Semaglutide

Also known as

Ozempic, Wegovy, Rybelsus

Supplied as

Several forms, depending on the product

Research

Strong human evidence

US status

US status: FDA-approvedchecked Oct 16, 2026

Weight: in STEP 1 (adults with obesity or overweight and no diabetes, 68 weeks), average body weight change was −14.9% on semaglutide 2.4 mg and −2.4% on placebo. In the label’s 72-week trials of the 7.2 mg dose in adults with obesity and no diabetes, it was −18.8% at 7.2 mg, −15.5% at 2.4 mg and −3.9% on placebo. In OASIS 4 (307 adults, 64 weeks), the 25 mg tablet that became Wegovy tablets gave −13.6%, compared with −2.2% on placebo. In STEP TEENS (201 adolescents with obesity, 68 weeks), BMI fell 16.1% on semaglutide and rose 0.6% on placebo. Heart and kidneys: in SELECT (17,604 adults with cardiovascular disease and overweight or obesity but no diabetes), cardiovascular death, heart attack or stroke occurred in 6.5% on semaglutide and 8.0% on placebo (hazard ratio 0.80); the label notes that the effect on cardiovascular death alone was not confirmed and the effect on heart failure is not established. In SUSTAIN-6 (3,297 adults with type 2 diabetes), the same events occurred in 6.6% on Ozempic and 8.9% on placebo (hazard ratio 0.74). In FLOW (3,533 adults with type 2 diabetes and chronic kidney disease, stopped early at a planned interim analysis, median 3.4 years), the risk of a major kidney or cardiovascular event was 24% lower (hazard ratio 0.76); the label adds that the benefit was not evident in people already taking an SGLT2 inhibitor, though there were few events in that group. With tablets, PIONEER 6 (3,183 adults with type 2 diabetes) showed oral semaglutide was not worse than placebo for heart risk (3.8% vs 4.8%), and SOUL (9,650 high-risk adults, 14 mg) found major cardiovascular events in 12.0% vs 13.8% on placebo (hazard ratio 0.86). Liver: in ESSENCE (800 adults with MASH and moderate to advanced fibrosis), at 72 weeks steatohepatitis resolved without worse fibrosis in 62.9% on semaglutide vs 34.3% on placebo, and fibrosis improved without worse steatohepatitis in 36.8% vs 22.4%; the trial continues to 240 weeks to show whether this prevents liver-related events. Novo Nordisk funded all of these trials.

Sources1237141516171819202122

The most common side effects are digestive: nausea, diarrhea, vomiting, constipation and stomach pain, mostly while the dose is being increased. In the Wegovy 2.4 mg weight trials, nausea affected 44% of people (16% on placebo), vomiting 24% (6%) and hair loss 3% (1%), and 6.8% stopped treatment because of side effects (3.2% on placebo). On Ozempic, nausea affected 15.8% at 0.5 mg and 20.3% at 1 mg (6.1% on placebo); on 14 mg tablets, 20% (6% on placebo). Unusual skin sensations such as sensitivity, pain or burning (dysesthesia) rise with the dose: 22% at Wegovy 7.2 mg, 6% at 2.4 mg and 0% on placebo, and 5% on Wegovy tablets; the FDA is investigating this reaction further. Every semaglutide label carries a boxed warning: semaglutide caused thyroid C-cell tumors in rodents, it is unknown whether it does in people, and it must not be used by anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2. Other label warnings include pancreatitis (including fatal cases reported after approval), gallbladder disease, severe stomach and bowel side effects, kidney injury from dehydration, low blood sugar with insulin or drugs that raise insulin release, a faster resting heart rate, serious allergic reactions and aspiration during anesthesia or deep sedation. In people with type 2 diabetes, diabetic eye complications were more frequent on semaglutide in SUSTAIN-6 (hazard ratio 1.76). Pens must never be shared, even with a new needle. The FDA had received 990 adverse event reports for compounded semaglutide as of May 31, 2026, and has reported overdoses from dosing errors, some needing hospital care, when compounded doses were measured in syringe units.

Sources1236121823