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  • Understanding Wegovy® Access Initiating a Wegovy® PA Wegovy® Patient Savings
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 |  Important Safety Information

Saxenda® (liraglutide) injection 3 mg

Wegovy® (semaglutide) tablets 25 mg

Wegovy® (semaglutide) injection 2.4 mg

    • How Wegovy® Works
    • Legacy of Wegovy®
    • Chronic Weight Management
    • Wegovy® and Cardiovascular Disease
    • Adolescent Indication
    • Safety Profile
    • Get to Know Wegovy® pen and pill
    • Wegovy® Dosing
    • Prescribing Wegovy®
    • Understanding Wegovy® Access
    • Initiating a Wegovy® PA
    • Wegovy® Patient Savings
    • For HCPs
    • For Pharmacists
    • Compounded “Semaglutide” Information
    • WeGoTogether®
    • Frequently Asked Questions

In addition to diet and exercise, to reduce risk of MACE (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CVD and either overweight or obesity, and for chronic weight management in patients with obesity ≥12 years and adults with overweight with at least one weight-related comorbidity. Click for Limitations of Use.

Resources

Frequently Asked Questions

Actor portrayals.

Actor portrayals.

Get the answers you need to help set patients up with a weight-management plan

As you consider prescribing Wegovy® for your patients, you may have some questions. Below you will find answers that will help you treat effectively and communicate pertinent information to your patients and staff.

You can also call 1-833-493-4689 anytime with questions about Wegovy®.

ABOUT WEGOVY®

The Wegovy® pen and the Wegovy® pill are indicated in combination with a reduced-calorie diet and increased physical activity1:

  • To reduce the risk of MACE (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight
  • To reduce excess body weight and maintain weight reduction long term in:
    - Adults with obesity
    - Adults with overweight in the presence of at least one weight-related comorbid condition

The Wegovy® pen is indicated in combination with a reduced-calorie diet and increased physical activity1:

  • To reduce excess body weight and maintain weight reduction long term in:
    - Pediatric patients aged 12 years and older with obesity

MACE, major adverse cardiovascular events.

Wegovy® targets areas of the brain that regulate appetite and food intake.1 94% similar to naturally occurring GLP-1, Wegovy® lowers your patients’ appetites to help them lose weight and keep it off.1,2* GLP-1 is a native hormone that is released in response to food intake and acts as a physiological regulator of appetite.2

Learn more about how Wegovy® works

The effect of Wegovy® was studied in animal models. The impact of Wegovy® in the brain is not fully understood.
*At 2 years.2
GLP-1, glucagon-like peptide-1.

In three randomized clinical trials to assess the safety and efficacy of subcutaneous Wegovy® for chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity, the following adverse reactions were 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
  • dysesthesia¶

The types and frequency of common adverse reactions of the Wegovy® pill were similar to the Wegovy® pen.

†Includes abdominal pain, lower abdominal pain, upper abdominal pain, gastrointestinal pain, abdominal tenderness, abdominal discomfort, and epigastric discomfort.1
‡Includes fatigue and asthenia.1
§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).1
∥Includes chronic gastritis, gastritis, erosive gastritis, and reflux gastritis.1
¶Includes paresthesia, hyperesthesia, burning sensation, allodynia, dysesthesia, skin burning sensation, pain of skin, and sensitive skin.1

Learn about Wegovy® safety profile

Once you’ve verified that your patient is covered and the prior authorization is approved, you can prescribe Wegovy® through your electronic health record system.

Learn more about prescribing Wegovy®

The Wegovy® pen and the Wegovy® pill are both indicated, in combination with a reduced-calorie diet and increased physical activity, to reduce the risk of MACE (defined as cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight.1

Learn more about the MACE indication

MACE, major adverse cardiovascular events.

