Semaglutide

Sold as Ozempic, Ozempic tablets, Wegovy, Wegovy HD, Rybelsus and the Wegovy pill

By MoveWell Research Team Updated November 1, 2026

Sequence diagram of semaglutide showing its 31 amino acids and the side chain at Lys26 — Semaglutide molecular structureFull structure and downloads

Evidence5/5FDA-approved

Status nowFDA-approved prescription drug sold as three brands (Ozempic, Wegovy and Rybelsus), as weekly injections and daily tablets. The US shortage ended February 21, 2025, so pharmacies can no longer make routine copies.²⁸

LatestSeptember 18, 2026: FDA told Empower Pharmacy that its semaglutide with added B12 was "essentially copies" of the approved drug.³⁵

NextJanuary 1, 2027: Wegovy's list price falls 50% to $675 a month.¹⁶ FDA has not finalized its plan to keep semaglutide off the 503B bulks list. Full history

Semaglutide is a GLP-1 receptor agonist, the drug inside Ozempic, Wegovy and Rybelsus. It is FDA-approved for type 2 diabetes, weight management, heart risk reduction, kidney disease in type 2 diabetes and a form of fatty liver disease. In the main weight trial, people lost 14.9% of body weight over 68 weeks, vs 2.4% on placebo.²⁰ Nausea and other stomach effects are common.

Products Ozempic Ozempic tablets Wegovy Wegovy HD Rybelsus Wegovy pill

Often compared with tirzepatide, which beat it on weight loss in a head-to-head trial²⁴

In this guide

Status and summary
At a glance
Where to get it
Molecular structure
Brands and approvals
How it works
Evidence map
Pick a goal
Approved vs compounded
Label dosing
Side effects
Compared with
Myths vs evidence
All options and prices
Legal status history
FAQ
References

At a glance

What it is	A modified GLP-1 peptide with a fatty acid chain attached, so it binds albumin and lasts about a week in the body¹
Sold as	Weekly injections (Ozempic, Wegovy, Wegovy HD) and daily tablets (Rybelsus, Ozempic tablets, Wegovy pill)
Approved for	Type 2 diabetes, chronic weight management, heart risk reduction, kidney disease in type 2 diabetes, and noncirrhotic MASH liver disease with F2–F3 fibrosis
Best evidence	Large outcome trials, including SELECT (n=17,604) and FLOW (n=3,533)^{21, 2}
Weight loss in trials	−14.9% at 68 weeks on the 2.4 mg injection;²⁰ −13.6% at 64 weeks on the 25 mg pill¹²
Main risks	Nausea (44% on Wegovy 2.4 mg), diarrhea, vomiting. Boxed warning for thyroid C-cell tumors seen in rodents. Pancreatitis and gallbladder disease¹
Typical cost	$349 a month self-pay for Wegovy (0.25 to 2.4 mg) and Ozempic (0.25 to 1 mg). Ozempic 2 mg is $499. Price announced Nov 2025^{15, 50}

Where to get it

MoveWell sells nothing. All options and prices

Self-pay, brandNovoCare and retail pharmacies

$349 a month for Wegovy up to 2.4 mg and Ozempic up to 1 mg, announced November 17, 2025. Ozempic 2 mg stays $499. You still need a prescription.^{15, 50}

See self-pay pricing

Prescription onlineTelehealth

NovoCare listed seven telehealth services in Jan 2026, including LifeMD, Ro and WeightWatchers.¹⁴ Hims & Hers has offered branded Wegovy and Ozempic since a Mar 2026 deal.⁴⁹

Compare providers

Prescription, insuredYour own doctor

Your clinician can prescribe any of the three brands. Insurance coverage depends on your plan and diagnosis.

Check your coverage

Not listed: compounded copies and "research use only" vials. Why

Molecular structure

A chain of 31 amino acids based on human GLP-1. Three changes set it apart: position 8 resists breakdown by the enzyme DPP-4, Lys26 carries a spacer and a C18 fatty diacid that binds albumin, and position 34 is changed so only one fatty acid attaches.¹

Lys26 and its fatty acid side chain, which binds albumin

Aib8K26R34

Class: GLP-1 receptor agonist
Formula: C187H291N45O59
Weight: 4113.58 g/mol (label)
Half-life: About 1 week
Made by: Yeast fermentation (backbone)
CAS: 910463-68-2
FDA UNII: 53AXN4NNHX
PubChem: 56843331
DrugBank: DB13928 (unconfirmed)

Formula, weight, half-life and the three modifications are from the Wegovy label.¹ FDA's substance registry confirms the CAS, UNII and PubChem IDs and the 31-residue chain.⁵⁴ The DrugBank ID comes from a secondary source and is unconfirmed.⁴ The label confirms the changes at positions 8, 26 and 34 but does not name the residue at 34.

