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Frequently Asked Questions
Get the answers you need to help set patients up with a weight-management plan1,2
As you consider prescribing Wegovy® for your patients, you may have some questions. Below you will find answers that will help you understand and communicate pertinent information to your patients and staff.
You can also call 1-833-493-4689 anytime with questions about Wegovy®.
ABOUT WEGOVY®
Wegovy® (semaglutide) injection 2.4 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of ≥30 kg/m2 (obesity) or ≥27 kg/m2 (overweight) in the presence of at least 1 weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia).1
Wegovy® targets areas of the brain that regulate appetite and food intake. 94% similar to naturally occurring GLP-1, Wegovy® lowers your patients’ appetite to help them lose weight and keep it off.* GLP-1 is a native hormone that is released in response to food intake and acts as a physiological regulator of appetite.
The effect of Wegovy® was studied in animal models. The impact of Wegovy® in the brain is not fully understood.
*At 68 weeks.
Adverse reactions reported in ≥2% of Wegovy®-treated patients and more frequently than with placebo1:
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal Pain†
- Headache
- Fatigue‡
- Dyspepsia
- Dizziness
- Abdominal Distention
- Eructation
- Hypoglycemia In Patients With Type 2 Diabetes Mellitus§
- Flatulence
- Gastroenteritis
- Gastroesophageal Reflux Disease
- Gastritis‖
- Gastroenteritis Viral
- Hair Loss
In STEP 1, nausea was the most common side effect seen in the trial and was generally mild or moderate and transient.3
†Includes abdominal pain, lower abdominal pain, upper abdominal pain, gastrointestinal pain, abdominal tenderness, abdominal discomfort, and epigastric discomfort.
‡Includes fatigue and asthenia.
§Defined as blood glucose <54 mg/dL with or without symptoms of hypoglycemia or severe hypoglycemia (requiring the assistance of another person) in patients with type 2 diabetes mellitus not on concomitant insulin (STEP 2, Wegovy® n=403, placebo n=402).
‖Includes chronic gastritis, gastritis, erosive gastritis, and reflux gastritis.
Once you’ve verified that your patient is covered and the prior authorization (PA) is approved, you can prescribe Wegovy® through your electronic health record (EHR) system.
When you prescribe, you can also provide your patient with a Wegovy® Sample Kit to help them get started right away.
TAKING WEGOVY®
- The Wegovy® starting dose is 0.25 mg injected subcutaneously once weekly
- Escalate the patient’s Wegovy® dose every 4 weeks for 16 weeks
- Please refer to the Prescribing Information for full Instructions for Use
- If patients do not tolerate a dose during dose escalation, consider delaying dose escalation for 4 weeks
- If patients do not tolerate the maintenance 2.4 mg once-weekly dose, the dose can be temporarily decreased to 1.7 mg once weekly, for a maximum of 4 weeks. After 4 weeks, increase Wegovy® to the maintenance 2.4 mg dose once weekly. Discontinue Wegovy® if the patient cannot tolerate the 2.4 mg dose
- In patients with type 2 diabetes, monitor blood glucose prior to starting Wegovy® and during Wegovy® treatment
- If patients do not tolerate a dose during dose escalation, consider delaying dose escalation for 4 weeks
- If patients do not tolerate the maintenance 2.4 mg dose
- The dose can be temporarily decreased to 1.7 mg once weekly, for a maximum of 4 weeks
- After 4 weeks, increase Wegovy® to the maintenance 2.4 mg dose once weekly
- Discontinue Wegovy® if the patient cannot tolerate the 2.4 mg dose
- The dose can be temporarily decreased to 1.7 mg once weekly, for a maximum of 4 weeks
Instruct patients to store the Wegovy® pen in the refrigerator between 36 °F and 46 °F (2 °C and 8 °C). If needed, before removing the pen cap, Wegovy® can be stored between 46 °F and 86 °F (8 °C and 30 °C) in the original carton for up to 28 days. Do not freeze Wegovy®. Patients should keep Wegovy® in the original carton to protect it from light. Safely discard the Wegovy® pen after use.
Refer patients to the full Prescribing Information for more details regarding injection and pen storage.
Consider administering the first injection of Wegovy® in-office to reduce the risk of administration errors.
Patients will inject their dose of Wegovy® under the skin in the upper arms, stomach (keep 2 inches away from belly button), or upper legs (front of thighs). Indicate each of the 3 appropriate injection areas when prescribing Wegovy® and ensure that patients understand that they should only inject subcutaneously.
If there are problems injecting, change to a firmer injection site, such as upper leg or upper arm, or consider standing up while injecting into the stomach.
Refer patients to the full Prescribing Information for full usage instructions.
Our video will guide you through the Wegovy® injection technique.
Refer patients to the full Prescribing Information for more information regarding proper injection, storage, and handling techniques.
PATIENT SUPPORT & SAVINGS
Novo Nordisk has developed a 3-step process to help identify patients with Wegovy® coverage and help those without coverage gain access.
For every prescription, patients may pay as little as $0 per 28-day supply (1 box) of Wegovy®.*
*Eligibility and restrictions apply. Patients with commercial insurance subject to a maximum savings of $200 per 28-day supply. If patients pay cash for their prescriptions, they can save up to $500 per 28-day supply (1 box) of Wegovy®. Novo Nordisk reserves the right to modify or cancel this program at any time. See terms and conditions at WegovyTerms.com.
WeGoTogether® is a program with behavior change resources designed to help your patients get started and stay on track with Wegovy®.