TAKING WEGOVY®

The Wegovy® pen1

  • The Wegovy® pen starting dose is 0.25 mg once weekly
  • Escalate the patient’s Wegovy® dose every 4 weeks
  • Please refer to the Prescribing Information for full dosing information
  • If patients do not tolerate a dose during dose escalation, consider delaying dose escalation for 4 weeks
  • The maintenance dose of the Wegovy® pen is either 2.4 mg (recommended) or 1.7 mg once weekly. Consider treatment response and tolerability when selecting the maintenance dose

The Wegovy® pill1

  • The Wegovy® pill starting dose is 1.5 mg once daily
  • Escalate the patient’s Wegovy® dose every 30 days
  • Please refer to the Prescribing Information for full dosing information
  • If patients do not tolerate a dose during dose escalation, consider delaying dose escalation
  • The maintenance dose of the Wegovy® pill is 25 mg once daily
  • If patients do not tolerate the 25 mg once-daily maintenance dosage, consider switching to Wegovy® pen 1.7 mg once weekly
Learn about dose escalation with Wegovy®

Every patient is different. Here are some general considerations for helping your patients manage nausea4,5

Bread and bowl of rice

Eat bland, low-fat foods such as crackers,
toast, and rice

Steaming bowl of soup

Eat foods that contain water, such as soup and gelatin

Person standing

Don't lie down after you eat

Fork, knife, and clock

Eat more slowly

Wind

Go outside and get some fresh air

For patients using Wegovy® pen, if patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks.1

For patients using Wegovy® pill, if patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation. If patients do not tolerate the 25 mg once-daily maintenance dosage, consider switching to Wegovy® pen 1.7 mg once weekly.1

How to switch formulations

The Wegovy® pen1

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® pen 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® pen. Patients should keep Wegovy® pen in the original carton to protect it from light. Safely discard the Wegovy® pen after use.1

The Wegovy® pill1

Instruct patients to store the Wegovy® pills between 68 °F to 77 °F (20 °C to 25 °C). Store and dispense the Wegovy® pills in the original bottle to protect the pills from moisture. Store Wegovy® pills in a dry place away from moisture.1

Refer patients to the full Prescribing Information for more details regarding injection and pill storage.

Prior to initiation of Wegovy® pen, train patients on proper injection technique. Refer to the Instructions for Use for complete administration instructions.

Consider if your patient would benefit from administering the first injection of Wegovy® in office.

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 patients understand that they should only inject subcutaneously.1

Instruct patients who have problems injecting to change to a firmer injection site, such as upper leg or upper arm, or consider standing up while injecting into the stomach.1

Refer patients to the full Prescribing Information for more details regarding injection and pen storage.

Patients should take the Wegovy® pill with a sip of water (up to 4 oz) first thing in the morning.1

They should wait 30 minutes before eating, drinking, or taking other oral medications.1

Do not take the Wegovy® pill with other liquids besides water.1

Swallow tablets whole. Do not split, crush, chew or dissolve in any solution.1

Wegovy® Pen Video
(2:09)

Review the complete Instructions for Use.

Our video will provide information about 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 3 steps to determining access to Wegovy®.

Learn how

Commercially insured or self-paying patients can download a savings card for the Wegovy® pen or the Wegovy® pill to use at retail pharmacies.

Learn more

Self-paying patients or patients without coverage can learn about a self-pay option from NovoCare® Pharmacy.

Visit NovoCare® Pharmacy

WeGoTogether® is a program with behavior change resources designed to help your patients get started and stay on track with Wegovy®.

Learn more

Your patients can get support with WeGoTogether®

Learn how

Learn how your eligible patients can save on their Wegovy® prescription, click here.