Brands and approvals

Semaglutide is sold as three brands: Ozempic, Wegovy and Rybelsus. Wegovy HD and the Wegovy pill are forms within the Wegovy label. All contain the same molecule. They differ in what they're approved for, how you take them and the dose.

Product	Approved for	Form	Dose range	Approved
Ozempic	Blood sugar in type 2 diabetes; heart risk in type 2 diabetes with heart disease; kidney disease in type 2 diabetes	Weekly injection pen	0.25 to 2 mg	December 5, 2017 (diabetes); January 16, 2020 (heart); March 28, 2022 (2 mg); January 28, 2025 (kidney)^{5, 6}
Ozempic tablets	Blood sugar in type 2 diabetes; heart risk in type 2 diabetes	Daily tablet	1.5 to 9 mg	Early 2026 (FDA announced February 4, 2026)⁴⁸
Wegovy	Chronic weight management; heart risk with overweight or obesity and heart disease; noncirrhotic MASH with F2–F3 fibrosis (accelerated approval); ages 12 and up for weight	Weekly injection pen	0.25 to 2.4 mg	June 4, 2021 (weight); March 8, 2024 (heart); August 15, 2025 (MASH)^{8, 9, 10}
Wegovy HD	Adults who have tolerated 2.4 mg for at least 4 weeks and need more weight loss	Weekly injection	7.2 mg	March 19, 2026¹¹
Rybelsus	Blood sugar in type 2 diabetes; heart risk in type 2 diabetes at high heart risk	Daily tablet	3 to 14 mg (R1) or 1.5 to 9 mg (R2)	September 20, 2019 (diabetes); October 17, 2025 (heart)^{7, 12, 3}
Wegovy pill	Weight reduction and maintenance; heart risk with overweight or obesity and heart disease	Daily tablet	1.5 to 25 mg	December 22, 2025; on sale January 5, 2026^{12, 14}

The MASH date is Novo Nordisk's announcement date.

How it works

Semaglutide activates the GLP-1 receptor.³⁶ Its structural changes keep it in the body far longer than a plain peptide:

Position 8. Modified so the enzyme DPP-4 can't cut it.¹
Fatty acid side chain. Binds albumin in the blood, which gives a half-life of about a week. The drug stays in circulation for about 5 to 7 weeks after the last dose.¹
Tablets. Only a small share of an oral dose is absorbed. The label puts it at about 1–2% for the tablets, vs 89% for an injection.¹ The tablets come with strict rules about food and water (see label dosing).

Evidence map

Each use is graded separately. Most are FDA-approved indications backed by large trials.

Weight management

FDA-approved: STEP 1 (n=1,961), OASIS 4 (n=307), STEP UP (n=1,407)

Type 2 diabetes

FDA-approved: Ozempic since 2017, Rybelsus since 2019

Heart attack and stroke risk

FDA-approved: SELECT (n=17,604), SUSTAIN-6 (n=3,297), SOUL (n=9,650)

Kidney disease in type 2 diabetes

FDA-approved: FLOW (n=3,533)

MASH liver disease

FDA-approved under accelerated approval: ESSENCE Part 1 (n=800)

Heart failure (HFpEF) with obesity

Strong human: STEP-HFpEF (n=529). Not an approved indication in our sources

Scale: 5 FDA-approved, 4 strong human, 3 limited human, 2 animal or lab only, 1 anecdotal

Key studies

Use	Study	Model	Finding
Weight	STEP 1²⁰	Human RCT n=1,961	−14.9% vs −2.4% at 68 weeks. 50.5% vs 4.9% lost at least 15%
Weight	OASIS 4^{58, 13}	Human RCT n=307	25 mg pill: −13.6% vs −2.2% at 64 weeks; −16.6% vs −2.7% in those who stayed on treatment
Weight	STEP UP^{56, 11}	Human RCT n=1,407	7.2 mg: −18.7% vs −3.9% on placebo at 72 weeks. Company figure: 89% vs 38% lost at least 5%
Weight	SURMOUNT-5²⁴	Human RCT n=751	Head-to-head: tirzepatide −20.2% vs semaglutide −13.7% at 72 weeks
Heart	SELECT^{21, 1}	Human RCT n=17,604	Heart attack, stroke or heart death 6.5% vs 8.0% (HR 0.80) in people with overweight or obesity and heart disease, without diabetes
Heart	SUSTAIN-6²	Human RCT n=3,297	Major heart events HR 0.74 in type 2 diabetes
Heart	SOUL³	Human RCT n=9,650	Rybelsus: major heart events HR 0.86 in type 2 diabetes
Kidney	FLOW^{2, 6}	Human RCT n=3,533	Kidney decline, kidney failure or death HR 0.76 (24% lower risk)
Heart failure	STEP-HFpEF²²	Human RCT n=529	Symptom score +16.6 vs +8.7 points; weight −13.3% vs −2.6%; walk test +21.5 m vs +1.2 m at 52 weeks
Liver	ESSENCE Part 1^{23, 10}	Human RCT n=800	MASH resolved without worse scarring in 62.9% vs 34.3%; fibrosis improved in 36.8% vs 22.4% at 72 weeks
Muscle	BELIEVE²⁵	Human RCT n=507	Semaglutide alone: −15.7% weight and −7.4% lean mass at 72 weeks; about 76% of the loss was fat

