semaglutide
updated
Semaglutide lowers appetite and helps control blood sugar. It’s the active ingredient in Ozempic, Wegovy and Rybelsus.
GLP-1 receptor agonist
- Prescription medicine
- Weekly injection or daily tablet
How much weight do people lose?
In STEP 1, people taking semaglutide lost an average of 14.9% of their starting weight in 68 weeks, compared with 2.4% on placebo. Both groups received help with diet and physical activity.
- Semaglutide
- 14.9%
- Placebo
- 2.4%
The trial included 1,961 adults with overweight or obesity who did not have diabetes. It tested a weekly injection, gradually increased to 2.4 mg.
STEP 1 · weight-loss trial
Randomized, double-blind trial
Wilding JPH et al. New England Journal of Medicine, 2021.
Average weight loss was 14.9% with semaglutide and 2.4% with placebo at 68 weeks.
- Participants / model
- 1,961 adults with overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo, with lifestyle support in both groups
- Follow-up
- 68 weeks
- Study design
- Randomized, double-blind, placebo-controlled trial
- Funding
- Novo Nordisk
The responder percentages use participants with weight data at week 68.
Read the original sourceWill I lose that much?
Results varied. About half of the semaglutide group with a week-68 weight measurement lost at least 15% of their starting weight.
| Weight lost | Semaglutide | Placebo |
|---|---|---|
| At least 5% | 86.4% | 31.5% |
| At least 10% | 69.1% | 12.0% |
| At least 15% | 50.5% | 4.9% |
Among the 1,212 semaglutide and 577 placebo participants with weight data at week 68.
STEP 1 · weight-loss trial
Randomized, double-blind trial
Wilding JPH et al. New England Journal of Medicine, 2021.
Average weight loss was 14.9% with semaglutide and 2.4% with placebo at 68 weeks.
- Participants / model
- 1,961 adults with overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo, with lifestyle support in both groups
- Follow-up
- 68 weeks
- Study design
- Randomized, double-blind, placebo-controlled trial
- Funding
- Novo Nordisk
The responder percentages use participants with weight data at week 68.
Read the original sourceHow quickly does it work?
In STEP 1, average weight was already lower at the first follow-up measurement, week 4. The group average continued falling and reached its lowest point at week 60. The study tracked weight at scheduled visits; it did not measure the first day people noticed less hunger.
STEP 1 · weight-loss trial
Randomized, double-blind trial
Wilding JPH et al. New England Journal of Medicine, 2021.
Average weight loss was 14.9% with semaglutide and 2.4% with placebo at 68 weeks.
- Participants / model
- 1,961 adults with overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo, with lifestyle support in both groups
- Follow-up
- 68 weeks
- Study design
- Randomized, double-blind, placebo-controlled trial
- Funding
- Novo Nordisk
The responder percentages use participants with weight data at week 68.
Read the original sourceHave Chinese and other East Asian patients been studied?
Yes. STEP 7 enrolled a predominantly East Asian population and found an average 12.1% weight reduction at 44 weeks, versus 3.6% with placebo. It included people with and without type 2 diabetes. These are separate trial results, not a reason to predict weight loss from ethnicity alone.
STEP 7 · East Asian weight-management trial
Randomized placebo-controlled trial
Mu et al. Lancet Diabetes & Endocrinology, 2024. PMID 38330988.
Mean weight change was −12.1% with semaglutide versus −3.6% with placebo at 44 weeks. Gastrointestinal events occurred in 67% versus 36%.
- Participants / model
- 375 adults with overweight or obesity, with or without type 2 diabetes.
- Treatment
- Weekly subcutaneous semaglutide 2.4 mg or placebo, plus lifestyle intervention.
- Follow-up
- 44 weeks
- Study design
- Double-blind trial at sites in China, Hong Kong, Brazil and South Korea.
- Funding
- Novo Nordisk
STEP 7 enrolled a predominantly East Asian population and followed participants for 44 weeks, so its result is separate from STEP 1.
Read the original sourceWhat side effects should I expect?
Nausea, diarrhea, vomiting, constipation and stomach pain are the most common. They tend to appear when treatment starts or the dose increases.
| Side effect | Semaglutide | Placebo |
|---|---|---|
| Nausea | 44% | 16% |
| Diarrhea | 30% | 16% |
| Vomiting | 24% | 6% |
| Constipation | 24% | 11% |
| Stomach pain | 20% | 10% |
Wegovy 2.4 mg weekly injection: pooled adult weight-loss trials, 2,116 people on treatment and 1,261 on placebo. These are not rates for every semaglutide product or dose.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceDo the stomach side effects go away?