Your patients can get support with WeGoTogether®
Important Safety Information for Wegovy® (semaglutide) injection 2.4 mg
WARNING: RISK OF THYROID C-CELL TUMORS
- In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Wegovy® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined
- Wegovy® is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Wegovy® and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Wegovy®
Indications and Usage
Wegovy® (semaglutide) injection 2.4 mg is indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in:
- adults with an initial body mass index (BMI) of ≥30 kg/m2 (obesity) or ≥27 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia)
- pediatric patients aged 12 years and older with an initial BMI at the 95th percentile or greater standardized for age and sex (obesity)
Limitations of Use
- Wegovy® contains semaglutide and should not be coadministered with other semaglutide-containing products or with any GLP-1 receptor agonist
- The safety and effectiveness of Wegovy® in combination with other products intended for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established
- Wegovy® has not been studied in patients with a history of pancreatitis
Important Safety Information
Contraindications
- Wegovy® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior serious hypersensitivity reaction to semaglutide or to any of the excipients in Wegovy®. Serious hypersensitivity reactions, including anaphylaxis and angioedema have been reported with Wegovy®
Warnings and Precautions
- Risk of Thyroid C-Cell Tumors: Patients should be further evaluated if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging
- Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists, including semaglutide. Acute pancreatitis was observed in patients treated with Wegovy® in clinical trials. Observe patients carefully for signs and symptoms of acute pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back, and which may or may not be accompanied by vomiting). If acute pancreatitis is suspected, discontinue Wegovy® promptly, and if acute pancreatitis is confirmed, do not restart
- Acute Gallbladder Disease: Treatment with Wegovy® was associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® pediatric patients aged 12 years and older than in Wegovy® adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® patients and 0.7% of placebo patients. Cholecystitis was reported by 0.6% of Wegovy® patients and 0.2% of placebo patients. In a clinical trial in pediatric patients aged 12 years and older, cholelithiasis was reported by 3.8% of Wegovy® patients and 0% placebo patients. Cholecystitis was reported by 0.8% of Wegovy® pediatric patients and 0% placebo patients. Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in Wegovy® patients than in placebo patients, even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated
- Hypoglycemia: Wegovy® lowers blood glucose and can cause hypoglycemia. In a trial of adult patients with type 2 diabetes, hypoglycemia was reported in 6.2% of Wegovy® patients versus 2.5% of placebo patients. Patients with type 2 diabetes taking Wegovy® with an insulin secretagogue (e.g. sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with type 2 diabetes
- Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which in some cases required hemodialysis, in patients treated with semaglutide. Patients with renal impairment may be at a greater risk of acute kidney injury, but some events have been reported in patients without known underlying renal disease. A majority of the events occurred in patients who experienced nausea, vomiting, or diarrhea, leading to volume depletion. Monitor renal function when initiating or escalating doses of Wegovy® in patients reporting severe adverse gastrointestinal reactions and in patients with renal impairment reporting any adverse reactions that could lead to volume depletion
- Hypersensitivity Reactions: Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported with Wegovy®. If hypersensitivity reactions occur, discontinue use of Wegovy®, treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of anaphylaxis or angioedema with another GLP-1 receptor agonist
- Diabetic Retinopathy Complications in Patients with Type 2 Diabetes: In a trial of adult patients with type 2 diabetes, diabetic retinopathy was reported by 4.0% of Wegovy® patients and 2.7% of placebo patients. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy
- Heart Rate Increase: Mean increases in resting heart rate of 1 to 4 beats per minute (bpm) were observed in Wegovy® adult patients compared to placebo in clinical trials. More Wegovy® adult patients compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% versus 34%) and 20 bpm or more (26% versus 16%). In a clinical trial in pediatric patients aged 12 years and older with normal baseline heart rate, more patients treated with Wegovy® compared to placebo had maximum changes in heart rate of 20 bpm or more (54% versus 39%). Monitor heart rate at regular intervals and instruct patients to report palpitations or feelings of a racing heartbeat while at rest. If patients experience a sustained increase in resting heart rate, discontinue Wegovy®
- Suicidal Behavior and Ideation: Suicidal behavior and ideation have been reported in clinical trials with other weight management products. Monitor patients for depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue Wegovy® in patients who experience suicidal thoughts or behaviors and avoid in patients with a history of suicidal attempts or active suicidal ideation
Adverse Reactions
- Most common adverse reactions (incidence ≥5%) are: nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distention, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis
Drug Interactions
- The addition of Wegovy® in patients treated with insulin has not been evaluated. When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia
- Wegovy® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications. Monitor the effects of oral medications concomitantly administered with Wegovy®
Use in Specific Populations
- Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue Wegovy®. Discontinue Wegovy® in patients at least 2 months before a planned pregnancy
- Pediatric: Adverse reactions with Wegovy® in pediatric patients aged 12 years and older were similar to those reported in adults. Pediatric patients ≥12 years of age treated with Wegovy® had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®
Please click here for Prescribing Information, including Boxed Warning.
References
1. Wegovy® [package insert]. Plainsboro, NJ: Novo Nordisk Inc.; 2022.
2. When you have nausea and vomiting. Medline Plus website. Updated August 22, 2016. Accessed November 15, 2022. https://medlineplus.gov/ency/patientinstructions/000122.htm
3. Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989.
4. Nausea and vomiting. Cleveland Clinic. Accessed November 15, 2022. https://my.clevelandclinic.org/health/symptoms/8106-nausea--vomiting