Show More Show Less

Important Safety Information for Wegovy®

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®

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 Wegovy®. Observe patients carefully for signs and symptoms of acute pancreatitis, which may include persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea, or vomiting. If pancreatitis is suspected, discontinue Wegovy® and initiate appropriate management
  • Acute Gallbladder Disease: Treatment with Wegovy® is associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® injection-treated pediatric patients aged ≥12 years than in Wegovy® injection-treated adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® injection-treated patients and 0.7% of placebo treated patients, and by 2.5% of Wegovy® tablet-treated patients and 1% of placebo treated patients. Cholecystitis was reported by 0.6% of Wegovy® injection-treated adult patients and 0.2% of placebo treated patients. In a clinical trial in pediatric patients aged ≥12 years, cholelithiasis was reported by 3.8% of Wegovy® injection-treated patients and 0% placebo treated patients. Cholecystitis was reported by 0.8% of Wegovy® injection-treated pediatric patients and 0% placebo treated 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 Wegovy® injection in adult patients with type 2 diabetes (T2D) and a BMI ≥27 kg/m2, hypoglycemia was reported in more patients treated with Wegovy® versus placebo. In glycemic control clinical trials, the risk of hypoglycemia was increased when semaglutide injection or tablet was used concomitantly with insulin or an insulin secretagogue (e.g., sulfonylurea). Patients with diabetes taking Wegovy® with an insulin or insulin secretagogue may have an increased risk of hypoglycemia, including severe hypoglycemia. The use of Wegovy® in patients with type 1 diabetes or in combination with insulin has not been evaluated. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with diabetes
  • Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of the reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Wegovy® that could lead to volume depletion, especially during initiation and escalation of Wegovy®
  • Severe Gastrointestinal (GI) Adverse Reactions: Use of Wegovy® has been associated with GI adverse reactions, sometimes severe. In adult clinical trials, severe GI adverse reactions were reported more frequently among patients receiving Wegovy® than placebo. Severe GI adverse reactions were reported in 4.1% and 0.9% of Wegovy®-injection treated and placebo treated patients, respectively, and in 2% of Wegovy® tablet-treated and 0% of placebo treated patients, respectively. Severe GI adverse reactions have also been reported postmarketing with GLP-1 receptor agonists. Wegovy® is not recommended in patients with severe gastroparesis
  • 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 T2D: In a trial of adult patients with T2D and BMI ≥27 kg/m2, diabetic retinopathy was reported by 4% of Wegovy® injection-treated patients and 2.7% of placebo patients. In a glycemic control trial evaluating a dose comparable to the 9 mg dose and the 25 mg semaglutide tablet doses in patients with T2D, 1.3% and 1.9% of patients in the 9 mg and 25 mg semaglutide group, respectively, reported moderate-severe non-proliferative diabetic retinopathy events, and 0% and 0.4% reported proliferative retinopathy events, respectively. 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® injection-treated adult patients compared to placebo in clinical trials. More adults treated with Wegovy® injection compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% vs 34%) and 20 bpm or more (26% vs 16%). In a clinical trial in pediatric patients aged ≥12 years with normal baseline heart rate, more patients treated with Wegovy® injection compared to placebo had maximum changes in heart rate of 20 bpm or more (54% vs 39%). Findings were similar in a trial with the Wegovy® tablets. 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
  • Pulmonary Aspiration During General Anesthesia or Deep Sedation: Wegovy® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Wegovy®

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 T2D, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis 

Drug Interactions

  • When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues or insulin to reduce the risk of hypoglycemia. The addition of Wegovy® in patients treated with insulin has not been evaluated
  • 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®. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring

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
  • Lactation: A clinical lactation study reported semaglutide concentrations below the lower limit of quantification in human breast milk. However, salcaprozate sodium (SNAC) and/or its metabolites are present in human milk. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of SNAC, an absorption enhancer for Wegovy® tablets, and because there are alternative formulations of semaglutide that do not contain SNAC that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with Wegovy® tablets
  • Pediatric: Adverse reactions with Wegovy® injection-treated pediatric patients ≥12 years with obesity were similar to those reported in adults. Pediatric patients ≥12 years treated with Wegovy® injection had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®. There are insufficient data in pediatric patients with T2D treated with Wegovy® injection for obesity to determine if there is an increased risk of hypoglycemia with Wegovy® injection treatment similar to that reported in adults.

    The safety and effectiveness of Wegovy® injection have not been established in pediatric patients to reduce the risk of major adverse CV events or to reduce excess body weight and maintain weight reduction long term in those <12 years. 

    The safety and effectiveness of Wegovy® tablets have not been established in pediatric patients
  • Geriatric: In the CV outcomes trial, patients ≥75 years reported more hip and pelvis fractures on Wegovy® injection than placebo. Patients ≥75 years (Wegovy® injection and placebo) reported more serious adverse reactions overall compared to younger adult patients
  • Type 2 Diabetes: Wegovy® tablets have not been studied for weight reduction in adults with T2D and obesity or overweight. Administration of Wegovy® injection resulted in less weight reduction in patients with T2D and obesity or overweight compared to those without T2D and obesity or overweight

Please click here for Wegovy® Prescribing Information, including Boxed Warning.