STEP 1 results come from a published abstract of the trial.²⁰

Pick a goal

Pick your goal to see which approved product fits and what the evidence shows.

Approved vs compounded

During the shortage, pharmacies could legally make copies of semaglutide. FDA declared the shortage over on February 21, 2025. Compounding pharmacies had until April 22, 2025, and outsourcing facilities until May 22, 2025, to stop.²⁸ On August 27, 2026, the Fifth Circuit upheld FDA's shortage decisions for semaglutide and tirzepatide (No. 25-10758, semaglutide; No. 25-10600, tirzepatide; unpublished).^{29, 55, 62}

	FDA-approved brand	Compounded	"Research use only"
FDA review	Safety, effectiveness and quality reviewed	None before sale³⁰	None
Status now	Prescription drug	Routine copies no longer allowed since the shortage ended²⁸	Sold without a prescription
Form	Prefilled pens or tablets	Often multidose vials, measured by syringe³⁶	Varies; no labeled dose you can trust³⁷
Known problems	Label side effects	Dosing errors of 5 to 20 times the intended dose (5 to 10 times when providers miscalculated)⁵¹; salt forms; added vitamins³⁶	Tested samples 7–14% pure, more drug than labeled, endotoxin in one³⁷

Compounded is not generic

FDA says "Compounded drugs are not FDA-approved" and "are also not the same as generic drugs, which are FDA-approved."³⁰ A generic has passed FDA review showing it matches the original. A compounded product has had no review of safety, effectiveness or quality before sale. On March 3, 2026, FDA warned 30 telehealth companies about claims such as "Generic Zepbound" and "Contains the active pharmaceutical ingredient in Wegovy."^{30, 31}

Some compounders use salt forms such as semaglutide sodium, which is not the approved molecule and hasn't been shown safe or effective.^{36, 38} Others add B12. In Sep 2026, FDA said one large pharmacy's B12 versions were "essentially copies" and that the differences looked "pretextual."³⁵

Compounded versions are still widely sold. In secret-shopper calls in West Virginia and Oklahoma in late 2025, 75 of 103 businesses offered compounded GLP-1 drugs, and 92.0% of those offered semaglutide. Of 21 supplier pharmacies with a confirmed license status, 4 had no sterile-compounding license.^{41, 42}

"Research" semaglutide

Vials sold "for research use only" skip the prescription, the pharmacy and every quality check. When researchers bought semaglutide from six such online sellers, purity was 7–14% against the 99% claimed, every sample held more drug than its label said, and one had raised endotoxin levels. Two of the sites had earlier FDA warning letters.³⁷ Red flags include no prescription, a non-US pharmacy, no expiry date, and sublingual or dissolving forms. FDA's BeSafeRx tool lets you check a pharmacy.³⁶

Label dosing

These are the FDA label schedules, for reference. Your prescriber sets your dose. Every product starts low and steps up.

Wegovy injection (weekly)

Weeks	Weekly dose
1–4	0.25 mg
5–8	0.5 mg
9–12	1 mg
13–16	1.7 mg
17 on	2.4 mg maintenance (or 1.7 mg)
Wegovy HD	Up to 7.2 mg, after at least 4 weeks on 2.4 mg

Heart risk and MASH: 2.4 mg, or 1.7 mg if 2.4 mg isn't tolerated. Ages 12 and up: 2.4 or 1.7 mg.¹

Wegovy pill (daily)

Days	Daily dose
1–30	1.5 mg
31–60	4 mg
61–90	9 mg
91 on	25 mg maintenance

Source: Wegovy label.¹

Ozempic (weekly)

When	Weekly dose
Weeks 1–4	0.25 mg
Week 5 on	0.5 mg
After 4+ weeks on 0.5 mg	1 mg (kidney disease maintenance dose)
After 4+ weeks on 1 mg	2 mg (maximum)

