Semaglutide is the “generic name” for Ozempic, Rybelsus, and Wegovy. Ozempic and Rybelsus are FDA-approved to treat type-2 diabetes, and Wegovy is FDA-approved for long-term weight management. Since the FDA-approved Wegovy in 2021 for adults with overweight or obesity, there has been a lot of online conversation about these three drugs. The demand for Wegovy has been so high that there are shortages.

GLP-1 agonists are in the drug class called incretin mimetics. Incretins are hormones released by the gastrointestinal tract that stimulate the pancreas to produce more insulin and lower blood sugar. Since type 2 diabetes is characterized by elevated blood sugar due to an inability to use insulin effectively, it makes sense to use a GLP-1 agonist to stimulate increased insulin release.

GLP-1s also act on the brain to regulate appetite and reduce hunger, an effect that can cause weight loss. In addition, GLP-1 agonists, such as semaglutide, also bind to receptors on the stomach lining, slowing stomach emptying. This makes you feel full longer, also contributing to weight loss. But it causes the gastrointestinal side-effects associated with GLP-1 agonists.

Semaglutide injection comes as a solution (liquid). It is usually injected once a week without regard to meals.

Use semaglutide injection on the same day each week at any time of day. You may change the day of the week that you use semaglutide as long as it has been 2 or more days (48 or more hours) since you used your last dose.

Follow the directions on your prescription label carefully, and ask your doctor or provider to explain any part you do not understand. Use semaglutide injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of semaglutide injection and increase your dose after 4 weeks. Your doctor may increase your dose again after another 4 weeks based on your body’s response to the medication. Semaglutide injection helps to control diabetes and weight loss, but it is not a cure.

Continue to use semaglutide injection even if you feel well. Do not stop using semaglutide injection without talking to your doctor. Carefully read the manufacturer’s instructions for use that comes with the medication. These instructions describe how to inject a dose of semaglutide injection. Be sure to ask your pharmacist or doctor if you have any questions about how to inject this medication. Always look at the semaglutide solution before you inject it. It should be clear, colorless, and free of particles.

Do not use semaglutide if it is colored, cloudy, thickened, or contains solid particles, or if the expiration date on the bottle has passed. Never reuse needles and never share needles or pens. Always remove the needle right after you inject your dose. Dispose of needles in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture resistant container. You can inject semaglutide in your upper arm, thigh, or stomach area. Change (rotate) the injection site with each injection. You can inject semaglutide and insulin in the same body area, but you should not give the injections right next to each other. Allow the pen to warm to room temperature before injecting if the pen was stored in the refrigerator.

Before taking semaglutide injection,

• Tell your doctor and pharmacist if you are allergic to semaglutide, albiglutide (Tanzeum; no longer available in the US), dulaglutide (Trulicity), exenatide (Bydureon, Byetta), liraglutide (Saxenda, Victoza), lixisenatide (Adlyxin, in Soliqua), any other medications, or any of the ingredients in semaglutide injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. It is especially important to tell your doctor about all the medications you take by mouth because semaglutide may change the way your body absorbs these medications. Also be sure to mention insulin and sulfonylureas such as chlorpropamide (Diabinese, Glucamide), glimepiride (Amaryl, in Duetact), glipizide (Glucotrol), glyburide (DiaBeta, Glynase), tolazamide, and tolbutamide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• Tell your doctor if you have or have ever had pancreatitis (inflammation of the pancreas), diabetic retinopathy (damage to the eyes caused by diabetes), or kidney disease. Also tell your doctor if you have recently had diarrhea, nausea, or vomiting or if you cannot drink liquids by mouth, which may cause dehydration (loss of a large amount of body fluids).
• Tell your doctor if you plan to become pregnant. Your doctor may tell you to stop using semaglutide injection for 2 months before a planned pregnancy.
• Tell your doctor if you are pregnant or are breastfeeding. If you become pregnant while using semaglutide injection, call your doctor.
• Ask your doctor what to do if there is a large change in your diet, exercise, or weight; or if you get sick, develop an infection or fever, experience unusual stress, or are injured. These changes and conditions can affect your blood sugar and the amount of semaglutide injection you may need.
• You should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are using semaglutide injection for weight loss. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: depression; talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

The most common side effects are gastrointestinal.

Clinical trial participants reported nausea, vomiting, diarrhea, constipation, gas, stomach pain, and heartburn. There was also an increased incidence of gallbladder disease. These side effects are common with all glucagon-like peptide 1 (GLP-1) agonists.