Semaglutide is an anti-diabetic medication used for the treatment of type 2 diabetes, and an anti-obesity medication used for weight management. It can be administered by subcutaneous injection or taken orally. It is sold as a generic drug by several drug companies in the Indian and Canadian markets, and worldwide by its originator, Novo Nordisk, under the brand names Ozempic and Rybelsus for diabetes; under the brand name Wegovy for weight management; and under the brand names Wegovy and Kayshild for the treatment of metabolic-associated steatohepatitis (nonalcoholic steatohepatitis) and liver cirrhosis. Wegovy is also used to reduce the risk of heart attacks. Semaglutide is a peptide similar to the hormone glucagon-like peptide-1 (GLP-1), modified with a side chain, and acts as a GLP-1 receptor agonist. The most common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation. Semaglutide was approved for medical use in the United States in 2017, in Canada, the European Union and Japan in 2018, and in Australia in 2019. In 2023, it was the nineteenth most commonly prescribed medication in the United States, with more than 25 million prescriptions. It is on the World Health Organization's List of Essential Medicines.
Medical uses
European Union In the European Union, semaglutide is indicated for the treatment of adults with insufficiently controlled type 2 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. Semaglutide (as Wegovy) is further 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 BMI ≥ 30 kg/m2) or who are overweight (initial BMI ≥ 27 kg/m2) and have at least one weight-related comorbidity such as dysglycemia (prediabetes or type 2 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 and older) with obesity and body weight above 60 kg (130 lb). Semaglutide (as Kayshild) is indicated in conjunction with diet and exercise for the treatment of adults with non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with moderate or advanced liver fibrosis (stage F2 or F3).
United States In the United States, semaglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes, and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. In combination with a reduced-calorie diet and increased physical activity, semaglutide (as Wegovy) is indicated to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal 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 obese individuals twelve years of age or older, or for overweight adults with at least one weight-related comorbid condition. In August 2025, the Food and Drug Administration (FDA) expanded the indication for semaglutide (as Wegovy) to include the treatment of noncirrhotic metabolic-associated steatohepatitis (MASH), formerly known as nonalcoholic steatohepatitis (NASH), with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis) in adults. In October 2025, the FDA further expanded the indication for semaglutide (as Rybelsus) to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes who are at high risk for these events. In December 2025, the FDA approved an oral version of semaglutide for weight management, using the same brand name (Wegovy) as the injectable version.
Contraindications Semaglutide is contraindicated in people with a personal or family history of medullary thyroid carcinoma or in people with multiple endocrine neoplasia type 2.
Adverse effects and safety profile Semaglutide can cause a variety of side effects.
Gastrointestinal dynamics The most common side effects include nausea, diarrhea, vomiting, constipation, and abdominal pain. These gastrointestinal effects are dose-dependent and mostly mild-to-moderate in severity. They are highly transient, typically peaking during the initial 8-to-12-week dose-escalation phase before waning over time. The drug delays gastric emptying, which can lead to indigestion, belching, and rarely, gastroparesis or bowel obstruction.
Gallbladder and biliary risk Semaglutide treatment is associated with an increased risk of biliary disease, specifically gallstones (cholelithiasis). While initially thought to be solely a byproduct of rapid weight loss, the exact mechanism may involve reduced gallbladder motility and changes in bile acid composition.
Pancreatic and thyroid safety Historically, GLP-1 receptor agonists have carried warnings regarding acute pancreatitis and pancreatic cancer. However, large-scale cardiovascular outcome trials for semaglutide have not found a statistically significant increase in the incidence of these conditions in humans. The US prescription label contains a boxed warning for thyroid C-cell tumors. This warning is based on rodent studies; rodents possess a high density of GLP-1 receptors in their thyroid C-cells, which leads to hyperplasia and tumors when stimulated. In contrast, human thyroids express these receptors only marginally, making the risk of medullary thyroid carcinoma highly specific to rodents and clinically unlikely in humans. Semaglutide remains contraindicated in individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2.
Microvascular effects (retinopathy) Initial trials noted an increase in complications related to diabetic retinopathy. Subsequent analyses have clarified that this early worsening of pre-existing retinopathy is a secondary effect caused by the rapid and robust drop in blood glucose levels, rather than a direct toxic effect of semaglutide on the eyes.
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