Semaglutide

Summary

Semaglutide is a long‑acting GLP‑1 analog used by subcutaneous injection or oral tablet for type 2 diabetes, obesity, and cardiovascular risk reduction.

Mechanism of Action

Agonist of the glucagon‑like peptide‑1 (GLP‑1) receptor, enhancing glucose‑dependent insulin secretion, suppressing glucagon, delaying gastric emptying and reducing appetite.

Routes of Administration

Goals & Uses

• Non-alcoholic steatohepatitis (NASH)HepaticModerate
• Cardiovascular risk reductionCardiovascularHigh
• Weight lossMetabolicHighChronic weight management and appetite reduction
• Glycemic controlDiabetesHigh
• Chronic weight management / obesityWeight ManagementHigh
• Weight reductionMetabolicHigh
• Glycemic control in type 2 diabetesMetabolicHigh
• Kidney disease risk reduction in T2DMRenalModerate
• Appetite suppression / satietyMetabolicHigh

Contraindications

• Diabetic ketoacidosisMetabolicHigh
• Personal or family history of medullary thyroid carcinoma (MTC)OncologicHigh
• Multiple endocrine neoplasia syndrome type 2 (MEN2)OncologicHigh
• Medullary thyroid carcinoma (MTC)OncologyHigh
• PregnancyPopulationModeratePotential fetal risk or insufficient safety data
• History of serious hypersensitivity to semaglutideImmunologicHigh
• Multiple endocrine neoplasia type 2 (MEN2)OncologyHigh

Adverse Effects

• PancreatitisGastrointestinalRareInflammation of the pancreas
• Injection site reactionsLocalUncommon
• Diabetic retinopathy complicationsOphthalmologicUncommon
• ConstipationGastrointestinalCommonReduced bowel frequency or difficulty passing stool
• Hypoglycaemia (with insulin or sulfonylureas)MetabolicUncommon
• NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
• VomitingGastrointestinalCommonForceful expulsion of stomach contents
• Acute pancreatitisGastrointestinalRare
• Gallbladder diseaseHepatobiliaryRareGallstones, cholecystitis, or biliary complications
• DiarrheaGastrointestinalCommonLoose or frequent stools

Drug Interactions

• InsulinModerateMay increase risk of low blood sugar
• Oral medications (general)Low
• WarfarinModerate
• Oral medications with narrow absorption windowLow
• Oral contraceptives (estrogen‑containing)Low
• SulfonylureasModerateMay increase risk of low blood sugar
• Insulin / Insulin secretagogues (sulfonylureas)High

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patients (<18 years)AgeRelative
• Pediatric patients (<18 y)AgeAbsolute
• Severe renal impairment / End-stage renal diseaseRenalRelative
• History of pancreatitisGastrointestinalRelative
• Pregnant womenReproductiveRelative
• Severe hepatic impairmentOrgan ImpairmentRelative
• Severe renal impairment (eGFR <30 mL/min/1.73 m²)RenalRelative
• Pregnancy and lactationReproductiveAbsolute

Regulatory Status

• European UnionApprovedApproved: type 2 diabetes, obesity
• United StatesApprovedApproved: type 2 diabetes, obesityOzempic (SC), Rybelsus (oral), Wegovy (SC)
• United KingdomApprovedApproved: type 2 diabetes, obesity

Approved in the US, EU and UK for type 2 diabetes (Ozempic, Rybelsus) and chronic weight management (Wegovy). Cardiovascular outcomes trial demonstrated MACE reduction.

Evidence & Sources

No sources recorded yet.

Frequently Asked Questions