They often ease after the dose stabilizes. In a pooled analysis of STEP 1–3, most stomach and bowel events were mild or moderate. Constipation often lasted longer than nausea, vomiting or diarrhea.
Contact your prescriber if symptoms persist or make it hard to eat and drink. The Wegovy label allows a delay in dose increases when a dose is not tolerated.
STEP 1–3 · stomach and bowel side effects
Pooled analysis of randomized trials
Wharton S et al. Diabetes, Obesity and Metabolism, 2022.
Most stomach and bowel events were mild or moderate and occurred during or shortly after dose increases. Weight loss also occurred in people who did not report these side effects.
- Participants / model
- Pooled STEP 1, STEP 2 and STEP 3 participants
- Treatment
- Semaglutide 2.4 mg weekly or placebo
- Study design
- Post hoc analysis of adverse events and weight change
This analysis used the STEP trials, so its participants overlap with those studies.
Read the original sourceWegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhat can help with nausea or constipation?
- Nausea: try smaller meals, plain foods such as toast or rice, and less fatty food. Avoid lying down soon after eating.
- Constipation: fluids, fruit, vegetables and whole grains can help. Regular movement, including walking, may help too.
If you have been told to restrict fluids because of heart or kidney disease, ask your care team how to manage hydration.
NHS · managing side effects
NHS patient guidance
Guy’s and St Thomas’ NHS Foundation Trust. Reviewed August 2025.
- Nausea: smaller meals, plain foods and less fatty food can help. Avoid lying down after eating.
- Constipation: try more fibre, regular fluids and movement such as walking.
- Contact your care team: repeated vomiting, difficulty keeping fluids down, dark urine or lightheadedness can signal dehydration.
Do I need to feel sick for it to work?
No. In the pooled STEP trials, people lost weight whether or not they reported stomach and bowel side effects. Nausea is not a measure of how well treatment is working.
STEP 1–3 · stomach and bowel side effects
Pooled analysis of randomized trials
Wharton S et al. Diabetes, Obesity and Metabolism, 2022.
Most stomach and bowel events were mild or moderate and occurred during or shortly after dose increases. Weight loss also occurred in people who did not report these side effects.
- Participants / model
- Pooled STEP 1, STEP 2 and STEP 3 participants
- Treatment
- Semaglutide 2.4 mg weekly or placebo
- Study design
- Post hoc analysis of adverse events and weight change
This analysis used the STEP trials, so its participants overlap with those studies.
Read the original sourceCan it cause gallbladder, kidney or eye problems?
- Gallbladder: pain in the upper abdomen, fever or yellow skin or eyes needs prompt medical attention. Gallstones and gallbladder inflammation are listed risks.
- Kidneys: vomiting or diarrhea can cause dehydration and acute kidney injury. This is different from the kidney benefits studied in people with type 2 diabetes and chronic kidney disease.
- Eyes: diabetic retinopathy can worsen, particularly when blood sugar improves quickly. Tell your prescriber about existing eye disease and report changes in vision.
MedlinePlus · symptoms and precautions
Patient medicine reference
MedlinePlus, US National Library of Medicine.
- Common symptoms: nausea, vomiting, diarrhea, constipation, stomach pain and heartburn. Tell your prescriber if they are severe or persist.
- Get urgent help: ongoing severe stomach pain, especially spreading to the back; trouble breathing or swallowing; swelling of the face, tongue or throat.
- Report promptly: reduced urination, changes in vision, or upper abdominal pain with fever or yellow skin or eyes.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhat about fatigue, reflux or hair loss?
These were also reported. In the adult Wegovy 2.4 mg injection trials, fatigue occurred in 11% versus 5% on placebo, reflux in 5% versus 3%, and hair loss in 3% versus 1%. The label associates hair loss with weight reduction.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWho should not take semaglutide?
Do not use it if you or a family member has had medullary thyroid carcinoma, if you have MEN2, or if you have had a serious allergic reaction to semaglutide or its ingredients.
MEN2 is an inherited condition called multiple endocrine neoplasia type 2. The boxed thyroid warning comes from tumors seen in rodents. It is not known whether semaglutide causes these tumors in people.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhich health conditions should I tell my prescriber about?
Tell them about previous pancreatitis, gallbladder disease, diabetic eye disease, kidney problems or serious digestive symptoms. Wegovy is not recommended for severe gastroparesis, a condition in which the stomach empties very slowly.
