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Semaglutide is an anti-diabetic medication used for the treatment of type2 diabetes and an anti-obesity medication used for long-term weight management. It is a peptide similar to the hormone glucagon-like peptide-1 (GLP-1), modified with a side chain. It can be administered by subcutaneous injection or taken orally. It is sold by Novo Nordisk under the brand names Ozempic and Rybelsus for diabetes, and under the brand name Wegovy for weight management, weight loss, and the treatment of metabolic-associated steatohepatitis (nonalcoholic steatohepatitis).
Semaglutide is a glucagon-like peptide-1 receptor agonist. The most common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.
It was approved for medical use in the US in 2017. In 2023, it was the nineteenth most commonly prescribed medication in the United States, with more than 25million prescriptions. It is on the World Health Organization's List of Essential Medicines.
In the US semaglutide (Wegovy) is indicated, in combination with a reduced calorie diet and increased physical activity, to reduce the risk of major adverse cardiovascular events (cardiovascular death, myocardial infarction, or stroke) in adults with established cardiovascular disease and who are either obese or overweight; to reduce excess body weight and maintain weight reduction long term in people aged twelve years of age and older with obesity or adults with overweight in the presence of at least one weight-related comorbid condition. After stopping semaglutide, individuals on average regain about two-thirds (67%) of the weight they lost during treatment within the following year.
In August 2025, the US Food and Drug Administration expanded the indication for semaglutide (Wegovy) to include the treatment of metabolic-associated steatohepatitis (MASH) in adults with moderate to advanced fibrosis (excessive scar tissue in the liver).
In the EU, semaglutide is indicated for the treatment of adults with insufficiently controlled type2 diabetes as an adjunct to diet and exercise as monotherapy when metformin is considered inappropriate due to intolerance or contraindications; in addition to other medicinal products for the treatment of diabetes.
In the EU, semaglutide (Wegovy) is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with obesity (initial body mass index (BMI) ≥ 30kg/m2) or who are overweight (initial BMI ≥ 27kg/m2) and have at least one weight-related comorbidity (e.g. dysglycemia (pre-diabetes or type2 diabetes), hypertension, dyslipidemia, or cardiovascular disease). It is also indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adolescents (aged twelve years of aged and older) with obesity and body weight above .
The US Food and Drug Administration prescription label for semaglutide contains a boxed warning for thyroid C-cell tumors in . It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma, in humans.
A 2025 observational study reported a modest increased risk of a serious eye condition in people with diabetes taking GLP-1 receptor agonists. The analysis found that individuals using these medications had a slightly higher incidence of neovascular age-related macular degeneration (nAMD)—a form of vision loss that can lead to blindness—compared to similar individuals not on the drugs. After one year, 0.2% of GLP-1 users developed nAMD versus 0.1% among non-users. The study, which analyzed health data from nearly 140,000 individuals in Canada, controlled for socioeconomic and health-related factors. The average participant age was 66. Since the risk factors for nAMD overlap with those of people prescribed GLP-1s, such as diabetes and related conditions, researchers investigated this potential link following reports of other eye-related side effects in people on GLP-1 therapies.
Semaglutide's half-life in the blood is about seven days (165–184 hours).
Research continued, and in 1993, Michael Nauck managed to infuse GLP-1 into people with type 2 diabetes, stimulating insulin while inhibiting glucagon and bringing blood glucose to normal levels. However, treating diabetes with GLP-1 hormones resulted in significant side effects, leading researchers financed by Novo Nordisk to start looking to develop a suitable compound for therapeutic use. In 1998, a team of researchers at Novo Nordisk led by the scientist Lotte Bjerre Knudsen developed liraglutide, a glucagon-like peptide-1 receptor agonist that could be used to treat diabetes. This was followed by the development of semaglutide by a team of researchers at Novo Nordisk, including inventors Jesper Lau, Thomas Kruse and Paw Bloch.
The US Food and Drug Administration (FDA) approved semaglutide based on evidence from seven clinical trials of 4087 participants with type2 diabetes. The trials were conducted at 536 sites in 33 countries, including Canada, Mexico, Russia, Ukraine, Turkey, India, South Africa, Japan, Hong Kong, multiple European countries, Argentina, and the United States. In two of these trials (NCT02054897 and NCT02305381), participants were randomly assigned to receive either semaglutide or placebo injection weekly. Neither the participant nor the health care provider knew which treatment was being given until after the trials were completed. Treatment was given for 30 weeks. In the other five trials (NCT01930188, NCT01885208, NCT02128932, NCT02207374, and NCT02254291), participants were randomly assigned to receive either semaglutide or another anti-diabetic medication, and the participant and provider knew which medication was being given in four trials. Treatment was given for 30 weeks or 56 weeks. In each trial, HbA1c was measured from the start of the trial to the end of the trial and compared between the semaglutide group and the other groups.
