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Semaglutide

Approved weight-loss and diabetes drug

The drug in Ozempic, Wegovy and Rybelsus

Match every finding to its exact substance, formulation, route and study population. A related molecule or approved medicine does not validate a catalog vial.

Human / product-specific records
Explore the evidenceWhy people take it
Compare this compoundRead original sources Community reports
HAibEGTFTSDVSSYLEGQAAKEFIAWLVRGRGC18HAibEGTFTSDVSSYLEGQAAKEFIAWLVRGRGC18
Schematic illustration · View structure evidence

The tag on K is a C18 fatty-acid chain

Color key
NonpolarAromaticPositive chargeNegative chargePolar Copper ion D-form or non-natural

At a glance

Why people take it. And what backs it up.

  1. Lose weight

    Approved for obesity (Wegovy)

    Approved as Wegovy for adults with obesity, or overweight plus a weight-related illness, and children 12 and up with obesity; adults lost about 15%.

    Sources (3)

  2. Control type 2 diabetes

    Approved for type 2 diabetes

    Prescribed as Ozempic shots or Rybelsus tablets to lower blood sugar in adults with type 2 diabetes, alongside diet and exercise.

    Sources (3)

  3. Quiet food noise

    Early human studies

    Many take it to silence ‘food noise’, the constant thoughts about food; in trials, people on it felt less hungry and had fewer cravings.

    Sources (4)

  4. Protect heart and kidneys

    Approved for some heart and kidney patients

    Approved to cut heart attack, stroke and heart-death risk in adults with heart disease and excess weight, and kidney decline in diabetic kidney disease.

    Sources (4)

  5. Microdose for inflammation

    People report it, not studied

    People with chronic pain or inflammation, and longevity seekers, take tiny weekly doses far below the label, sometimes prescribed by clinics.

    Sources (3)

Evidence briefing

Sources checked

What the sources support.

Semaglutide is FDA-approved as Ozempic, Rybelsus and Wegovy in product-specific injectable and oral forms. A semaglutide research-vial product is not one of those approved products.

Keep in mind

FDA approval and evidence are product-, route- and indication-specific; they do not establish equivalence of research-vial material.

Identity and research status reviewRead the original sources

The research. What’s been studied.

Supported by human evidence

  • Significant weight loss

    Adults with obesity lost about 15% of their body weight on average over 68 weeks in the STEP 1 trial.

  • Appetite control

    Helps you feel full sooner and stay full longer, and quiets food cravings, by acting on appetite centers in the brain and slowing stomach emptying.

  • Blood sugar control

    Lowers A1c in type 2 diabetes by boosting insulin only when blood sugar is high, so on its own it rarely causes lows.

  • Heart protection

    In the SELECT trial, people with heart disease and overweight had 20% fewer heart attacks, strokes and cardiovascular deaths.

  • Kidney protection

    Slowed kidney disease in people with type 2 diabetes and chronic kidney disease (FLOW trial).

What do these labels mean?
  • Human evidence: approved-drug data or larger human studies, within the populations and uses studied.
  • Early human studies: small, preliminary or limited human studies.
  • Animal & lab studies: animal or laboratory findings that do not establish effects in people.
  • Unverified: a proposed use or claim without verified supporting clinical evidence.
How each claim was reviewed (5)

Reported effects and evidence.

A citation may support, qualify or correct a claim. Read the study scope; a laboratory result is not an established benefit in people. Each review covers a claim as it was first collected; the tiles above show the collection’s current wording.

  1. Human RCT; approved product indication

    Review of “Significant weight loss”

    In STEP 1, adults with overweight/obesity without diabetes lost 14.9% versus 2.4% with placebo over 68 weeks, alongside lifestyle intervention.

    Limitations and applicability. STEP 1 supports the approximate mean. Specify population, comparator and lifestyle co-intervention.

    Original collected claim and review history

    Original title: Significant weight loss

    Adults with obesity lost about 15% of their body weight on average over 68 weeks in the STEP 1 trial.

