Skip to content
ContentLora

    Tip: press / anywhere to search.

    product

    Semaglutide

    Also known as Ozempic, Wegovy, Rybelsus, Wegovy pill, Wegovy HD, oral semaglutide

    Semaglutide is a long-acting GLP-1 receptor agonist made by Novo Nordisk and sold as Ozempic and Rybelsus for diabetes and as Wegovy for weight management.[1][2] Beyond weight loss, it has trial-backed approvals for cutting cardiovascular, kidney and liver risks. A pill version for weight loss launched in the US in January 2026.[3][4][5][6]

    Editor reviewedStrict sourcingUpdated GLP-1 and metabolic medicineHealth and medicineLife sciences
    Key facts

    Semaglutide is the molecule that turned GLP-1 drugs into a mass-market obesity treatment. Novo Nordisk engineered it from the natural hormone, extending its half-life about two-thousand-fold so that one injection a week is enough.[1] It was approved in the US for type 2 diabetes in 2017 and for weight loss, as Wegovy, in 2021.[1]

    Evidence

    In the STEP 1 trial, weekly semaglutide 2.4 mg produced a mean 14.9% weight loss at 68 weeks, compared with 2.4% on placebo.[7] Its outcome-trial record is the broadest in the class. In SELECT, cardiovascular death, heart attack or stroke fell to 6.5% versus 8.0% on placebo in people without diabetes.[8] In FLOW, it lowered major kidney events by 24% in type 2 diabetes with kidney disease.[9] In ESSENCE, it improved liver histology in MASH.[10] These trials led to FDA approvals in 2024 (cardiovascular), January 2025 (kidney) and August 2025 (MASH, accelerated).[3][4][5] Not every trial was positive: semaglutide did not slow early Alzheimer’s disease in evoke and evoke+.[11]

    In head-to-head comparison, tirzepatide produced more weight loss than semaglutide: 20.2% versus 13.7% at 72 weeks in SURMOUNT-5.[12]

    New forms: pill and higher dose

    On 22 December 2025 the FDA approved the Wegovy pill, once-daily oral semaglutide 25 mg. It was the first oral GLP-1 drug approved for weight management.[13] In OASIS 4 it produced 13.6% mean weight loss at 64 weeks.[14] Novo launched it in the US on 5 January 2026. By mid-July, weekly US prescriptions exceeded 265,000.[6][15] It gained EU approval in July 2026.[16] Unlike Lilly’s orforglipron, it must be taken in the morning at least 30 minutes before food.[17] A 7.2 mg injectable dose, Wegovy HD, received accelerated US approval in March 2026.[18]

    Safety

    Gastrointestinal effects are the most common side effects of the class. In SELECT, 16.6% of semaglutide patients stopped treatment because of adverse events, versus 8.2% on placebo.[19] In 2025 the EMA’s safety committee recommended listing NAION, a form of sudden vision loss, as a very rare side effect affecting up to 1 in 10,000 people.[20]

    Stopping and switching

    Benefits fade when treatment stops. One year after semaglutide and the lifestyle programme were withdrawn in the STEP 1 extension, participants had regained about two-thirds of the weight they had lost.[21] Lilly’s ATTAIN-MAINTAIN trial tested a switch instead: people who had lost weight on semaglutide injections and moved to the orforglipron pill kept an estimated 79.3% of the loss at one year, versus 37.6% with placebo.[22] Between the two pills, a 2026 indirect comparison estimated about 3 percentage points more weight loss with oral semaglutide 25 mg than with orforglipron 36 mg. It was not a head-to-head trial.[23]

    Supply, price and patents

    US shortages of semaglutide injections, which had allowed compounded copies, were declared resolved by the FDA on 21 February 2025.[24] In April 2026 the FDA proposed barring outsourcing facilities from compounding semaglutide from bulk ingredients, with comments due by 29 June 2026.[25] Under a November 2025 White House agreement, Wegovy and Ozempic were offered at $350 a month through TrumpRx, and Medicare’s price was set at $245.[26] Separately, Medicare’s negotiated 30-day price of $274, against a $959 list price, takes effect in 2027.[2] Outside the US, Novo reports that loss of exclusivity in Canada and other markets has lowered realised prices.[27]

    Questions readers ask

    Are Ozempic and Wegovy the same drug?