Source: Ozempic label.²

Rybelsus (daily)

Step	R1 tablets	R2 tablets
Start	3 mg, days 1–30	1.5 mg
Then	7 mg	4 mg
Optional	14 mg, from day 61	9 mg

R1 and R2 are not interchangeable milligram for milligram. The label pairs 7 mg R1 with 4 mg R2, and 14 mg R1 with 9 mg R2.³

Taking the tablets

Both Rybelsus and the Wegovy pill are taken in the morning on an empty stomach, with no more than 4 oz of plain water. Swallow the tablet whole. Wait at least 30 minutes before eating, drinking or taking other oral medicines.^{1, 3}

Side effects and who should avoid it

Boxed warningSemaglutide caused thyroid C-cell tumors in rodents. Whether it causes them in people, including medullary thyroid cancer (MTC), is unknown.^{1, 2}

Don't use ifYou or a family member has had MTC, or you have MEN 2.¹

Label warnings

The Wegovy label (May 2026) lists: thyroid C-cell tumors, acute pancreatitis, acute gallbladder disease, low blood sugar, kidney injury from dehydration, severe stomach and bowel reactions, allergic reactions, diabetic eye complications in type 2 diabetes, faster heart rate, and inhaling stomach contents under anesthesia or deep sedation.¹ Ozempic carries the same core warnings, plus "Never share an Ozempic pen."²

In Jan 2026, the warning on suicidal behavior and ideation was removed from the Wegovy label.¹

Common side effects

Reactions in at least 5% of people on Wegovy 2.4 mg, compared with placebo.¹

Reaction	Wegovy 2.4 mg	Placebo
Nausea	44%	16%
Diarrhea	30%	16%
Vomiting	24%	6%
Constipation	24%	11%
Abdominal pain	20%	10%
Headache	14%	10%
Fatigue	11%	5%
Indigestion	9%	3%
Dizziness	8%	4%
Bloating	7%	5%
Belching	7%	<1%
Low blood sugar (type 2 diabetes)	6%	2%
Gas	6%	4%
Gastroenteritis	6%	4%
Reflux (GERD)	5%	3%

The Wegovy pill's most common side effects are nausea, diarrhea and vomiting, similar to the injection.¹²

Other things to know

Sudden vision loss (NAION). In Jun 2025, the EMA's safety committee concluded that NAION, a type of optic nerve damage, is a very rare side effect of Ozempic, Rybelsus and Wegovy, affecting up to 1 in 10,000 people. Large studies in type 2 diabetes found roughly double the risk, about 1 extra case per 10,000 person-years. It advised stopping semaglutide if NAION is confirmed.²⁶ NAION is not on the current US labels for Wegovy, Ozempic or Rybelsus.^{1, 2, 3} If your vision changes suddenly, contact your doctor.
"Ozempic face." Fast weight loss shrinks the fat pads in the face, which can hollow the cheeks and temples and deepen folds. A dermatology practice describes these changes as a normal response to weight loss, not something unique to GLP-1 drugs; speed makes them more noticeable.²⁷ That source is a clinic webpage, not a study.
Muscle. Not all weight lost is fat. In BELIEVE, semaglutide alone lowered lean mass 7.4% over 72 weeks; about 76% of the weight lost was fat.²⁵

Compared with

	Semaglutide	Tirzepatide	Retatrutide	Liraglutide
Status	FDA-approved	Shortage declared over; ruling upheld Aug 2026²⁹	In trials, not FDA-approved; filing planned Q1 2027^{43, 44}	—
Targets	GLP-1	—	GIP, GLP-1 and glucagon⁴³	—
Taken	Weekly injection or daily tablet	—	Weekly injection⁴³	—
Weight loss	−14.9% at 68 weeks (STEP 1)²⁰	−20.2% vs −13.7% for semaglutide at 72 weeks (SURMOUNT-5)²⁴	−25.0% on 12 mg vs −3.9% on placebo at 80 weeks (TRIUMPH-1, NEJM)⁵⁹; −18.8% vs −5.1% with type 2 diabetes (TRIUMPH-2, Lancet)⁶⁰	—
Stopped for stomach side effects	5.6% (SURMOUNT-5)	2.7% (SURMOUNT-5)²⁴	—	—
Compounding	FDA proposed keeping it off the 503B bulks list³²	Same proposal³²	No lawful compounding path⁴⁵	Same proposal³²