MedlinePlus · symptoms and precautions
Patient medicine reference
MedlinePlus, US National Library of Medicine.
- Common symptoms: nausea, vomiting, diarrhea, constipation, stomach pain and heartburn. Tell your prescriber if they are severe or persist.
- Get urgent help: ongoing severe stomach pain, especially spreading to the back; trouble breathing or swallowing; swelling of the face, tongue or throat.
- Report promptly: reduced urination, changes in vision, or upper abdominal pain with fever or yellow skin or eyes.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceCan I take it during pregnancy or while trying to conceive?
Semaglutide should not be used for weight loss during pregnancy. The labels advise stopping at least two months before a planned pregnancy because the drug takes time to leave the body.
If you become pregnant, contact your prescriber. People taking Wegovy for MASH need a separate specialist discussion about the benefits and risks of continuing.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceOzempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceWhat about breastfeeding?
The Wegovy label does not recommend breastfeeding while taking its tablets. For the injection, it calls for weighing the need for treatment against possible risks to the baby. Discuss the exact product with your prescriber before starting or resuming it.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceCan I combine it with other medicines?
- Other GLP-1 medicines: Wegovy is not recommended with another semaglutide product or another GLP-1 receptor agonist.
- Insulin or sulfonylureas: the combination can cause low blood sugar. Your prescriber may need to change those doses.
- Medicines taken by mouth: slower stomach emptying can affect absorption. Tell your prescriber and pharmacist everything you take, including levothyroxine.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhat if I have surgery or a procedure with sedation?
Tell the anesthesia team you take semaglutide. Food can remain in the stomach despite fasting, creating a risk of it entering the lungs during anesthesia or deep sedation. The label does not give one stopping interval that fits every procedure. Your team should give you instructions for your situation.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceIs semaglutide an injection or a tablet?
Both forms exist. Approved injections are taken once a week. Approved tablets are taken once a day. Check the brand, form and strength on your prescription before following dose instructions.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceRybelsus and Ozempic tablets · FDA label
US prescribing information · January 2026
FDA prescribing information for Rybelsus and Ozempic tablets.
This label covers Rybelsus and Ozempic tablets for adults with type 2 diabetes, including cardiovascular risk reduction in adults at high risk.
- Rybelsus strengths: 3, 7 and 14 mg.
- Ozempic tablet strengths: 1.5, 4 and 9 mg.
- Switching: these tablets are taken daily, but the two products cannot be substituted milligram for milligram.
- Funding
- Novo Nordisk, manufacturer
The product label provides the specific instructions for switching.
Read the original sourceHow are the injections and tablets taken?
Injections go under the skin of the abdomen, thigh or upper arm. Change the injection site each time. They can be taken with or without food.
Wegovy tablets are taken in the morning on an empty stomach with no more than 4 ounces of water. Swallow the tablet whole and wait at least 30 minutes before eating, drinking or taking other oral medicines.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhy does treatment start at a low dose?
Gradual dose increases reduce stomach and bowel side effects during treatment. If a dose is difficult to tolerate, your prescriber can review the schedule before increasing it.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceOzempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceWhat if I miss a dose?
Ozempic injection: take the missed dose within five days. After that, skip it and take the next dose on your usual day.
Wegovy injection: if the next scheduled dose is more than two days away, take the missed dose as soon as possible. If it is less than two days away, skip it. After two or more consecutive missed doses, contact your prescriber about restarting the dose escalation.
Wegovy tablets: skip the missed tablet and take the next one the following day. Do not take an extra tablet to make up for it.
Ozempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceWegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceWhat does the research say about microdosing?
STEP 1 tested gradual increases to 2.4 mg once a week. It did not test community microdosing schedules or show that much smaller doses produce the same weight loss.
STEP 1 · weight-loss trial
Randomized, double-blind trial
Wilding JPH et al. New England Journal of Medicine, 2021.
Average weight loss was 14.9% with semaglutide and 2.4% with placebo at 68 weeks.
- Participants / model
- 1,961 adults with overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo, with lifestyle support in both groups
- Follow-up
- 68 weeks
- Study design
- Randomized, double-blind, placebo-controlled trial
- Funding
- Novo Nordisk
The responder percentages use participants with weight data at week 68.
Read the original sourceDo I need to mix a vial with bacteriostatic water?
Approved semaglutide injection products are ready to use. Instructions for mixing a research vial are not instructions for an approved Ozempic or Wegovy product.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceOzempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceWhat happens when I stop?
