In-depth entry

Semaglutide

also known as: Ozempic, Wegovy, Rybelsus, NN9535

A once-weekly GLP-1 receptor agonist FDA-approved for type 2 diabetes and chronic weight management.

A synthetic GLP-1 analog with 94% sequence homology to native human GLP-1, engineered for a ~7-day half-life via fatty acid conjugation.

Mechanism of action

Agonist at the GLP-1 receptor. Enhances glucose-dependent insulin secretion, suppresses inappropriate glucagon, slows gastric emptying, and acts centrally to reduce appetite via hypothalamic and area postrema pathways. Weight loss is driven primarily by the central appetite-suppressing effect rather than the peripheral metabolic actions.

Primary uses

Type 2 diabetes mellitus
Chronic weight management (BMI ≥30, or ≥27 with comorbidity)
Cardiovascular risk reduction in T2DM with established CVD (SELECT trial)

Typical dosing

0.25–2.4 mg weekly (subcutaneous (Ozempic/Wegovy); oral daily (Rybelsus))

Titrated over 16–20 weeks to minimize GI side effects. Wegovy maintenance is 2.4 mg weekly; Ozempic diabetes doses are 0.5–2.0 mg weekly.

Regulatory status

FDA-approved as Ozempic (T2DM, 2017), Wegovy (chronic weight management, 2021), and Rybelsus (oral T2DM, 2019). Manufactured by Novo Nordisk.

References

[fda-pi] Ozempic (semaglutide) Prescribing Information. Novo Nordisk.
[fda-pi] Wegovy (semaglutide) Prescribing Information. Novo Nordisk.
[clinical-trial] Wilding JPH, et al. "Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1)." N Engl J Med, 2021;384:989-1002.
[clinical-trial] Lincoff AM, et al. "Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT)." N Engl J Med, 2023;389:2221-2232.

Related peptides

Tirzepatide

A once-weekly GLP-1/GIP dual agonist that produced unprecedented weight loss in SURMOUNT trials — up to ~21% at highest dose.

Retatrutide

An investigational triple hormone agonist that produced ~24% weight loss at 48 weeks in Phase 2 — the largest in any single-agent obesity trial to date.

Liraglutide

The first once-daily GLP-1 analog to be FDA-approved for both type 2 diabetes (Victoza) and chronic weight management (Saxenda).

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.