What Is Wegovy? Uses, Side Effects, Dosage, & More

What Is Wegovy?

Wegovy, the brand name for semaglutide, is an injectable medication FDA-approved to help adults and children over the age of 12 with obesity. FDA approval of a medication is granted based on evidence of clinical benefit seen in large research trials. Wegovy is not available as a generic.

Wegovy mimics GLP-1, an appetite hormone, targeting the areas of the brain that regulate appetite and food intake. This hormone mimic assists patients in losing weight and keeping it off. Wegovy does not currently have any off-label (non-FDA approved) uses. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.^{1, 2}

How Does Wegovy Work?

Your brain receives signals from appetite hormones, which help regulate how much food you eat. Wegovy reduces appetite by working similarly to one of the natural hormones, slowing down the movement of food in your stomach and allowing you to feel fuller longer. Wegovy leads to weight loss due to this decrease in calorie intake.^{1, 3, 4}

What Is Wegovy Used to Treat?

Wegovy is an FDA-approved medication indicated for the treatment of obesity and chronic weight management in patients who have struggled with weight loss. To get a Wegovy prescription, patients must have already tried other weight loss methods without sufficient or sustained results. It is not recommended for use in patients under 12 years of age and cannot be used in patients with a personal or family history of medullary thyroid cancer or known hypersensitivity to Wegovy or any of its ingredients.^{1, 2, 3}

Criteria for Wegovy prescription include:¹

• Obese patients: Obesity is defined as a body mass index (BMI) ≥30 for adults or a BMI ≥95th percentile for age and sex for children.
• Overweight patients: Being overweight is defined as having a BMI ≥27 and having weight-related medical problems.

Wegovy Warnings & Precautions

Wegovy has been associated with an increased risk of suicidal thoughts and behaviors. Wegovy should be avoided in patients with a history of suicidal attempts or active suicidal thoughts. Patients and caregivers should closely monitor for these during the initial months of treatment and when dosage adjustments are made. Wegovy may impact organs such as the pancreas, gallbladder, and kidney. Patients with preexisting conditions relating to these organs should be cautious when using Wegovy and contact a provider immediately if any changes or worsening symptoms occur.¹

Providers and pharmacists play a key role in monitoring and managing these potential risks to ensure well-being during treatment with Wegovy.

Avoid taking Wegovy if you:^{1, 4}

• Are pregnant or breastfeeding: Wegovy may cause fetal harm. Wegovy should be discontinued at least 2 months before a planned pregnancy. If an unplanned pregnancy occurs, discontinue Wegovy as soon as possible. In studies, Wegovy was present in the milk of lactating rats, and it is likely that the drug will be present in human milk. There is no data on the effects of breastfeeding while taking Wegovy.
• Have a risk of thyroid c-cell tumors: Wegovy is contraindicated in patients who have a personal or family history of medullary thyroid cancer and in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2).
• Have acute pancreatitis: Discontinue Wegovy if pancreatitis is suspected. Do not restart Wegovy if pancreatitis is confirmed.
• Have acute gallbladder disease: If cholelithiasis (formation of gallstones) is suspected, further clinical follow-up is indicated.
• Have hypoglycemia (low blood sugar): Patients are at increased risk of severe hypoglycemia when using Wegovy alongside insulin. Your prescriber may change your dose of insulin. Signs of hypoglycemia include a fast heartbeat, shaking, sweating, and dizziness.
• Have acute kidney injury: Kidney function should be monitored in patients who have reported severe stomach-related reactions (e.g. nausea, vomiting) or those with kidney impairment.
• Have hypersensitivity reactions: Severe allergic reactions and severe swelling (angioedema) have been reported. Wegovy should be discontinued if either reaction is experienced and medical treatment should be sought as soon as possible.
• Have eye complications in patients with type 2 diabetes: Diabetic patients with a history of eye complications should be monitored for worsening symptoms.
• Increased heart rate: Regularly monitor heart rate.
• Have suicidal behavior and/or thoughts: Wegovy may increase suicidal thoughts and behavior for some people.