A dash means our sources don't cover it yet. Only SURMOUNT-5 compared drugs directly; other numbers come from different trials and can't be compared one to one. On October 28, 2026, Lilly reported by press release that retatrutide 12 mg beat Ozempic 2 mg in type 2 diabetes (TRANSCEND-T2D-2): weight −20.9% vs −9.4% over 80 weeks, counting people who stayed on treatment. It has not been peer reviewed, and Ozempic 2 mg is a diabetes dose, not Wegovy's weight dose.⁶¹

Myths vs evidence

ClaimCompounded semaglutide is generic Ozempic

EvidenceFDA says compounded drugs are not FDA-approved and "not the same as generic drugs."³⁰ Some use salt forms or untested additives.³⁶ Vials have led to people injecting 5 to 20 times the intended dose.⁵¹

ClaimAdding B12 makes it a different, legal product

EvidenceFDA called semaglutide plus B12 "essentially copies" and the differences "pretextual."³⁵

ClaimResearch-grade semaglutide is the same thing, just cheaper

EvidenceTested samples were 7–14% pure, held more drug than labeled, and one had endotoxin.³⁷

ClaimYou only lose fat

EvidenceIn BELIEVE, lean mass fell 7.4%. About 76% of the weight lost was fat, not all of it.²⁵

ClaimThe pill is a weaker, different drug

EvidenceSame molecule. The 25 mg pill gave −13.6% weight change at 64 weeks in OASIS 4.¹² Only a small share of a tablet is absorbed.¹

ClaimIt's a peptide, so it's natural and safe

EvidenceIt carries a boxed warning and label warnings for pancreatitis and gallbladder disease, and nausea affects 44% of people on Wegovy 2.4 mg.¹

ClaimOzempic face is a drug side effect

EvidenceIt is facial fat loss from losing weight fast. One dermatology practice says it isn't unique to GLP-1 drugs.²⁷

All options and prices

MoveWell sells nothing. Providers are listed alphabetically. Prices are dated because they change often

Brand self-pay prices

Product	Price	Where	Date
Wegovy injection, 0.25 to 2.4 mg	$349 a month	Self-pay, about 70,000 retail pharmacies	Announced November 17, 2025^{15, 50}
Ozempic, 0.25 to 1 mg	$349 a month	Self-pay, about 70,000 retail pharmacies	Announced November 17, 2025^{15, 50}
Ozempic, 2 mg	$499 a month	Self-pay	Unchanged November 17, 2025⁵⁰
Wegovy HD, 7.2 mg	Price unconfirmed	Self-pay	—
Wegovy injection	$499 a month, all doses	NovoCare Pharmacy, filled by CenterWell	March 5, 2025; since lowered⁵³
Wegovy pill, 1.5 mg	$149 a month	Self-pay	At launch, January 5, 2026⁵²
Wegovy pill, 4 mg	$149 a month until April 15, 2026, then $199	Self-pay	At launch, January 5, 2026⁵²
Wegovy pill, 9 mg and 25 mg	$299 a month	Self-pay	At launch, January 5, 2026⁵²
Wegovy pill	From $149, by strength	TrumpRx	Site launched February 5, 2026⁵⁷

Novo Nordisk will cut Wegovy's list price 50% to $675 a month and Ozempic's by 35% from January 1, 2027. Rybelsus and the Wegovy pill are also included. Self-pay prices don't change.^{16, 17} Today's list prices are unconfirmed; one report says brand GLP-1 drugs can cost over $1,000 a month.³⁶

Telehealth

In Jan 2026, NovoCare linked to these services. Novo Nordisk said it "does not endorse" them.¹⁴ We haven't confirmed the current list.

Provider	Listed by NovoCare	Link
9amHealth	Jan 2026	Visit
eMed	Jan 2026	Visit
Form Health	Jan 2026	Visit
Hims & Hers	No; Novo Nordisk deal March 9, 2026⁴⁹	Visit
Knownwell	Jan 2026	Visit
LifeMD	Jan 2026; also a 2025 partner¹⁸	Visit
Ro	Jan 2026; also a 2025 partner¹⁸	Visit
WeightWatchers	Jan 2026; also a 2025 partner¹⁸	Visit

Hims & Hers was not on NovoCare's Jan 2026 list. In Feb 2026, Hims launched and then withdrew a compounded semaglutide pill.¹⁹ On March 9, 2026, Novo Nordisk signed a deal for Hims & Hers to offer branded Wegovy injection, the Wegovy pill and Ozempic, and Hims stopped selling compounded semaglutide.⁴⁹

Your own doctor and insurance

Any licensed prescriber can write a prescription for the approved products, and you can fill it at a retail pharmacy. Whether your plan covers it depends on the plan and on your diagnosis, such as type 2 diabetes, heart disease or obesity. Ask your plan which products it covers and whether it needs prior authorization.