Weight regain was common after treatment ended. In the STEP 1 extension, people regained about two-thirds of the weight they had lost over the following year. The diet and activity support provided by the trial ended too.
This follow-up included 327 people from STEP 1. It did not test whether tapering, a lower maintenance dose or continued lifestyle support would prevent regain.
STEP 1 extension · after stopping
Exploratory post-treatment follow-up
Wilding JPH et al. Diabetes, Obesity and Metabolism, 2022.
Participants regained about two-thirds of their earlier weight loss in the year after treatment ended.
- Participants / model
- 327 participants
- Treatment
- Follow-up after semaglutide and lifestyle support stopped
- Follow-up
- 1 year off treatment
- Study design
- Subset of the original STEP 1 trial
The study did not test tapering or different maintenance treatments.
Read the original sourceDid another trial test continuing versus stopping?
Yes. In STEP 4, participants first received semaglutide for 20 weeks. The 803 people who reached randomization then either continued treatment or switched to placebo.
Over the next 48 weeks, the continuation group lost another 7.9% from their week-20 weight on average. The group switched to placebo gained 6.9%. This is a separate study from the STEP 1 extension.
STEP 4 · continuing versus stopping
Randomized withdrawal trial
Rubino D et al. JAMA, 2021.
From week 20 to week 68, mean weight changed by -7.9% with continued semaglutide and +6.9% after switching to placebo.
- Participants / model
- 803 randomized adults
- Treatment
- A 20-week semaglutide run-in followed by continued 2.4 mg weekly or placebo
- Follow-up
- 48-week randomized period
- Study design
- Participants completed a run-in first
Only people who completed the run-in and reached randomization entered this comparison.
Read the original sourceDoes it cause muscle loss?
A STEP 1 substudy found decreases in both fat mass and lean mass. Lean mass includes muscle, organs and other non-fat tissue. The results were reported in a conference abstract, which did not include strength tests.
| Measurement | Change from baseline |
|---|---|
| Total fat mass | 19.3% lower |
| Lean mass | 9.7% lower |
Exploratory DXA analysis of 140 STEP 1 participants, reported at 68 weeks in a conference abstract.
The 9.7% figure is the change in lean mass from its starting amount. It does not mean that 9.7% of the weight lost was muscle.
STEP 1 · body-composition substudy
Exploratory substudy
Wilding JPH et al. Exploratory STEP 1 DXA analysis, 2021.
Fat mass fell 19.3% and lean mass fell 9.7% from baseline in the semaglutide group.
- Participants / model
- 140 participants
- Treatment
- Semaglutide 2.4 mg weekly; measurements at 68 weeks
- Follow-up
- 68 weeks
- Study design
- DXA body-composition measurements
DXA lean mass is not a direct measurement of skeletal muscle or strength. These participants were also part of STEP 1.
Read the original sourceDid the study measure strength or physical performance?
No. These DXA measurements describe body composition. They do not tell us how much strength someone gained or lost, and lean mass is not a direct measurement of skeletal muscle.
STEP 1 · body-composition substudy
Exploratory substudy
Wilding JPH et al. Exploratory STEP 1 DXA analysis, 2021.
Fat mass fell 19.3% and lean mass fell 9.7% from baseline in the semaglutide group.
- Participants / model
- 140 participants
- Treatment
- Semaglutide 2.4 mg weekly; measurements at 68 weeks
- Follow-up
- 68 weeks
- Study design
- DXA body-composition measurements
DXA lean mass is not a direct measurement of skeletal muscle or strength. These participants were also part of STEP 1.
Read the original sourceHow much does semaglutide lower blood sugar?
In SUSTAIN China, semaglutide lowered HbA1c more than sitagliptin in adults whose type 2 diabetes was not adequately controlled with metformin.
| Study treatment | Reduction in percentage points |
|---|---|
| Semaglutide 0.5 mg weekly | 1.4 |
| Semaglutide 1.0 mg weekly | 1.7 |
| Sitagliptin 100 mg daily | 0.9 |
Average starting HbA1c was 8.1%. All groups continued metformin.
SUSTAIN China · glucose control on metformin
Randomized active-comparator trial
Ji et al. Diabetes, Obesity and Metabolism, 2021. PMID 33074557.
Both semaglutide doses lowered HbA1c and weight more than sitagliptin. The primary endpoint was HbA1c change.
- Participants / model
- 868 adults with type 2 diabetes inadequately controlled on metformin; 605 enrolled in mainland China, Hong Kong or Taiwan.