    Original headline statistic: About 15%

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record semaglutide:benefit:1 · Annotated 2026-10-01 · Review method

  2. Human RCT; mechanism partly qualified

    Review of “Appetite control”

    A small randomized trial found less hunger, fewer cravings and reduced energy intake. Gastric-emptying effects vary with treatment duration and measurement.

    Limitations and applicability. Appetite effects supported; the 20-week trial found no delayed gastric emptying by its indirect measurement.

    Original collected claim and review history

    Original title: Appetite control

    Helps you feel full sooner and stay full longer, and quiets food cravings, by acting on appetite centers in the brain and slowing stomach emptying.

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record semaglutide:benefit:2 · Annotated 2026-10-01 · Review method

  3. Human RCT / approved diabetes indication

    Review of “Blood sugar control”

    Approved semaglutide products improve glycemic control in type 2 diabetes; insulin release is glucose-dependent.

    Limitations and applicability. Specify diabetes product and avoid absolute “only.” Hypoglycemia risk rises with insulin or secretagogues.

    Original collected claim and review history

    Original title: Blood sugar control

    Lowers A1c in type 2 diabetes by boosting insulin only when blood sugar is high, so on its own it rarely causes lows.

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record semaglutide:benefit:3 · Annotated 2026-10-01 · Review method

  4. Human cardiovascular-outcome RCT

    Review of “Heart protection”

    SELECT found 20% lower relative risk of the composite of cardiovascular death, nonfatal heart attack or stroke in its high-risk population.

    Limitations and applicability. 20% is relative reduction in a composite, not each event separately or a 20-point absolute reduction.

    Original collected claim and review history

    Original title: Heart protection

    In the SELECT trial, people with heart disease and overweight had 20% fewer heart attacks, strokes and cardiovascular deaths.

    Original headline statistic: 20% fewer

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record semaglutide:benefit:4 · Annotated 2026-10-01 · Review method

  5. Human kidney-outcome RCT

    Review of “Kidney protection”

    FLOW found fewer major kidney-disease events in adults with type 2 diabetes and chronic kidney disease.

    Limitations and applicability. FLOW studied adults with type 2 diabetes and chronic kidney disease, not general kidney prevention.

    Original collected claim and review history

    Original title: Kidney protection

    Slowed kidney disease in people with type 2 diabetes and chronic kidney disease (FLOW trial).

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record semaglutide:benefit:5 · Annotated 2026-10-01 · Review method

The research in detail

Evidence category

FDA-approved (US)

One of the most studied drugs of the decade. In STEP 1, adults with obesity lost about 15% of body weight over 68 weeks. The SELECT trial found a 20% drop in heart attacks, strokes and cardiovascular deaths in people with heart disease and overweight.

Evidence is assessed claim by claim above. Regulatory approval, study design, findings and relevance are separate questions; there is no single evidence score.

Risks and unknowns. What to know first.

Collected cautions follow. These are not an exhaustive or independently validated safety assessment; claim references do not automatically support every caution.

  • Nausea, vomiting, diarrhea and constipation are common.
  • Less common: gallbladder problems, pancreatitis, and muscle loss alongside fat loss.
  • Boxed warning for thyroid C-cell tumors seen in rodents.
  • Measuring errors with self-mixed vials have sent people to poison control.

What people report

Show all 8 cautionsShow fewer cautions

Read this first: what “research use only” means

Published dosing records. What the approved label says.

Historical label and trial records for the named product, route, population and indication. These records are not a personal schedule or a validated regimen for a catalog vial. Source attribution does not establish applicability.

Wegovy

Long-term weight management in adults with obesity, or with overweight and a weight-related health problem, and in children 12 and older with obesity. The same ramp is used to lower the risk of heart attack, stroke and heart death in adults with heart disease and obesity or overweight, and to treat the liver disease MASH with moderate to advanced scarring (not cirrhosis) in adults.

Long-termApproved label

Source: Wegovy prescribing information (FDA, revised 06/2026)

How
Injection under the skin (belly, thigh or upper arm)
How often
Once a week, on the same day each week
How long
Ongoing

Dose, step by step

  1. Weeks 1–4 0.25 mg
  2. Weeks 5–8 0.5 mg
  3. Weeks 9–12 1 mg
  4. Weeks 13–16Can stay on 1.7 mg
  5. Week 17 onCan stay on 2.4 mg

Limit. 7.2 mg once a week (the Wegovy HD pen). The label allows going above 2.4 mg only for adults losing weight who have handled 2.4 mg for at least 4 weeks.