Compounded and research semaglutide

We don't list sellers. The shortage that allowed routine compounding ended in Feb 2025, and "research use only" products have shown low purity and wrong doses. Details

Legal status history

Current status first, then newest to oldest.

Current statusNov 1, 2026FDA-approved as three brands (Ozempic, Wegovy and Rybelsus). Routine compounding of copies ended with the shortage in 2025. FDA's proposal to keep semaglutide off the 503B bulks list has no final action yet.^{32, 33}
Next · Jan 1, 2027Lower list prices take effect for Wegovy, Ozempic, Rybelsus and the Wegovy pill.^{16, 17}
Sep 18, 2026FDA warning letter to Empower Pharmacy calls its semaglutide with B12 "essentially copies."³⁵
Aug 27, 2026Fifth Circuit upholds FDA's shortage-resolution decisions for semaglutide and tirzepatide (No. 25-10758, semaglutide; No. 25-10600, tirzepatide; unpublished).^{29, 55, 62}
Jun 26, 2026Comment period on the 503B proposal extended to Jul 30, 2026.³⁴
Jun 2026FDA sends 25 more letters to telehealth companies over compounded GLP-1 claims.⁴⁰
Apr 30, 2026FDA proposes not adding semaglutide, tirzepatide or liraglutide to the 503B bulks list. It does not change 503A rules.^{32, 33}
Mar 19, 2026Wegovy HD 7.2 mg approved.¹¹
Mar 9, 2026Novo Nordisk signs a deal for Hims & Hers to offer branded Wegovy, the Wegovy pill and Ozempic. Hims stops selling compounded semaglutide.⁴⁹
Mar 3, 2026FDA warns 30 telehealth companies about claims that compounded drugs are the same as approved ones.³⁰
Feb 24–25, 2026Novo Nordisk announces list-price cuts, effective 2027.¹⁶
Feb 5–9, 2026Hims & Hers launches a compounded semaglutide pill. FDA promises "decisive steps," HHS refers Hims to the Justice Department, Hims withdraws the pill, and Novo Nordisk sues.¹⁹
Feb 4, 2026FDA approval of Ozempic tablets (1.5, 4 and 9 mg) announced, for blood sugar and heart risk in type 2 diabetes.⁴⁸
Jan 2026Suicidal behavior and ideation warning removed from the Wegovy label.¹ The Wegovy pill goes on sale Jan 5.¹⁴
Dec 22, 2025Wegovy pill approved, the first oral GLP-1 for weight management.^{12, 13}
Dec 2025Novo Nordisk files for FDA approval of CagriSema (cagrilintide plus semaglutide).^{46, 47}
Nov 17, 2025Self-pay price for Wegovy (up to 2.4 mg) and Ozempic (up to 1 mg) cut to $349 a month. Ozempic 2 mg stays $499.^{15, 50}
Oct 17, 2025Rybelsus approved to lower heart risk in type 2 diabetes.^{12, 3}
Sep 2025First wave of FDA and HHS warning letters on compounded GLP-1 marketing, including to Hims & Hers.^{38, 39}
Aug 15, 2025Wegovy approved for noncirrhotic MASH with F2–F3 fibrosis (accelerated approval).¹⁰
Jun 6, 2025EMA safety committee concludes NAION is a very rare side effect.²⁶
May 22, 2025Grace period ends for outsourcing facilities (503B). Pharmacies (503A) had until Apr 22.²⁸
Feb 21, 2025FDA declares the semaglutide shortage resolved.²⁸
Jan 28, 2025Ozempic approved for kidney disease in type 2 diabetes.⁶
Mar 8, 2024Wegovy approved to lower heart risk.⁹
Mar 28, 2022Ozempic 2 mg approved.⁵
Jun 4, 2021Wegovy approved for chronic weight management.⁸
Jan 16, 2020Ozempic approved to lower heart risk in type 2 diabetes.⁵
Sep 20, 2019Rybelsus approved, the first oral GLP-1.⁷
Dec 5, 2017Ozempic approved for type 2 diabetes.⁵

FAQ

Is Wegovy the same drug as Ozempic?

Yes, both are semaglutide. Wegovy is approved for weight and heart risk at doses up to 2.4 mg (7.2 mg for Wegovy HD). Ozempic is approved for type 2 diabetes at doses up to 2 mg, and also comes as a daily tablet.

How much weight do people lose?

In STEP 1, the 2.4 mg injection gave 14.9% average loss over 68 weeks, vs 2.4% on placebo. The 25 mg pill gave 13.6% in OASIS 4. Results vary widely between people.