- Follow-up
- 30 weeks
- Study design
- Double-blind, double-dummy, multiregional randomized trial.
- Funding
- Novo Nordisk
The displayed estimates describe the whole trial, using on-treatment data without rescue medication.
Read the original sourceHbA1c reflects average blood glucose over the preceding months. These results concern diabetes treatment, not a target for someone with normal blood sugar.
Ozempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceDoes it reduce heart attacks and strokes?
In SELECT, heart attack, stroke or cardiovascular death occurred in 6.5% of people taking semaglutide and 8.0% taking placebo over an average of 39.8 months.
All 17,604 participants already had cardiovascular disease and overweight or obesity. They did not have diabetes. The trial tested a 2.4 mg weekly injection.
SELECT · cardiovascular trial
Randomized cardiovascular outcomes trial
Lincoff AM et al. New England Journal of Medicine, 2023.
Heart attack, stroke or cardiovascular death occurred in 6.5% with semaglutide and 8.0% with placebo.
- Participants / model
- 17,604 adults with established cardiovascular disease and overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo
- Follow-up
- 39.8 months mean follow-up
- Study design
- Randomized, double-blind, placebo-controlled outcomes trial
- Funding
- Novo Nordisk
All participants already had cardiovascular disease. The trial did not test prevention in otherwise healthy adults.
Read the original sourceWhat does “20% lower risk” mean?
The reported hazard ratio was 0.80, a relative comparison over follow-up. The difference between the observed event rates was 1.5 percentage points: 8.0% minus 6.5%.
SELECT does not tell us whether a healthy person without cardiovascular disease would get the same benefit.
What did the kidney and liver trials find?
Semaglutide has been studied in people with type 2 diabetes and chronic kidney disease, and in people with MASH, a form of fatty liver disease involving inflammation and liver damage.
Kidney disease: FLOW
In FLOW, the main outcome occurred in 18.7% of people taking semaglutide and 23.2% taking placebo over a median 3.4 years. It combined kidney failure, a drop of at least 50% in eGFR, or death from kidney-related or cardiovascular causes. eGFR is a measure of how well the kidneys filter blood.
The trial enrolled 3,533 adults who had both type 2 diabetes and chronic kidney disease. It tested a 1.0 mg weekly injection.
FLOW · kidney-outcome trial
Randomized outcomes trial
Perkovic V et al. New England Journal of Medicine, 2024.
Primary events occurred in 331 of 1,767 people on semaglutide and 410 of 1,766 on placebo. The hazard ratio was 0.76.
- Participants / model
- 3,533 adults with type 2 diabetes and chronic kidney disease
- Treatment
- Semaglutide 1.0 mg injected weekly or placebo
- Follow-up
- Median follow-up 3.4 years
- Study design
- Randomized, placebo-controlled outcomes trial
- Funding
- Novo Nordisk
Participants had both type 2 diabetes and chronic kidney disease.
Read the original sourceLiver disease: ESSENCE
ESSENCE enrolled 1,197 people with biopsy-confirmed MASH and moderate to advanced scarring, called F2 or F3 fibrosis. The planned 72-week interim analysis covered the first 800 participants.
| Outcome | Semaglutide | Placebo |
|---|---|---|
| MASH resolved without worse scarring | 62.9% | 34.3% |
| Scarring improved without worse MASH | 36.8% | 22.4% |
These are biopsy findings. The interim analysis does not yet tell us the long-term effect on liver failure or death.
ESSENCE · MASH trial
Planned interim analysis
Sanyal AJ et al. New England Journal of Medicine, 2025.
MASH resolved without worse fibrosis in 62.9% versus 34.3%. Fibrosis improved without worse MASH in 36.8% versus 22.4%.
- Participants / model
- 800 participants with MASH and F2 or F3 fibrosis in the planned interim analysis
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo
- Follow-up
- 72-week interim analysis
- Study design
- Planned interim analysis of a randomized phase 3 trial
- Funding
- Novo Nordisk
These are week-72 liver-biopsy outcomes. Longer follow-up is needed for liver failure and mortality outcomes.
Read the original sourceWhat is the difference between Ozempic, Wegovy and Rybelsus?