The FDA also considered data from one separate trial (NCT01720446) of 3297 participants with type2 diabetes who were at high risk for cardiovascular events. This trial was conducted in 20 countries: multiple European countries, Russia, Turkey, Brazil, Israel, Malaysia, Mexico, Thailand, Taiwan, Canada, and the United States. The participants were randomly assigned to receive semaglutide or placebo. Neither the participant nor the health care provider knew which treatment was being given. Treatment was given for 104 weeks (2 years), and the occurrence of cardiovascular events, including heart attacks, strokes, and hospitalization due to unstable angina (near heart attack) were recorded and compared in the two groups of participants.
A 2022 review of anti-obesity treatments found that semaglutide as well as tirzepatide (which has an overlapping mechanism of action) were more promising than previous anti-obesity drugs, although less effective than bariatric surgery.
A version of semaglutide to treat diabetes that can be taken orally ( Rybelsus) was approved for medical use in the United States in September 2019, and in the European Union in April 2020. In January 2023, the US FDA prescription label for Rybelsus was updated to reflect that it can be used as a first-line treatment for adults with type2 diabetes.
In June 2021, a higher-dose version for injectable use, sold under the brand name Wegovy, was approved by the FDA as an anti-obesity medication for long-term weight management in adults. In January 2022, Wegovy was approved for medical use in the European Union.
In the US, Wegovy has a list price of $1,349.02 per month as of 2022, suggesting that because of the Medication costs many people "who could most benefit from weight loss may be unable to afford such expensive drugs". High costs of Ozempic prompted some insurance companies to investigate and refuse to cover individuals with what the companies considered was insufficient evidence to support a diabetes diagnosis, alleging off-label prescribing for weight loss. In 2023, Ozempic, the semaglutide injection used for type 2 diabetes treatment, had list price of one-month supply of $936 in the United States, $169 in Japan, $147 in Canada, $144 in Switzerland, $103 in Germany and the Netherlands, $96 in Sweden, $93 in the United Kingdom, and $87 in Australia, France had the lowest price at $83.
In the UK, semaglutide is available on NHS prescription for diabetes at nominal or no cost to the individual. It is also available for obesity, limited to treatment for two years. In Finland, semaglutide is included in the national price regulation scheme and is available by prescription; however, for people with type 2 diabetes and a BMI over 27, part of the cost is covered by Kela—the Finnish Social Insurance Institution. In Australia, semaglutide is available on the PBS prescription for diabetes at the regular co-payment rates of $31.60, or $7.70 for concession card holders.
High demand caused worldwide supply shortages of semaglutide in 2023; new UK prescriptions were not issued during the shortage. Novo Nordisk revealed in April 2024, that to meet the enormous demand for semaglutide, it was running its production facilities 24 hours a day, 365 days per year; it had budgeted $6 billion in 2024 to expand its crowded and congested facilities; and it had hired over 10,000 new employees in 2023 alone.
Profits from Novo Nordisk generate returns for the Novo Nordisk Foundation, which holds the controlling stake in Novo Nordisk. The profits results in increased Danish tax revenues and employment. Novo Nordisk added 3,500 jobs in Denmark in 2022, bringing the total in the country to 21,000 employees, out of 59,000 worldwide.
The US National Association of Boards of Pharmacy claims that there are tens of thousands of online pharmacies operating out of compliance with state and federal regulations or the association's recommendations. Novo Nordisk has taken action against several compounding pharmacies producing bad versions of the drug, with impurities, the wrong amount of active ingredient, or even no active ingredient. Some compounded versions have been found to contain salts of semaglutide, including the sodium and the acetate in an attempt to avoid the patent of the base semaglutide product. These are not evaluated for safety and effectiveness by the FDA and thus are considered not shown to be safe or effective.
In March 2023, a Novo Nordisk official said, based on a randomized, double-blind study (NCT03548935) funded by the company, that people using semaglutide to lose weight regained two-thirds of their original weight loss one year (52 weeks) after discontinuing use of the drug. After two years (120 weeks), the patients retained roughly one-third of their original weight loss (5.6% of the original 17.3% loss).
In July 2023, the Icelandic Medicines Agency reported two cases of suicidal thoughts and one case of self-injury of users of the injection, prompting a safety assessment of Ozempic, Wegovy, Saxenda, and similar drugs. In January 2024, a preliminary review conducted by the US Food and Drug Administration (FDA) confirmed no evidence had been found to suggest that the medicine causes suicidal thoughts or actions.
In June 2025 EMA has recommended that the product information for semaglutide medicines is updated to include NAION as a side effect with a frequency of 'very rare' while WHO concluded that the Risk Management Plan for semaglutide should be revised to include NAION as a potential risk
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