  • The label’s maintenance dose is 2.4 mg (recommended) or 1.7 mg once a week. For MASH it is 2.4 mg, lowered to 1.7 mg if 2.4 mg is not tolerated.
  • If a step is not tolerated, the label says to consider waiting 4 more weeks before the next increase.
  • Missed dose: the label says to give it as soon as possible if the next dose is more than 2 days away, and to skip it if the next dose is less than 2 days away. After 2 or more missed doses in a row, the ramp restarts at a lower dose.
  • Wegovy also comes as a daily pill: 1.5 mg on days 1–30, 4 mg on days 31–60, 9 mg on days 61–90, then 25 mg a day.

Ozempic

Type 2 diabetes in adults: blood sugar control; also lowering the risk of heart attack, stroke and heart death in those with heart disease, and of kidney decline, kidney failure and heart death in those with chronic kidney disease

Long-termApproved label

Source: Ozempic prescribing information (FDA, revised 05/2026)

How
Injection under the skin (belly, thigh or upper arm)
How often
Once a week, on the same day each week
How long
Ongoing

Dose, step by step

  1. Weeks 1–4 0.25 mg
  2. Weeks 5–8Can stay on 0.5 mg
  3. Weeks 9–12Can stay on 1 mg
  4. Week 13 onCan stay on 2 mg

Limit. 2 mg once a week.

  • The label’s maintenance dose is 0.5 mg, 1 mg or 2 mg once a week, depending on blood sugar control. It allows 1 mg, then 2 mg, each after at least 4 weeks on the dose before, if more blood sugar control is needed.
  • For type 2 diabetes with chronic kidney disease, the label’s maintenance dose is 1 mg once a week, after at least 4 weeks on 0.5 mg.
  • Missed dose: the label says to give it within 5 days. After more than 5 days, it is skipped and the next dose is given on the usual day.
  • Semaglutide also comes as daily pills for type 2 diabetes, under a separate FDA label (Rybelsus and Ozempic tablets, revised 01/2026). Rybelsus starts at 3 mg for 30 days, then 7 mg, and can go to 14 mg. Ozempic tablets start at 1.5 mg for 30 days, then 4 mg, and can go to 9 mg.
  • The two pills are not interchangeable milligram for milligram, and their 30-day starting doses do not control blood sugar (same tablets label).

These are the label’s doses for the approved medicine, started and adjusted by a prescriber. A research vial is not that medicine: no regulator has checked what’s in it, or how much.

Community protocols. Reported online. Not clinically validated.

Community reports Collection date: 30 Sep 2026

The main off-label pattern is “microdosing”: weekly doses below the 0.25 mg starting dose (about 0.05–0.25 mg, often 0.1–0.2 mg), usually from compounded vials measured in syringe units, with many people staying under 0.5 mg.

More about this

Telehealth pharmacies also use their own small-step ladders (0.2, 0.4, 0.6 mg and so on), twice-weekly “flex” dosing and, at the extremes, doses above the 2.4 mg brand maximum. Longevity clinics promote 0.1–0.5 mg a week, or far smaller “nanodoses”.

Not testedFrequently encountered in reviewed sources

Microdosing for weight loss or tolerability

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
0.05–0.25 mg (often 0.1–0.2 mg); many stay below 0.5 mg
How often
Once a week
Route
Injection under the skin
Timing
Same day each week
How long
Open-ended
Ramp
Small steps of 0.05–0.125 mg, often every 3–4 weeks (one sample schedule: 0.1 mg, then 0.2 mg, then 0.3 mg, a month each)
Mixing
Compounded multi-dose vials measured in insulin-syringe units (one telehealth program: 8 units = 0.2 mg)
  • Offered by telehealth companies, mostly with compounded semaglutide, because brand pens cannot deliver doses below 0.25 mg.
  • Some users start even lower than prescribed (for example 4 units instead of 8).
Sources (4)