They contain the same active ingredient, semaglutide. Their forms, strengths and approved uses differ. Some brand names now cover both injections and tablets.
| Product | Form | Approved uses, summarized |
|---|---|---|
| Wegovy | Weekly injection | Weight management; cardiovascular risk reduction; MASH with specified liver scarring. |
| Wegovy | Daily tablet | Adult weight management and cardiovascular risk reduction. |
| Wegovy HD | 7.2 mg weekly injection | Adult weight management under the label’s higher-dose criteria. |
| Ozempic | Weekly injection | Type 2 diabetes; cardiovascular and kidney risk reduction in specified groups. |
| Ozempic | Daily tablet | Type 2 diabetes and cardiovascular risk reduction in specified adults. |
| Rybelsus | Daily tablet | Type 2 diabetes and cardiovascular risk reduction in specified adults. |
Each indication has eligibility requirements. The MASH indication uses accelerated approval.
Wegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceOzempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceRybelsus and Ozempic tablets · FDA label
US prescribing information · January 2026
FDA prescribing information for Rybelsus and Ozempic tablets.
This label covers Rybelsus and Ozempic tablets for adults with type 2 diabetes, including cardiovascular risk reduction in adults at high risk.
- Rybelsus strengths: 3, 7 and 14 mg.
- Ozempic tablet strengths: 1.5, 4 and 9 mg.
- Switching: these tablets are taken daily, but the two products cannot be substituted milligram for milligram.
- Funding
- Novo Nordisk, manufacturer
The product label provides the specific instructions for switching.
Read the original sourceCan I swap tablets and injections at the same dose?
No. Oral and injected milligrams are not equivalent. The label also says that Rybelsus and Ozempic tablets cannot be substituted milligram for milligram. A switch needs the instructions for both the current and the replacement product.
Rybelsus and Ozempic tablets · FDA label
US prescribing information · January 2026
FDA prescribing information for Rybelsus and Ozempic tablets.
This label covers Rybelsus and Ozempic tablets for adults with type 2 diabetes, including cardiovascular risk reduction in adults at high risk.
- Rybelsus strengths: 3, 7 and 14 mg.
- Ozempic tablet strengths: 1.5, 4 and 9 mg.
- Switching: these tablets are taken daily, but the two products cannot be substituted milligram for milligram.
- Funding
- Novo Nordisk, manufacturer
The product label provides the specific instructions for switching.
Read the original sourceHow does semaglutide work?
Semaglutide activates the GLP-1 receptor. It reduces appetite, helps the pancreas release insulin when blood sugar is high, and reduces glucagon, a hormone that raises blood sugar. It also slows stomach emptying.
Ozempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceHow long does it stay in the body?
Injected semaglutide has an elimination half-life of about one week. After the last dose, the drug takes several weeks to leave the body.
Ozempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceDoes it reduce alcohol cravings?
A small trial found lower weekly cravings and fewer drinks on drinking days. Semaglutide is not approved to treat alcohol use disorder.
The nine-week trial randomized 48 adults. It found less alcohol consumed in a laboratory drinking task, using complete data from 25 participants. It did not find a significant reduction in average drinks per calendar day or the number of drinking days.
That small trial is not enough to establish semaglutide as a treatment for alcohol use disorder.
Alcohol use disorder · phase 2 trial
Phase 2 randomized trial
Hendershot CS et al. JAMA Psychiatry, 2025.
Alcohol consumption fell in a laboratory drinking task. Average drinks per calendar day and drinking days did not differ significantly.
- Participants / model
- 48 adults with alcohol use disorder
- Follow-up
- 9 weeks
- Study design
- Phase 2 randomized, placebo-controlled trial
48 adults were randomized; 25 had complete laboratory procedure data. The laboratory test followed the 0.5 mg phase.
Read the original sourceStudies and sources
STEP 1 · weight-loss trial
Randomized, double-blind trial
Wilding JPH et al. New England Journal of Medicine, 2021.
Average weight loss was 14.9% with semaglutide and 2.4% with placebo at 68 weeks.
- Participants / model
- 1,961 adults with overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo, with lifestyle support in both groups
- Follow-up
- 68 weeks
- Study design
- Randomized, double-blind, placebo-controlled trial
- Funding
- Novo Nordisk
The responder percentages use participants with weight data at week 68.
Read the original sourceSELECT · cardiovascular trial
Randomized cardiovascular outcomes trial
Lincoff AM et al. New England Journal of Medicine, 2023.
Heart attack, stroke or cardiovascular death occurred in 6.5% with semaglutide and 8.0% with placebo.
- Participants / model
- 17,604 adults with established cardiovascular disease and overweight or obesity, without diabetes
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo
- Follow-up
- 39.8 months mean follow-up
- Study design
- Randomized, double-blind, placebo-controlled outcomes trial
- Funding
- Novo Nordisk
All participants already had cardiovascular disease. The trial did not test prevention in otherwise healthy adults.