Is compounded semaglutide legal now?

Routine copies aren't. The shortage ended in Feb 2025, and the Fifth Circuit upheld that decision in Aug 2026. FDA has since sent warning letters to telehealth firms and pharmacies, including over B12 versions.

Is there a generic?

Not in the US. Compounded versions are not generics.

How long does it stay in the body?

The half-life is about a week. Semaglutide stays in circulation for about 5 to 7 weeks after the last dose, per the label.

Can I switch between Rybelsus tablets?

Not milligram for milligram. The R1 and R2 tablets are dosed differently: 7 mg R1 matches 4 mg R2, and 14 mg R1 matches 9 mg R2. Ask your prescriber.

Does it cause vision loss?

Europe's regulator lists NAION, a sudden optic nerve problem, as a very rare side effect, up to 1 in 10,000 people. It isn't on the current US labels. Contact your doctor if your vision changes suddenly.

Will I lose muscle?

Some. In BELIEVE, about 76% of the weight lost on semaglutide alone was fat, and lean mass fell 7.4%.

Is the suicide warning still on the label?

Not on Wegovy. The suicidal behavior and ideation warning was removed from the Wegovy label in Jan 2026.

Is semaglutide a peptide?

Yes. It's a 31-amino-acid peptide based on human GLP-1, with a fatty acid chain attached.