Box Warning for Wegovy

Wegovy has a black box warning (the most severe FDA warning for a medication) for causing an increased risk of thyroid c-cell tumors, particularly a type called medullary thyroid carcinoma (MTC). Patients with a personal or family history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2) should avoid using Wegovy. It is important for patients to undergo regular thyroid cancer screening while taking Wegovy, as early detection of MTC is crucial for successful treatment.

Patients should discuss their medical history thoroughly with their healthcare providers to assess the potential risks and benefits of using Wegovy. In some cases, genetic testing may be recommended to determine if there is a specific mutation associated with MTC or MEN 2. Patients should always consult their provider and pharmacist for personalized advice and guidance regarding the use of Wegovy and any potential risks associated with its use.¹

Side Effects of Wegovy

Wegovy delays gastric emptying, which is the process of moving the contents of the stomach into the duodenum (small intestine). This delay may cause some patients to feel stomach upset, including nausea, diarrhea, constipation, vomiting, stomach pain, gas, belching, and feeling bloated. For many, Wegovy side effects are mild to moderate and should only last a few days. Patients most commonly had these side effects after each dose increase. Other side effects associated with dose increases may include dizziness, heartburn, headache, or tiredness. These symptoms should subside after a few days of taking the new dose.^{1, 3, 4}

Serious side effects that should be discussed with a healthcare provider immediately include blurred vision, fast heartbeat, mood changes, slurred speech, and swelling of the face, lips, or throat. These side effects may be a sign of a more severe reaction to Wegovy, including hypoglycemia (low blood sugar), kidney failure, or a serious allergic reaction.^{1, 4}

Common Side Effects of Wegovy

Nausea is the most common side effect when taking Wegovy. Less frequently, patients may notice an upset stomach (bloating, gas, or belching), diarrhea, constipation, headache, or tiredness. The most common reason patients discontinued Wegovy was nausea. This can be managed by eating bland, low-fat foods such as crackers, toast, and rice. Additional tips to decrease side effects include eating foods that contain water, like soups, eating slowly, avoiding lying down after eating, and going outdoors for fresh air.

Many of these side effects do not require medical attention. However, reactions will vary by individual, and serious reactions should be reported to a healthcare professional.^{1, 4}

Common side effects of Wegovy include:*^{1, 4}

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Headache
• Fatigue

*All medications, including Wegovy, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your provider or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Wegovy

Rarely, Wegovy may cause serious side effects, which require immediate medical care. If experiencing severe side effects, patients should immediately seek urgent care or call 911. Wegovy has a black box warning for the development of thyroid c-cell tumors and should not be used in patients with a personal or family history of thyroid cancer. Symptoms of thyroid tumors include a mass in the neck, persistent hoarseness, shortness of breath, and difficulty swallowing.

In research trials, Wegovy caused acute pancreatitis, acute gallbladder disease, acute kidney injury, and eye complications in diabetic patients. If a patient has a history of these conditions, Wegovy should be used with caution and discontinued with worsening symptoms. Patients with diabetes should use Wegovy with caution due to the increased risk of hypoglycemia (low blood sugar) when using with insulin.

Wegovy also carries a warning for increased suicidal behavior and thoughts. Patients with depression should be monitored for worsening depressive episodes.^{1, 4}

Serious side effects of Wegovy may include:*^{1, 4}

• Thyroid C-cell tumors**
• Acute pancreatitis
• Acute gallbladder disease
• Eye complications in patients with diabetes (diabetic retinopathy)
• Increased risk of low blood sugar (hypoglycemia)

*All medications, including Wegovy, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your provider or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.

**This medication carries a black box warning for this serious risk. 

Allergic Reactions to Wegovy

Some patients may be allergic to Wegovy. Symptoms of a serious allergic reaction may include swelling of the face, lips, tongue, or throat, severe rash or itching, problems breathing or swallowing, rapid heartbeat, or feeling faint or dizzy. Patients who notice any of these symptoms should contact their provider or pharmacist right away. Patients who notice very severe rashes or swelling of the facial area should call 911 immediately.^{2, 3}

Allergic reactions to Wegovy may include:^{1, 4}

• Swelling of the facial area
• Problems breathing or swallowing
• Severe rash or itching
• Fainting or feeling dizzy
• Very rapid heartbeat

Wegovy can include mild allergic reactions such as nausea, upset stomach, or fatigue. It may also cause severe allergic reactions such as severe swelling (angioedema) and anaphylaxis. Any signs of allergy should be reported immediately to your provider or pharmacist. Patients with severe reactions will likely be discontinued from Wegovy, and other options for weight loss treatment may be explored.³

Interactions With Wegovy

Wegovy may have interactions with oral medications due to its effect on delaying stomach emptying. This may impact the absorption of oral medications administered at the same time or around the time of the injection. In research trials, 1 mg of Wegovy did not affect the absorption but lower absorption of other medications may be present with increasing doses of Wegovy.