Read the original sourceSTEP 1 extension · after stopping
Exploratory post-treatment follow-up
Wilding JPH et al. Diabetes, Obesity and Metabolism, 2022.
Participants regained about two-thirds of their earlier weight loss in the year after treatment ended.
- Participants / model
- 327 participants
- Treatment
- Follow-up after semaglutide and lifestyle support stopped
- Follow-up
- 1 year off treatment
- Study design
- Subset of the original STEP 1 trial
The study did not test tapering or different maintenance treatments.
Read the original sourceWegovy · FDA prescribing information
US prescribing information · June 2026
FDA prescribing information. Injection and tablet products, including Wegovy HD.
The label covers weekly injections, daily tablets and the 7.2 mg Wegovy HD injection. Approved uses and dose instructions differ by form.
- Common side effects: adult 2.4 mg injection trials reported nausea in 44%, diarrhea in 30%, vomiting in 24%, constipation in 24% and stomach pain in 20%.
- Do not use: personal or family history of medullary thyroid carcinoma, MEN2, or a serious allergy to semaglutide or its ingredients.
- Other warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury, diabetic retinopathy and aspiration during anesthesia or deep sedation.
- Funding
- Novo Nordisk, manufacturer
The side-effect percentages here apply to the adult 2.4 mg injection trials.
Read the original sourceOzempic injection · FDA label
US prescribing information · October 2025
FDA prescribing information for Ozempic injection.
Ozempic injection is used for type 2 diabetes. Its cardiovascular and kidney indications apply to specified groups with type 2 diabetes.
- Schedule: inject once a week. Gradual dose increases help with gastrointestinal tolerability.
- Missed dose: take it within five days; after that, skip it and resume the usual schedule.
- Mechanism: it activates GLP-1 receptors. Its elimination half-life is about one week.
- Funding
- Novo Nordisk, manufacturer
This is the injection label. Ozempic tablets have separate instructions.
Read the original sourceRybelsus and Ozempic tablets · FDA label
US prescribing information · January 2026
FDA prescribing information for Rybelsus and Ozempic tablets.
This label covers Rybelsus and Ozempic tablets for adults with type 2 diabetes, including cardiovascular risk reduction in adults at high risk.
- Rybelsus strengths: 3, 7 and 14 mg.
- Ozempic tablet strengths: 1.5, 4 and 9 mg.
- Switching: these tablets are taken daily, but the two products cannot be substituted milligram for milligram.
- Funding
- Novo Nordisk, manufacturer
The product label provides the specific instructions for switching.
Read the original sourceMedlinePlus · symptoms and precautions
Patient medicine reference
MedlinePlus, US National Library of Medicine.
- Common symptoms: nausea, vomiting, diarrhea, constipation, stomach pain and heartburn. Tell your prescriber if they are severe or persist.
- Get urgent help: ongoing severe stomach pain, especially spreading to the back; trouble breathing or swallowing; swelling of the face, tongue or throat.
- Report promptly: reduced urination, changes in vision, or upper abdominal pain with fever or yellow skin or eyes.
STEP 4 · continuing versus stopping
Randomized withdrawal trial
Rubino D et al. JAMA, 2021.
From week 20 to week 68, mean weight changed by -7.9% with continued semaglutide and +6.9% after switching to placebo.
- Participants / model
- 803 randomized adults
- Treatment
- A 20-week semaglutide run-in followed by continued 2.4 mg weekly or placebo
- Follow-up
- 48-week randomized period
- Study design
- Participants completed a run-in first
Only people who completed the run-in and reached randomization entered this comparison.
Read the original sourceFLOW · kidney-outcome trial
Randomized outcomes trial
Perkovic V et al. New England Journal of Medicine, 2024.
Primary events occurred in 331 of 1,767 people on semaglutide and 410 of 1,766 on placebo. The hazard ratio was 0.76.
- Participants / model
- 3,533 adults with type 2 diabetes and chronic kidney disease
- Treatment
- Semaglutide 1.0 mg injected weekly or placebo
- Follow-up
- Median follow-up 3.4 years
- Study design
- Randomized, placebo-controlled outcomes trial
- Funding
- Novo Nordisk
Participants had both type 2 diabetes and chronic kidney disease.
Read the original sourceESSENCE · MASH trial
Planned interim analysis
Sanyal AJ et al. New England Journal of Medicine, 2025.
