Semaglutide

FDA-approved (prescription) Evidence grade A — regulator-approved with pivotal randomised trials Updated 2026-10-20

This page describes published research and public regulatory records. It is not medical advice. SoluneFit does not sell, supply, or recommend any compound. The SoluneFit app includes a private, on-device tracker for people who want a record of what they and their clinician have already decided — the app neither suggests compounds nor doses.

Also known as: Ozempic, Wegovy, Rybelsus, Wegovy HD.

Regulatory status

FDA-approved (initial US approval 2017): Ozempic injection for type 2 diabetes, MACE reduction and CKD outcomes [1]; Wegovy injection and tablets for chronic weight management (adults and ages 12+), MACE reduction in obesity/overweight with CV disease, and noncirrhotic MASH with F2-F3 fibrosis (accelerated approval) [2]; Rybelsus and Ozempic tablets for type 2 diabetes [3]. Prescription only.

What it is

GLP-1 receptor agonist (acylated GLP-1 analogue, >99 % albumin-bound).

A long-acting GLP-1 analogue given as a weekly injection (Ozempic, Wegovy) or a daily tablet (Rybelsus, Ozempic tablets, Wegovy tablets). Approved in the US for type 2 diabetes and its cardiovascular and kidney risks, and for chronic weight management, cardiovascular risk reduction in obesity and MASH with liver fibrosis.

What the published research shows

Large phase 3 programmes in diabetes and weight; STEP 1 randomised 1,961 adults for 68 weeks; SELECT outcomes trial in 17,604 patients.

Published human studies and reports (these describe trial populations, not SoluneFit claims):

Type 2 diabetes (Ozempic injection label): Label: 0.25 mg subcutaneously once weekly for 4 weeks, then 0.5 mg once weekly; may go to 1 mg and then 2 mg once weekly, each after at least 4 weeks on the previous dose; label maximum 2 mg weekly.
Chronic weight management (Wegovy injection label): Label: 0.25 mg once weekly for 4 weeks, escalating every 4 weeks through 0.5, 1 and 1.7 mg to a maintenance of 1.7 or 2.4 mg once weekly (2.4 mg preferred by the label); adults tolerating 2.4 mg for at least 4 weeks may go to a label maximum of 7.2 mg weekly (Wegovy HD). Wegovy tablets: 25 mg once daily maintenance.
Type 2 diabetes (Rybelsus oral label): Label: 3 mg by mouth once daily for 30 days (not effective for glucose control), then 7 mg daily; may go to 14 mg daily. Taken on an empty stomach in the morning with up to 4 oz of water, waiting at least 30 minutes before food, drink or other oral medicines.
Weight loss in adults with overweight or obesity without diabetes (STEP 1 trial): Semaglutide 2.4 mg once weekly: mean body-weight change at week 68 of -14.9 % versus -2.4 % with placebo (difference -12.4 percentage points).
Cardiovascular outcomes in obesity without diabetes (SELECT trial): 17,604 patients with established CV disease; major adverse CV events in 6.5 % with semaglutide 2.4 mg versus 8.0 % with placebo over a mean 39.8 months (hazard ratio 0.80).

Mechanism, as reported

Activates the GLP-1 receptor, increasing glucose-dependent insulin release, lowering glucagon, slowing gastric emptying and reducing appetite. Binding to albumin and resistance to DPP-4 breakdown give it a half-life of about a week.

Practical record

Elimination half-life: 168.0 h (confidence: high). Labels: elimination half-life approximately 1 week (the app uses 7 × 24 h); steady state after 4-5 weeks of weekly dosing; SC bioavailability 89 %; apparent Vd about 12.5 L. Oral bioavailability is about 0.4-1 % (Rybelsus) or about 1-2 % (Wegovy tablets). Present in the circulation for about 5-7 weeks after the last dose.
Studied routes: subcutaneous, oral.
Typical supply: Ozempic multi-dose pens delivering 0.25/0.5, 1 or 2 mg per weekly dose; Wegovy single-dose pens and syringes 0.25-2.4 mg and 7.2 mg (HD); Rybelsus tablets 3, 7, 14 mg; Ozempic tablets 1.5, 4, 9 mg; Wegovy tablets (Rx).
Reconstitution: Supplied as ready solutions or tablets; not reconstituted.
Storage: Pens: refrigerate 2-8 °C before first use, do not freeze. Ozempic pen after first use: up to 56 days at 15-30 °C or refrigerated. Wegovy single-dose pen/syringe: may be kept at 8-30 °C for up to 28 days. Tablets: 20-25 °C in the original bottle.

Safety signals on record

Reported adverse events: Mainly gastrointestinal: nausea, vomiting, diarrhoea, constipation, abdominal pain; also headache, fatigue, dyspepsia, dizziness, abnormal skin sensation (dysesthesia, more frequent at 7.2 mg), hair loss and, with insulin or sulfonylureas, hypoglycaemia.
Contraindications: Boxed warning for thyroid C-cell tumours in rodents: contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2, and after a serious hypersensitivity reaction to semaglutide. Warnings for pancreatitis, gallbladder disease, acute kidney injury from dehydration, severe GI reactions, diabetic retinopathy complications, heart-rate increase and aspiration under anaesthesia.
Interactions: Slows gastric emptying, which can change absorption of oral drugs; the tablet raised levothyroxine exposure by about 33 %. Insulin or sulfonylurea doses may need lowering to avoid hypoglycaemia.
Notes: Labels advise stopping at least 2 months before a planned pregnancy because of the long half-life. Pens must never be shared between people.

Sources

General wellness education, not medical advice. Unapproved compounds have no established dosing, purity standard, or safety profile.

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