References

62 sources, with links

FDA. Wegovy (semaglutide) injection and tablets, prescribing information, revised 05/2026. PDF
FDA. Ozempic (semaglutide) injection, prescribing information, revised 05/2026. PDF
FDA. Rybelsus (semaglutide) tablets, prescribing information, revised 10/2025. PDF
Wikipedia. Semaglutide (infobox identifiers; secondary source). Link
Drugs.com. Ozempic FDA approval history. Link
HCPLive. FDA approves semaglutide (Ozempic) for type 2 diabetes and chronic kidney disease (Jan 28, 2025). Link
HealthDay. First oral GLP-1 treatment receives FDA approval for T2DM (Sep 20, 2019). Link
BioSpace (FDA release). FDA approves new drug treatment for chronic weight management, first since 2014 (Jun 4, 2021). Link
BioSpace (FDA release). FDA approves first treatment to reduce risk of serious heart problems specifically in adults with obesity or overweight (Mar 8, 2024). Link
HCPLive. FDA approves semaglutide (Wegovy) injection 2.4 mg for noncirrhotic MASH (Aug 15, 2025). Link
HCPLive. FDA approves higher-dose semaglutide (Wegovy HD) injection 7.2 mg for obesity (Mar 19, 2026). Link
HCPLive. FDA approves semaglutide (Wegovy) pill as first oral GLP-1 for weight loss. Link
Becker's Hospital Review. FDA approves Wegovy pill as 1st oral GLP-1 for weight loss (Dec 23, 2025). Link
STAT. Telehealth swoops in offering Wegovy pill (Jan 6, 2026). Link
ABC7. Cash price of popular weight-loss drug Wegovy dropping, manufacturer says (Nov 17, 2025). Link
FOX 9. Novo Nordisk to slash list prices of Ozempic, Wegovy up to 50% (Feb 25, 2026). Link
News Tribune (AP). Novo Nordisk to halve US list price of Wegovy (Mar 3, 2026). Link
MobiHealthNews. Novo Nordisk partners with WeightWatchers after Hims & Hers fallout. Link
Polsinelli. FDA threatens escalating enforcement on GLP-1 compounding (Feb 9, 2026). Link
STEP 1 abstract. J Endocr Soc 2021;5(Suppl 1):A10. PMC8089593
American College of Cardiology. SELECT trial summary (Lincoff, NEJM 2023;389:2221–32). Link
American College of Cardiology. STEP-HFpEF trial summary (Kosiborod, NEJM 2023;389:1069–84). Link
Healio. Semaglutide tied to significant improvements in MASH, liver fibrosis at 72 weeks (ESSENCE; May 1, 2025). Link
American College of Cardiology journal scan. SURMOUNT-5 (Aronne, NEJM 2025;393:26–36; Jul 10, 2025). Link
Pharmacy Times. Bimagrumab–semaglutide combination achieves significant weight loss while preserving muscle mass (BELIEVE; Mar 12, 2026). Link
European Medicines Agency. PRAC concludes eye condition NAION is a very rare side effect of semaglutide medicines Ozempic, Rybelsus and Wegovy (Jun 6, 2025). Link
Forefront Dermatology. Fixing Ozempic face: addressing facial volume loss the healthy way (undated practice webpage). Link
Foley & Lardner. GLP-1 drugs: FDA removes semaglutide from drug shortage list (Feb 2025). Link
Clark Hill. Fifth Circuit upholds FDA GLP-1 shortage decisions. Link
FDA. FDA warns 30 telehealth companies against illegal marketing of compounded GLP-1s (Mar 3, 2026). fda.gov
Foley & Lardner. GLP-1 compliance: FDA targets telehealth marketing in 30 new warning letters (Mar 12, 2026). Link
Epstein Becker Green. FDA proposal would leave semaglutide, tirzepatide and liraglutide off 503B bulks list. Link
Drug Topics. FDA proposes to exclude GLP-1s from 503B bulk list (May 13, 2026). Link
Federal Register. Comment period extension (Jun 26, 2026). govinfo.gov
Frier Levitt. FDA warning letter on compounded GLP-1 products (Sep 25, 2026). Link
Medical Daily. Compounded GLP-1 salt forms and B12 additives: safety (2026). Link
Drugs.com / HealthDay. Semaglutide products being sold online without prescriptions (on Ashraf et al., JAMA Netw Open 2024). Link
Venable. FDA's latest GLP-1 crackdown: what compounders need to know (Mar 2026). Link
Holland & Knight. FDA, HHS taking action against telehealth's compounded drug advertising (Sep 29, 2025). Link
Reuters via KFGO. US FDA sends 25 letters to telehealth companies over claims on compounded weight-loss drugs (Jun 16, 2026). Link
Drug Topics. New study finds compounded GLP-1s remain robust despite end of shortages (Jul 20, 2026; on DiStefano et al., JAMA Health Forum 2026;7(7):e262207). Link
Becker's Hospital Review. GLP-1 compounders find loophole in FDA crackdown, study suggests (Jul 20, 2026). Link
Drugs.com. Retatrutide FDA approval history. Link
Ground News. Eli Lilly says it will file for approval of next-generation obesity drug in 2027. Link
Arizona Board of Osteopathic Examiners. FDA letter regarding retatrutide. Link
PharmExec. Novo Nordisk submits NDA to FDA for CagriSema. Link
Drugs.com. CagriSema approval history. Link
BNN Bloomberg. Novo to launch Ozempic pill for diabetes in second quarter of 2026 (Feb 4, 2026). Link
PharmExec. Novo Nordisk signs deal with Hims & Hers (Mar 9, 2026). Link
Fierce Pharma. Novo unveils newly reduced self-pay prices for Wegovy, Ozempic after White House deal (Nov 2025). Link
FDA. FDA alerts health care providers, compounders and patients of dosing errors associated with compounded semaglutide (Jul 26, 2024). fda.gov
KVIA (CNN Health). Starter dose of Wegovy now available as a daily pill instead of weekly injection (Jan 5, 2026). Link
Drug Topics. Novo Nordisk to provide cash options for Wegovy through online pharmacy (Mar 5, 2025). Link
FDA Global Substance Registration System. Semaglutide, UNII 53AXN4NNHX. precision.fda.gov
US Court of Appeals for the Fifth Circuit. No. 25-10600 (tirzepatide), unpublished opinion (Aug 27, 2026). PDF
News-Medical. Higher-dose semaglutide helps people lose nearly 19% of body weight (STEP UP; Wharton, Lancet Diabetes Endocrinol 2025; Sep 16, 2025). Link
Pharmaceutical Technology. TrumpRx launches to slash drug prices for cash-paying US patients (Feb 2026). Link
AJMC. FDA approves oral semaglutide as first GLP-1 pill for weight loss (OASIS 4). Link
Jastreboff AM, Kaplan LM, Davies MJ et al. Retatrutide, a triple hormone receptor agonist, for treatment of obesity (TRIUMPH-1). NEJM, published online Sep 29, 2026. doi:10.1056/NEJMoa2604169. Summary: GPnotebook
Bellido V, le Roux CW, Ekinci EI et al. Retatrutide in adults with obesity and type 2 diabetes (TRIUMPH-2). Lancet, published online Sep 29, 2026. doi:10.1016/S0140-6736(26)01861-1. Summary: Cardioteca
Eli Lilly press release. TRANSCEND-T2D-2: retatrutide vs Ozempic 2 mg, topline results (Oct 28, 2026). Not peer reviewed. Link
US Court of Appeals for the Fifth Circuit. No. 25-10758 (semaglutide), unpublished opinion (Aug 27, 2026; revised Sep 1, 2026). PDF

This page is for education and is not medical advice. Semaglutide is a prescription drug. Talk to a clinician before starting, stopping or changing any dose.