MASH resolved without worse fibrosis in 62.9% versus 34.3%. Fibrosis improved without worse MASH in 36.8% versus 22.4%.
- Participants / model
- 800 participants with MASH and F2 or F3 fibrosis in the planned interim analysis
- Treatment
- Semaglutide 2.4 mg injected weekly or placebo
- Follow-up
- 72-week interim analysis
- Study design
- Planned interim analysis of a randomized phase 3 trial
- Funding
- Novo Nordisk
These are week-72 liver-biopsy outcomes. Longer follow-up is needed for liver failure and mortality outcomes.
Read the original sourceSTEP 1 · body-composition substudy
Exploratory substudy
Wilding JPH et al. Exploratory STEP 1 DXA analysis, 2021.
Fat mass fell 19.3% and lean mass fell 9.7% from baseline in the semaglutide group.
- Participants / model
- 140 participants
- Treatment
- Semaglutide 2.4 mg weekly; measurements at 68 weeks
- Follow-up
- 68 weeks
- Study design
- DXA body-composition measurements
DXA lean mass is not a direct measurement of skeletal muscle or strength. These participants were also part of STEP 1.
Read the original sourceAlcohol use disorder · phase 2 trial
Phase 2 randomized trial
Hendershot CS et al. JAMA Psychiatry, 2025.
Alcohol consumption fell in a laboratory drinking task. Average drinks per calendar day and drinking days did not differ significantly.
- Participants / model
- 48 adults with alcohol use disorder
- Follow-up
- 9 weeks
- Study design
- Phase 2 randomized, placebo-controlled trial
48 adults were randomized; 25 had complete laboratory procedure data. The laboratory test followed the 0.5 mg phase.
Read the original sourceSTEP 1–3 · stomach and bowel side effects
Pooled analysis of randomized trials
Wharton S et al. Diabetes, Obesity and Metabolism, 2022.
Most stomach and bowel events were mild or moderate and occurred during or shortly after dose increases. Weight loss also occurred in people who did not report these side effects.
- Participants / model
- Pooled STEP 1, STEP 2 and STEP 3 participants
- Treatment
- Semaglutide 2.4 mg weekly or placebo
- Study design
- Post hoc analysis of adverse events and weight change
This analysis used the STEP trials, so its participants overlap with those studies.
Read the original sourceNHS · managing side effects
NHS patient guidance
Guy’s and St Thomas’ NHS Foundation Trust. Reviewed August 2025.
- Nausea: smaller meals, plain foods and less fatty food can help. Avoid lying down after eating.
- Constipation: try more fibre, regular fluids and movement such as walking.
- Contact your care team: repeated vomiting, difficulty keeping fluids down, dark urine or lightheadedness can signal dehydration.
STEP 7 · East Asian weight-management trial
Randomized placebo-controlled trial
Mu et al. Lancet Diabetes & Endocrinology, 2024. PMID 38330988.
Mean weight change was −12.1% with semaglutide versus −3.6% with placebo at 44 weeks. Gastrointestinal events occurred in 67% versus 36%.
- Participants / model
- 375 adults with overweight or obesity, with or without type 2 diabetes.
- Treatment
- Weekly subcutaneous semaglutide 2.4 mg or placebo, plus lifestyle intervention.
- Follow-up
- 44 weeks
- Study design
- Double-blind trial at sites in China, Hong Kong, Brazil and South Korea.
- Funding
- Novo Nordisk
STEP 7 enrolled a predominantly East Asian population and followed participants for 44 weeks, so its result is separate from STEP 1.
Read the original sourceSUSTAIN China · glucose control on metformin
Randomized active-comparator trial
Ji et al. Diabetes, Obesity and Metabolism, 2021. PMID 33074557.
Both semaglutide doses lowered HbA1c and weight more than sitagliptin. The primary endpoint was HbA1c change.
- Participants / model
- 868 adults with type 2 diabetes inadequately controlled on metformin; 605 enrolled in mainland China, Hong Kong or Taiwan.
- Follow-up
- 30 weeks
- Study design
- Double-blind, double-dummy, multiregional randomized trial.
- Funding
- Novo Nordisk
The displayed estimates describe the whole trial, using on-treatment data without rescue medication.
Read the original sourceWhy is semaglutide in S tier?
The S tier reflects large randomized trials showing weight-loss, cardiovascular, and kidney benefits in the studied populations, plus positive biopsy outcomes in a planned phase 3 liver-disease interim analysis.
read Semaglutide in the reptides guide, chapter 01: 11 pages, free to read.