Caution should be used with patients using insulin, an insulin secretagogue (e.g. glyburide, glipizide, glimeperide), or other oral diabetes medications. The risk of severely low blood glucose (hypoglycemia) is increased when Wegovy is used in combination with these diabetes medications. When initiating Wegovy, your provider may adjust the dose of your insulin to reduce the risk of hypoglycemia.^{1, 4}

3 drug classes you should use with caution while taking Wegovy include:¹

• Insulin (e.g. lispro, aspart, bovine, detemir, degludec, glulisine, gliquidone)
• Insulin secretagogue (e.g. glyburide, glipizide, glimeperide)
• Diabetes medications (e.g. metformin)

Wegovy Dosages

Wegovy is FDA-approved for the treatment of obesity. Wegovy injections come in five different strengths, and the injection is given once weekly. The recommended starting dose of Wegovy is 0.25 mg once weekly for 4 weeks. The maximum weekly dose is 2.4 mg. Wegovy is not recommended for use in patients younger than 12 years old. Wegovy dosages are adjusted every 4 weeks until the maximum effective dose is reached. Wegovy does not require dose adjustments for patients with kidney or liver impairment.^{1, 4}

Wegovy Forms & Strengths

Wegovy is available only as an injection. There are 5 different injection pen doses available. All patients will start at a dose of 0.25 milligrams and increase to higher doses every 4 weeks until the full dose of 2.4 mg is reached. Each individual responds to medications differently, and you can expect to see weight loss within a few weeks, or it can take several months.²

Wegovy is available in the following forms and strengths:^{1, 4}

• 0.25 milligrams (mg)/0.5 milliliters (mL) once weekly injection
• 0.5 mg/0.5 mL once weekly injection
• 1.0 mg/0.5 mL once weekly injection
• 1.7 mg/0.75 mL once weekly injection
• 2.4 mg/0.75 mL once weekly injection

How Should I Take Wegovy?

Wegovy is a once-weekly injection that can be injected into your upper legs, stomach, or upper arms. If an area is bruised, red, tender, or hard, do not inject into this site. It is very important to receive training from your healthcare provider before you start treatment.

To prepare for your injection, wash your hands and swab your injection site with an alcohol swab or soap and water. To inject, push the pen firmly against your skin, applying pressure until the yellow bar on the pen has stopped moving. You will hear two clicks during the injection indicating the injection has started and that the injection is ongoing. When the yellow bar has stopped moving, the injection is complete.

Wegovy pens should be thrown away immediately after each use in a sharps-appropriate container. Take Wegovy as directed by a prescriber, and consult a pharmacist with additional questions.^{1, 4}

What Should I Do If I Miss a Dose of Wegovy?

Do not stop taking Wegovy without first consulting a provider or pharmacist. If one dose is missed, and your next dose is more than 2 days (48 hours) away, administer Wegovy as soon as possible. If one dose is missed and your next dose is less than 2 days away, do not administer the missed dose. Resume dosing on your regularly scheduled day of the week. If 2 or more doses are missed in a row, resume dosing as scheduled. If too many doses are missed, Wegovy may need to be initiated from the starting dose and escalated every 4 weeks. Take Wegovy as directed by a prescriber, and consult a pharmacist with additional questions if you miss any doses.^{1, 4}

Can You Overdose on Wegovy?

Yes, you can overdose on Wegovy. Signs and symptoms of an overdose on Wegovy include severe nausea, severe vomiting, and severe hypoglycemia (low blood sugar). In the event of an overdose, appropriate supportive treatment with medications should be initiated based on your symptoms. Patients who experience an overdose should be observed for worsening symptoms over approximately one week, the amount of time it will take Wegovy to be completely out of the body.

