Clinical data
Trade namesOzempic, Rybelsus, Wegovy, others
License data
Routes of
Subcutaneous, by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Elimination half-life1 week
Duration of action63.6 h
ExcretionUrine and faeces
CAS Number
PubChem CID
ECHA InfoCard100.219.541 Edit this at Wikidata
Chemical and physical data
Molar mass4113.641 g·mol−1
3D model (JSmol)
  • InChI=1S/C187H291N45O59/c1-18-105(10)154(180(282)208-108(13)159(261)216-133(86-114-89-200-119-50-40-39-49-117(114)119)170(272)218-129(82-102(4)5)171(273)228-152(103(6)7)178(280)215-121(53-44-72-199-186(192)193)162(264)201-91-141(242)209-120(52-43-71-198-185(190)191)161(263)204-94-151(257)258)230-172(274)131(83-111-45-33-31-34-46-111)219-167(269)126(64-69-149(253)254)214-166(268)122(51-41-42-70-195-144(245)98-290-79-78-289-76-74-197-145(246)99-291-80-77-288-75-73-196-139(240)66-61-127(183(285)286)211-140(241)54-37-29-27-25-23-21-19-20-22-24-26-28-30-38-55-146(247)248)212-158(260)107(12)206-157(259)106(11)207-165(267)125(60-65-138(189)239)210-142(243)92-202-163(265)123(62-67-147(249)250)213-168(270)128(81-101(2)3)217-169(271)130(85-113-56-58-116(238)59-57-113)220-175(277)135(95-233)223-177(279)137(97-235)224-179(281)153(104(8)9)229-174(276)134(88-150(255)256)221-176(278)136(96-234)225-182(284)156(110(15)237)231-173(275)132(84-112-47-35-32-36-48-112)222-181(283)155(109(14)236)227-143(244)93-203-164(266)124(63-68-148(251)252)226-184(287)187(16,17)232-160(262)118(188)87-115-90-194-100-205-115/h31-36,39-40,45-50,56-59,89-90,100-110,118,120-137,152-156,200,233-238H,18-30,37-38,41-44,51-55,60-88,91-99,188H2,1-17H3,(H2,189,239)(H,194,205)(H,195,245)(H,196,240)(H,197,246)(H,201,264)(H,202,265)(H,203,266)(H,204,263)(H,206,259)(H,207,267)(H,208,282)(H,209,242)(H,210,243)(H,211,241)(H,212,260)(H,213,270)(H,214,268)(H,215,280)(H,216,261)(H,217,271)(H,218,272)(H,219,269)(H,220,277)(H,221,278)(H,222,283)(H,223,279)(H,224,281)(H,225,284)(H,226,287)(H,227,244)(H,228,273)(H,229,276)(H,230,274)(H,231,275)(H,232,262)(H,247,248)(H,249,250)(H,251,252)(H,253,254)(H,255,256)(H,257,258)(H,285,286)(H4,190,191,198)(H4,192,193,199)/t105-,106-,107-,108-,109+,110+,118-,120-,121-,122-,123-,124-,125-,126-,127+,128-,129-,130-,131-,132-,133-,134-,135-,136-,137-,152-,153-,154-,155-,156-/m0/s1

Semaglutide, sold under the brand name Ozempic among others, is an antidiabetic medication used for the treatment of type 2 diabetes and long-term weight management.[15][16][17]

Semaglutide acts like human glucagon-like peptide-1 (GLP-1) in that it increases insulin secretion, thereby increasing sugar metabolism. It is distributed as a metered subcutaneous injection in a prefilled pen, or as an oral form. One of its advantages over other antidiabetic drugs is that it has a long duration of action, so a once-a-week injection is sufficient.[18]

An injectable version (Ozempic) was approved for medical use in the United States in December 2017,[19] and in the European Union,[12] Canada,[20] and Japan in 2018. A version which is taken by mouth (Rybelsus) was approved for medical use in the United States in September 2019,[21] and in the European Union in April 2020.[13] It is the first glucagon-like peptide receptor protein treatment approved for use in the United States that does not need to be injected.[22] It was developed by Novo Nordisk. Side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.[9]