    Both contain semaglutide. CMS groups Ozempic, Rybelsus and Wegovy together as one drug for Medicare price negotiation.[2]

    How well does the Wegovy pill work compared with the injection?

    In OASIS 4, oral semaglutide 25 mg produced 13.6% mean weight loss at 64 weeks versus 2.2% on placebo. In STEP 1, the 2.4 mg injection produced 14.9% at 68 weeks. These were separate trials, not a head-to-head comparison.[14][7]

    Is generic semaglutide available?

    Novo Nordisk reports that semaglutide has lost exclusivity in Canada and certain other international markets, lowering its realised prices there. In the US, Medicare negotiated prices take effect in 2027.[27][2]

    Does semaglutide help with Alzheimer's disease?

    The phase 3 evoke and evoke+ trials did not show slower Alzheimer's progression.[11]

    Sources

    Each numbered claim is a statement we checked against the sources listed with it. Status shows how well established it is.

    1. [1]

      Novo Nordisk scientists developed liraglutide and then semaglutide, whose half-life was extended about two-thousand-fold, allowing once-weekly injection; semaglutide was approved in the US for diabetes in 2017 and for weight loss in 2021. confirmedas of 2026-10-10

    2. [2]

      Under the Medicare Drug Price Negotiation Program, CMS set a negotiated 30-day price of $274 for Ozempic, Rybelsus and Wegovy, against a 2024 list price of $959, effective 1 January 2027. confirmedas of 2025-11-25

    3. [3]

      On 8 March 2024 the FDA approved Wegovy to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and obesity or overweight, the first weight-loss medicine with such an indication. confirmedas of 2024-03-08

    4. [4]

      On 28 January 2025 the FDA expanded Ozempic's label to reduce kidney and cardiovascular risks in adults with type 2 diabetes and chronic kidney disease. confirmedas of 2025-01-28

    5. [5]

      In August 2025 the FDA granted Wegovy accelerated approval for noncirrhotic MASH with moderate to advanced (F2 to F3) liver fibrosis. confirmedas of 2025-08-15

    6. [6]

      Novo Nordisk launched the Wegovy pill in the US on 5 January 2026. confirmedas of 2026-02-03

    7. [7]

      In the STEP 1 trial, weekly semaglutide 2.4 mg plus lifestyle intervention produced a mean 14.9% weight loss at 68 weeks versus 2.4% with placebo. confirmedas of 2021-02-10

    8. [8]

      In the SELECT trial of 17,604 adults aged 45 or older with cardiovascular disease and overweight or obesity but no diabetes, semaglutide 2.4 mg reduced cardiovascular death, heart attack or stroke to 6.5% versus 8.0% on placebo (hazard ratio 0.80). confirmedas of 2023-11-11

    9. [9]

      In the FLOW trial of 3,533 people with type 2 diabetes and chronic kidney disease, semaglutide lowered the risk of major kidney events or kidney- or cardiovascular-related death by 24% (hazard ratio 0.76); the trial stopped early at a prespecified interim analysis after a median 3.4 years of follow-up. confirmedas of 2024-05-24

    10. [10]

      In part 1 of the ESSENCE trial in people with MASH and moderate or advanced liver fibrosis, steatohepatitis resolved without worsening fibrosis in 62.9% on semaglutide versus 34.3% on placebo at 72 weeks, in a planned interim analysis of the ongoing 240-week trial based on liver histology. confirmedas of 2025-04-30

    11. [11]

      On 24 November 2025 Novo Nordisk reported that the evoke and evoke+ trials in 3,808 adults with early Alzheimer's disease did not show that semaglutide slowed disease progression, although Alzheimer's biomarkers improved. confirmedas of 2025-11-24

    12. [12]

      In the open-label SURMOUNT-5 trial, people with obesity but without diabetes lost a mean 20.2% of body weight on tirzepatide versus 13.7% on semaglutide at 72 weeks. confirmedas of 2025-05-11

    13. [13]

      On 22 December 2025 the FDA approved the Wegovy pill (once-daily oral semaglutide 25 mg), the first oral GLP-1 receptor agonist approved for weight management, including to reduce cardiovascular risk. confirmedas of 2025-12-22

    14. [14]

      In the OASIS 4 trial, once-daily oral semaglutide 25 mg produced a mean 13.6% weight loss at 64 weeks versus 2.2% with placebo; Novo Nordisk reports 16.6% among people who adhered to treatment. confirmedas of 2025-12-22