Not testedCommon

Compounded telehealth ladder with small steps

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
About 0.2 mg rising through steps such as 0.4, 0.6, 0.9, 1.12, 1.5 and 1.9 mg to about 2.3 mg
How often
Once a week
Route
Injection under the skin
How long
Open-ended
Ramp
2-week steps at first, then 4-week steps (one pharmacy label); others use 4-week steps (0.2, 0.4, 0.8 mg)
Mixing
Compounded vials, often with an added ingredient such as glycine, vitamin B12 or L-carnitine; doses are written in syringe units (for example 4 mg/mL, so 5 units = 0.2 mg)
  • These odd-numbered steps (such as 0.4 mg) come from compounding-pharmacy labels, not the brand-name schedule, and often confuse patients.
Sources (4)
Show all 8 protocolsShow fewer protocols

Not testedCommon

Longevity / anti-inflammatory microdose

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
0.1–0.5 mg (clinic); “nanodosing” at one-fifth to one-fiftieth of the 0.25 mg starting dose (influencer)
How often
Once a week
Route
Injection under the skin; one clinic’s trial also tests an under-the-tongue form
How long
Open-ended
  • Aimed at inflammation, insulin sensitivity and “healthspan” rather than weight loss, often in people who are not overweight.
  • The originator of the “microdosing” idea says most so-called microdoses are really ordinary starting doses.
Sources (4)

Not testedCommon

Split weekly dose

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
Same weekly total, halved (for example 0.25 mg as two 0.125 mg shots, or 2 mg a week as two 1 mg shots)
How often
Twice a week, 3–4 days apart
Route
Injection under the skin
  • Done to reduce nausea or late-week hunger. At least one telehealth pharmacy now sells a twice-a-week “flex” dose.
Sources (4)

Not testedCommon

Stretching the interval for maintenance

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
The last effective dose or lower (often 0.25–1 mg; some keep 1.7–2 mg)
How often
Every 10 days to every 3 weeks (every 2 weeks is common)
Route
Injection under the skin
How long
Months (reports of 6–10 months)
Ramp
Some slowly lower the dose as well as spacing it out
  • Used after reaching goal weight, to cut cost and side effects; sometimes suggested by the prescriber.
Sources (4)

Not testedSometimes seen

Counting pen clicks for a partial dose

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
Part of the smallest pen dose
How often
Once a week
Route
Injection under the skin (brand pen)
  • The pen maker says doses should not be set by counting clicks.
Sources (1)

Not testedSometimes seen

Grey-market research vials

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
Label-style weekly doses, sometimes pushed past the brand maximum (one user self-dosed 2.7 mg)
How often
Once a week
Route
Injection under the skin
How long
Open-ended
Mixing
Research powder + bacteriostatic water mixed at home, for example 15 mg vial + 3 mL (2.7 mg = 54 units)
  • Grey-market buyers have largely moved on to tirzepatide and retatrutide, so recent semaglutide-specific posts are fewer.
Sources (2)

Not testedFringe

High doses above the brand maximum

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
Above 2.4 mg a week (reports of 6.4 mg a week)
How often
Once or twice a week
Route
Injection under the skin
Ramp
Telehealth “levels” that jump, for example from 2.4 mg to 6.4 mg a week
  • Reported by patients of at least one telehealth company; patients themselves questioned the jump.
Sources (2)

Where the numbers come from

The “microdosing” idea was popularised by naturopath Dr. Tyna Moore as very small “nano-signaling” doses for inflammation, then adopted by telehealth companies (including Hims & Hers, Noom and Found by late 2025) for starting below the 0.25 mg label dose. No trial has tested these doses, and clinics use no agreed definition.

Research notes

“Microdose” has no agreed meaning: clinics use it for 0.05–0.25 mg, telehealth marketing uses it for standard starting doses, and the idea’s originator means far smaller doses. Compounding of semaglutide at scale ended in 2025 when the FDA declared the shortage over, so microdosing now relies on patient-specific compounding or grey-market vials.