In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection sold under the brand name Wegovy for long-term weight management in adults.[11][17]

Medical uses

Semaglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.[9][10]

Semaglutide may be administered in combination with other antidiabetic drugs; dose of concomitant insulin or sulfonylurea may need to be reduced.[23]

Semaglutide (Wegovy) is also indicated as an adjunct to diet and exercise for long-term weight management in adults with obesity (initial body mass index (BMI) ≥ 30 kg/m2) or overweight (initial BMI ≥ 27 kg/m2) with at least one weight-related comorbidity.[11][14][17]

Adverse effects

Side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.[9] In people with heart problems, it can cause damage to the retina of the eye (retinopathy).[24] Other, less common side effects include kidney problems, allergic reactions, low blood sugar, and pancreatitis.[22]


It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma and in patients with multiple endocrine neoplasia syndrome type 2.[10][9]

Mechanism of action

Semaglutide is a glucagon-like peptide-1 receptor agonist. It increases the production of insulin, a hormone that lowers the blood sugar level.[25] It also appears to enhance growth of β cells in the pancreas, which are the sites of insulin production.[26] It also inhibits glucagon, which is a hormone that increases blood sugar. It additionally reduces food intake by lowering appetite and slows down digestion in the stomach.[24] In this way it reduces body fat.[27]


Semaglutide is chemically similar to human glucagon-like peptide-1 (GLP-1), with 94% similarity. The only differences are two amino-acid substitutions at positions 8 and 34, where alanine and lysine are replaced by 2-aminoisobutyric acid and arginine, respectively.[28] Amino-acid substitution at position 8 prevents chemical breakdown by dipeptidyl peptidase-4. In addition, lysine at position 26 is in its derivative form (acylated with stearic diacid). Acylation with a spacer and C-18 fatty diacid chain increases the drug binding to blood protein (albumin), which enables longer presence in the blood circulation.[29] Its half-life in the blood is about 7 days (165–184 hours); therefore, once-weekly injection is enough.[18][26]


Semaglutide was developed in 2012,[30] by a team of researchers at Novo Nordisk as a longer-acting alternative to liraglutide as a once-weekly diabetes therapy.[31] It was given the brand name Ozempic. Clinical trials were started on 6 January 2016, and completed on 19 May 2017.[32]

Researchers at the University of Leeds and Novo Nordisk reported in 2017, that it can also be used for the treatment of obesity.[33] It reduces hunger, food craving and body fat.[34] A Phase 3 Randomized Controlled Trial found that once-weekly injection of 2.4 mg of the drug resulted in an average change of −14.9% body weight at 68 weeks compared to −2.4% for the placebo.[35]

The US FDA New Drug Application (NDA) was filed in December 2016, and in October 2017, the FDA Advisory Committee voted 16–0 in favor.[36] Approval was announced in December 2017.[19] It can be administered by injection or orally.[37] Marketing authorization in the European Union was granted in February 2018.[12][38] The Japanese Ministry of Health, Labour and Welfare announced approval on 23 March 2018.[39] Health Canada issued approval on 4 January 2018.[20]

Semaglutide was approved for medical use in Australia in August 2019 for "the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise; and as monotherapy when metformin is not tolerated or contraindicated."[1][3]

Society and culture

Legal status

In November 2021, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Wegovy, intended for the treatment of people with obesity or who are overweight in the presence of other related conditions.[40] The applicant for this medicinal product is Novo Nordisk A/S.[40] Wegovy was approved for medical use in the European Union in January 2022.[14]


Semaglutide was found to be inferior to tirzepatide, in a study of tirzepatide (LY3298176) vs semaglutide once weekly as add-on therapy to metformin in participants with type 2 diabetes (SURPASS-2), in both endpoints of reduction in A1C and body weight, with a roughly similar safety profile.[41][42]


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