Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics natural incretin hormones to regulate blood glucose and promote weight loss. Available as FDA-approved Ozempic® for Type 2 diabetes, Wegovy® for chronic weight management, and Rybelsus® as the first oral GLP-1 medication. Clinical trials demonstrate exceptional efficacy with 14.9% average weight loss and 26% reduction in major cardiovascular events.
Semaglutide Dosing Guide
Primary Benefits
- Superior weight loss (14.9% in STEP-1 clinical trial)
- Excellent glycemic control (1.8% HbA1c reduction)
- 26% reduction in major adverse cardiovascular events
- FDA approved for both diabetes and weight management
- Weekly dosing improves compliance vs daily medications
How It Works
Semaglutide is a long-acting GLP-1 receptor agonist that binds specifically to GLP-1 receptors throughout the body, with highest density in pancreatic beta cells, brain (hypothalamus and brainstem), and gastrointestinal tract. Upon binding, it activates adenylyl cyclase leading to increased intracellular cAMP levels. In pancreatic beta cells, this results in glucose-dependent insulin secretion - insulin is only released when glucose levels are elevated, reducing hypoglycemia risk. Simultaneously, it suppresses inappropriate glucagon secretion from alpha cells. In the central nervous system, GLP-1 receptor activation in the hypothalamic arcuate nucleus and brainstem reduces food intake through enhanced satiety signaling. Gastric emptying is delayed through direct GLP-1 receptor activation in the gastric fundus and pylorus, contributing to prolonged satiety and improved postprandial glucose control.
Quick Reference
Typical Dosage Range
Semaglutide requires careful dose escalation to minimize gastrointestinal side effects. For diabetes (Ozempic): start 0.25mg weekly for 4 weeks, increase to 0.5mg weekly, with optional escalation to 1.0mg weekly if additional glycemic control needed. For weight management (Wegovy): initiate 0.25mg weekly for 4 weeks, escalate to 0.5mg for 4 weeks, then 1.0mg for 4 weeks, 1.7mg for 4 weeks, and finally 2.4mg for maintenance. Oral formulation (Rybelsus) starts at 3mg daily for 30 days, increasing to 7mg daily, with possible escalation to 14mg daily. Injections should be administered same day each week, rotating between abdomen, thigh, or upper arm. Critical monitoring includes monthly weight tracking, quarterly HbA1c for diabetics, and biannual comprehensive metabolic panels.
Administration Methods
Semaglutide is administered via subcutaneous injection using pre-filled, single-use pens (FlexTouch for Ozempic and Wegovy) containing multiple doses. Inject into subcutaneous tissue of abdomen, thigh, or upper arm at a 90-degree angle using integrated needle. Prime pen before first use, dial appropriate dose, insert needle fully, press and hold injection button for 6 seconds after dose counter reaches 0. Rotate injection sites within chosen area to prevent lipodystrophy. Store pen in refrigerator between uses, allow to reach room temperature before injection. Oral formulation (Rybelsus) must be taken on empty stomach with ≤4 ounces water, waiting 30 minutes before food, drink, or other medications. Consistent weekly timing for injections optimizes therapeutic levels and reduces breakthrough symptoms.
Medical Disclaimer
Semaglutide is FDA-approved as Ozempic® for Type 2 diabetes, Wegovy® for chronic weight management, and Rybelsus® as oral GLP-1 therapy. This information is for educational purposes and should not replace consultation with healthcare providers. Individual results may vary. Prescribing information and medical supervision are required for all therapeutic uses.