If you or someone you know is experiencing potential overdose symptoms, it is critical to contact a healthcare professional or 911 immediately.³ You may also consider contacting the poison control center (800-222-1222). When seeking medical attention, it is important to provide information about the medication taken, the dosage, and the time of injection.^{1, 4}

Wegovy Alternatives for Weight Loss

Wegovy, Ozempic, and Rybelsus are all medications used to aid in weight loss. These medications have similar mechanisms of action in the body. Ozempic (semaglutide) is another once-weekly injection that works similarly to Wegovy. Ozempic is FDA-approved to treat type 2 diabetes and is used off-label to treat obesity. Rybelsus (semaglutide)is a tablet that is taken once daily. Like Ozempic, Rybelsus is FDA-approved to treat type 2 diabetes and is used off-label to treat obesity. The choice between them may depend on individual preferences, such as whether you prefer an injection or oral tablet, as well as other factors your healthcare providers can help you consider.^{1, 3}

Additional FDA-approved weight loss medications include orlistat, phentermine, Saxenda (liraglutide), Contrave (naltrexone-bupropion), and Qsymia (topiramate-phentermine). It’s important to note that these medications have different mechanisms of action and different side effects. It is best to consult with your healthcare provider to determine the most appropriate alternative for you based on your individual needs and medical history.

Wegovy Vs. Ozempic

Wegovy and Ozempic are both medications that belong to a class of medications called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). They work by mimicking the effects of a hormone that helps regulate blood sugar levels and appetite.

Wegovy is FDA-approved for chronic weight management, while Ozempic is FDA-approved for the treatment of type 2 diabetes. Both have been shown to have significant weight loss effects in research trials. Wegovy is typically prescribed at a higher dose compared to Ozempic. Therefore, Wegovy generally shows greater weight loss compared to Ozempic. Both medications cause common side effects such as nausea and diarrhea. However, Wegovy may have a higher incidence of these side effects due to the higher dose.^{1, 3, 4}

Both of these medications should be used under the guidance of a healthcare provider. Your healthcare provider or pharmacist can help you determine which medication is best suited for your specific needs and goals.

Questions to Ask Your Healthcare Provider About Wegovy (Semaglutide)

Individuals might want to learn about Wegovy when seeking treatment for weight loss, particularly if other treatments or methods have proven ineffective. When consulting one’s doctor or pharmacist, one should inquire about the potential benefits, risks, and side effects of Wegovy, as well as its compatibility with one’s medical history and current medications.⁴

Questions to ask your care team about Wegovy include:³

• How long will it take for me to adjust to taking Wegovy?
• Can I drink alcohol with Wegovy?
• What can I do to ensure I experience few side effects? And are they better or worse than other medications, such as the side effects of Qysmia?
• How do I store Wegovy?
• What happens if I miss a dose?
• How do I inject myself?
• Does my insurance cover Wegovy?
• What are some Wegovy alternatives to consider?
• Could Wegovy be used as an alternative to phentermine for weight loss?
• What other peptides for weight loss may be effective?

In My Experience

In my experience, many of my patients have had success with Wegovy treatment for chronic weight management in adults with obesity or who are overweight with at least one weight-related condition (e.g. diabetes, high blood pressure). It is always best to consult with your doctor or pharmacist for personalized advice to discuss any specific concerns you may have about Wegovy. I’ve seen the most success with Wegovy when this medication is used alongside a reduced-calorie diet and increased physical activity.

It is not a substitute for healthy lifestyle changes but rather a tool to support weight management efforts. Wegovy does have a high incidence of side effects in patients due to the high dose, so it’s important to slowly increase the dose as recommended by your prescriber to avoid severe side effects. As your body gets used to Wegovy, these side effects related to stomach upset (e.g. nausea, diarrhea, vomiting, abdominal pain) should lessen or disappear. Wegovy is a higher-cost medication, so some patients have difficulty paying for Wegovy if their prescription insurance doesn’t cover weight loss products on their formulary.  You can talk to your pharmacist about options to lower the price of Wegovy if you are interested in starting treatment.

Regular follow-up with your healthcare providers is important while using Wegovy. They will assess your progress, monitor for side effects, and make necessary adjustments to your treatment plan.