drugs, over-the-counter drugs, or herbal products. Wegovy has not been studied in patients with a history of pancreatitis.

Semaglutide’s safety and efficacy were studied in four 68-week trials. Three were randomized, double-blind, placebo-controlled trials (including 16 weeks of dose increases) and one was a double-blind, placebo-controlled, randomized withdrawal trial in which patients receiving Wegovy either continued with the treatment or switched to a placebo. More than 2,600 patients received semaglutide for up to 68 weeks in these four studies and more than 1,500 patients received placebo.

The largest placebo-controlled trial enrolled adults without diabetes. The average age at the start of the trial was 46 years and 74% of patients were female. The average body weight was 231 pounds (105 kg) and average BMI was 38 kg/m2. Individuals who received Wegovy lost an average of 12.4% of their initial body weight compared to individuals who received placebo. Another trial enrolled adults with type 2 diabetes. The average age was 55 years and 51% were female. The average body weight was 220 pounds (100 kg) and average BMI was 36 kg/m2. In this trial, individuals who received  semaglutide lost 6.2% of their initial body weight compared to those who received placebo.

Semaglutide should not be used in patients with a history of severe allergic reactions to semaglutide or any of the other components of peptides. Patients should stop Semaglutide immediately and seek medical help if a severe allergic reaction is suspected. Semaglutide also contains warnings for inflammation of the pancreas (pancreatitis), gallbladder problems (including gallstones), low blood sugar, acute kidney injury, diabetic retinopathy (damage to the eye's retina), increased heart rate and suicidal behavior or thinking. Patients should discuss with their healthcare professional if they have symptoms of pancreatitis or gallstones. If Wegovy is used with insulin or a substance that causes insulin secretion, patients should speak to their health care provider about potentially lowering the dose of insulin or the insulin-inducing drug to reduce the risk of low blood sugar. Healthcare providers should monitor patients with kidney disease, diabetic retinopathy and depression or suicidal behaviors or thoughts.

The FDA granted the approval to Novo Nordisk. Semaglutide 1 mg injection (Ozempic) was first approved as a treatment for type 2 diabetes in 2017.

Obesity is a chronic disease and global public health challenge.1-3 Obesity can lead to insulin resistance, hypertension, and dyslipidemia,4 is associated with complications such as type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease,2,5 and reduces life expectancy.6 More recently, obesity has been linked to increased numbers of hospitalizations, the need for mechanical ventilation, and death in persons with coronavirus disease 2019 (Covid-19).7,8

Although lifestyle intervention (diet and exercise) represents the cornerstone of weight management,1,2 sustaining weight loss over the long term is challenging.9 Clinical guidelines suggest adjunctive pharmacotherapy, particularly for adults with a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 30 or greater, or 27 or greater in persons with coexisting conditions.1,2,10 However, the use of available medications remains limited by modest efficacy, safety concerns, and cost.3

Semaglutide is a glucagon-like peptide-1 (GLP-1) analogue that is approved, at doses up to 1 mg administered subcutaneously once weekly, for the treatment of type 2 diabetes in adults and for reducing the risk of cardiovascular events in persons with type 2 diabetes and cardiovascular disease.11 Semaglutide induced weight loss in persons with type 2 diabetes and in adults with obesity who were participants in a phase 2 trial,12-14 findings that supported further investigation. The global phase 3 Semaglutide Treatment Effect in People with Obesity (STEP) program aims to evaluate the efficacy and safety of semaglutide administered subcutaneously at a dose of 2.4 mg once weekly in persons with overweight or obesity, with or without weight-related complications.

Once-Weekly Semaglutide in Adults with Overweight or Obesity | NEJM this article had explained how it works and the test result.