    15. [15]

      By mid-July 2026, US weekly prescriptions for the Wegovy pill exceeded 265,000, with more than 5 million prescriptions since launch. confirmedas of 2026-08-04

    16. [16]

      The Wegovy pill received a positive CHMP opinion in May 2026 and EU approval in July 2026, and launched in the UK in July 2026. confirmedas of 2026-08-04

    17. [17]

      Foundayo can be taken at any time of day without food or water restrictions, whereas the Wegovy pill must be taken in the morning at least 30 minutes before food or drinks other than water. confirmedas of 2026-04-01

    18. [18]

      The FDA granted accelerated approval to a 7.2 mg dose of injectable semaglutide (Wegovy HD) in March 2026 under the Commissioner's National Priority Voucher pilot, and Novo Nordisk launched it in the US on 7 April 2026. confirmedas of 2026-08-04

    19. [19]

      In SELECT, adverse events led to permanent discontinuation in 16.6% of semaglutide patients versus 8.2% on placebo. confirmedas of 2023-11-11

    20. [20]

      In June 2025 the EMA's safety committee recommended listing NAION, a form of sudden vision loss, as a very rare side effect of semaglutide medicines, affecting up to 1 in 10,000 people. confirmedas of 2025-06-06

    21. [21]

      One year after stopping semaglutide and lifestyle intervention in the STEP 1 extension, participants had regained about two-thirds of their prior weight loss, and most cardiometabolic improvements reverted toward baseline. confirmedas of 2022-05-19

    22. [22]

      In the phase 3b ATTAIN-MAINTAIN trial, people who switched from injectable tirzepatide or semaglutide to daily orforglipron kept an estimated 74.7% and 79.3% of their prior weight loss at 52 weeks, versus 49.2% and 37.6% with placebo. confirmedas of 2026-05-13

    23. [23]

      A 2026 indirect (not head-to-head) comparison using OASIS 4 and ATTAIN-1 data estimated about 3 percentage points more weight loss and fewer adverse-event discontinuations with oral semaglutide 25 mg than with orforglipron 36 mg. confirmedas of 2026-06-01

    24. [24]

      The FDA determined on 21 February 2025 that the US shortage of semaglutide injection products was resolved, ending temporary leeway for compounders to make copies after set grace periods. confirmedas of 2025-02-21

    25. [25]

      On 30 April 2026 the FDA proposed excluding semaglutide, tirzepatide and liraglutide from the 503B bulks list, which would bar outsourcing facilities from compounding them from bulk ingredients; comments were accepted until 29 June 2026. confirmedas of 2026-04-30

    26. [26]

      Under a 6 November 2025 agreement announced by the White House with Eli Lilly and Novo Nordisk, Medicare prices for Ozempic, Wegovy, Mounjaro and Zepbound were set at $245 a month with a $50 monthly copay for beneficiaries, and Ozempic and Wegovy at $350 through the TrumpRx website. confirmedas of 2025-11-06

    27. [27]

      Novo Nordisk reported that loss of exclusivity for semaglutide in Canada and certain other international markets, together with the US most-favoured-nation agreement, lowered its realised prices in 2026. confirmedas of 2026-08-04

    28. [28]

      GLP-1 is a hormone released from gut enteroendocrine cells that augments insulin secretion, inhibits glucagon secretion, slows gastric emptying and reduces food intake. confirmedas of 2026-10-10

    29. [29]

      CagriSema is a fixed-dose combination of cagrilintide 2.4 mg, a long-acting amylin analogue, and semaglutide 2.4 mg. confirmedas of 2026-10-10

    Revision history (2)
    1. Page created.
    2. Refresh: added what happens after stopping semaglutide (STEP 1 extension, ATTAIN-MAINTAIN switch data), the 2026 indirect pill comparison and the FDA's 503B compounding proposal.

    Created Oct 10, 2026. Last reviewed by an editor on Oct 10, 2026. Next scheduled review: Jan 10, 2027.

    Cite this page

    "Semaglutide." ContentLora, updated Oct 10, 2026. https://contentlora.com/wiki/semaglutide

    Spotted an error? Suggest a correction or emailcorrections@contentlora.com.

    Keep exploring

    Connections
    Novo Nordisk Developed byCagriSema Component ofTirzepatide Outperformed in head-to-h…Orforglipron Competing oral GLP-1
    ☰ Contents