Taken with

Measurement basics and calculator

Explore vial arithmetic

What it is. In plain English.

The GLP-1 drug that started the current wave of weight-loss medicines.

TapClick a dotted word to see what it means.

A synthetic copy of the gut hormone with two changes: one amino acid swapped to resist breakdown, and a fatty-acid side chain that lets it ride on albumin in the blood. That stretches its from minutes to about a week. The vendor sells it under the code NXP-1P (one receptor target).

It boosts insulin when blood sugar is high, slows stomach emptying, and acts on appetite centers in the brain, so people feel full sooner and eat less.

Reviewed 2026-10-01.

Structure. What it really looks like.

Experimental

Cryo-EM structure of semaglutide (blue) bound to the human GLP-1 receptor (gray).

Semaglutide (blue) bound to the human GLP-1 receptor (gray), the receptor it acts on. Also part of the experiment, but not drawn: a G protein and an antibody fragment.

Missing parts

  • The fatty-acid chain isn’t visible: it wasn’t resolved in the experiment. Only the short linker that joins it to the peptide is drawn.
  • The peptide’s last amino acid has no coordinates either.

7KI0, Zhang et al., 2021. Rendered with Mol* (Sehnal et al., 2021) from RCSB PDB data (Berman et al., 2000).

Specs. The facts at a glance.

Length
31 amino acids + fatty-acid chain
Sequence
H-Aib-E-G-T-F-T-S-D-V-S-S-Y-L-E-G-Q-A-A-K(C18)-E-F-I-A-W-L-V-R-G-R-G
Sold as
  • NXP-1P kit · 5 mg or 10 mg
Regulatory status
FDA-approved in the US as Ozempic and Rybelsus for type 2 diabetes and as Wegovy for weight management and other label-specific indications, including cardiovascular risk reduction in some adults with overweight or obesity and noncirrhotic MASH. Approved products include injections and tablets. Approval applies to the labeled drug products, not research-vial semaglutide.
Also known as
The drug in Ozempic, Wegovy and Rybelsus

Sources. What this page rests on.

Every source behind this page, with what it says and when it was checked, is in the Source library.

Semaglutide in the Source library

Original overview and research notes · annotated 2026-10-01

Historical collection text. Read alongside the claim corrections above; identity or evidence qualifications may supersede this wording.

Weight loss and blood sugar control

The GLP-1 drug that started the current wave of weight-loss medicines.

A synthetic copy of the gut hormone GLP-1 with two changes: one amino acid swapped to resist breakdown, and a fatty-acid side chain that lets it ride on albumin in the blood. That stretches its half-life from minutes to about a week. The vendor sells it under the code NXP-1P (one receptor target).

It boosts insulin when blood sugar is high, slows stomach emptying, and acts on appetite centers in the brain, so people feel full sooner and eat less.

One of the most studied drugs of the decade. In STEP 1, adults with obesity lost about 15% of body weight over 68 weeks. The SELECT trial found a 20% drop in heart attacks, strokes and cardiovascular deaths in people with heart disease and overweight.

Original status record: FDA-approved as Ozempic and Rybelsus (type 2 diabetes) and Wegovy (weight management). The approval covers the pharmaceutical product, not research-chemical vials.

More in Weight & metabolism.

Glossary

GLP-1 / GIP

Gut hormones released after eating that raise insulin and reduce appetite. The basis of today’s weight-loss drugs.

Full glossary

Glossary

Half-life

The time it takes for half a dose to be cleared. Minutes for many natural peptides; about a week for drugs engineered with fatty-acid chains.

Full glossary

Glossary

Cryo-EM

Cryo-electron microscopy. Molecules are frozen in a thin layer of ice and photographed thousands of times with an electron microscope; the images are combined into a 3D map.

Full glossary

Glossary

Resolution

How sharp a structure is, measured in ångströms (Å; a ten-billionth of a meter). Smaller is sharper.

Full glossary

Glossary

Protein Data Bank (PDB)

The free worldwide archive of 3D structures of proteins and other molecules measured in experiments. Each entry has a four-character code, like 7KI0.

Full glossary