Indications and Usage

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg and Wegovy® (semaglutide) tablets 25 mg are indicated in combination with a reduced calorie diet and increased physical activity to:  

  • Reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight
  • Reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight in the presence of at least one weight-related comorbidity 

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in pediatric patients aged 12 and older with obesity

Limitations of Use:

Concomitant use of Wegovy® tablets or Wegovy® injection with other semaglutide-containing products or with any GLP-1 receptor agonist is not recommended

Indications and Usage

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg and Wegovy® (semaglutide) tablets 25 mg are indicated in combination with a reduced calorie diet and increased physical activity to:  

  • Reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight
  • Reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight in the presence of at least one weight-related comorbidity 

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in pediatric patients aged 12 and older with obesity

Limitations of Use:

Concomitant use of Wegovy® tablets or Wegovy® injection with other semaglutide-containing products or with any GLP-1 receptor agonist is not recommended

Important Safety Information for Wegovy®

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®

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 Wegovy®. Observe patients carefully for signs and symptoms of acute pancreatitis, which may include persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea, or vomiting. If pancreatitis is suspected, discontinue Wegovy® and initiate appropriate management
  • Acute Gallbladder Disease: Treatment with Wegovy® is associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® injection-treated pediatric patients aged ≥12 years than in Wegovy® injection-treated adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® injection-treated patients and 0.7% of placebo treated patients, and by 2.5% of Wegovy® tablet-treated patients and 1% of placebo treated patients. Cholecystitis was reported by 0.6% of Wegovy® injection-treated adult patients and 0.2% of placebo treated patients. In a clinical trial in pediatric patients aged ≥12 years, cholelithiasis was reported by 3.8% of Wegovy® injection-treated patients and 0% placebo treated patients. Cholecystitis was reported by 0.8% of Wegovy® injection-treated pediatric patients and 0% placebo treated 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 Wegovy® injection in adult patients with type 2 diabetes (T2D) and a BMI ≥27 kg/m2, hypoglycemia was reported in more patients treated with Wegovy® versus placebo. In glycemic control clinical trials, the risk of hypoglycemia was increased when semaglutide injection or tablet was used concomitantly with insulin or an insulin secretagogue (e.g., sulfonylurea). Patients with diabetes taking Wegovy® with an insulin or insulin secretagogue may have an increased risk of hypoglycemia, including severe hypoglycemia. The use of Wegovy® in patients with type 1 diabetes or in combination with insulin has not been evaluated. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with diabetes
  • Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of the reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Wegovy® that could lead to volume depletion, especially during initiation and escalation of Wegovy®
  • Severe Gastrointestinal (GI) Adverse Reactions: Use of Wegovy® has been associated with GI adverse reactions, sometimes severe. In adult clinical trials, severe GI adverse reactions were reported more frequently among patients receiving Wegovy® than placebo. Severe GI adverse reactions were reported in 4.1% and 0.9% of Wegovy®-injection treated and placebo treated patients, respectively, and in 2% of Wegovy® tablet-treated and 0% of placebo treated patients, respectively. Severe GI adverse reactions have also been reported postmarketing with GLP-1 receptor agonists. Wegovy® is not recommended in patients with severe gastroparesis
  • 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 T2D: In a trial of adult patients with T2D and BMI ≥27 kg/m2, diabetic retinopathy was reported by 4% of Wegovy® injection-treated patients and 2.7% of placebo patients. In a glycemic control trial evaluating a dose comparable to the 9 mg dose and the 25 mg semaglutide tablet doses in patients with T2D, 1.3% and 1.9% of patients in the 9 mg and 25 mg semaglutide group, respectively, reported moderate-severe non-proliferative diabetic retinopathy events, and 0% and 0.4% reported proliferative retinopathy events, respectively. 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® injection-treated adult patients compared to placebo in clinical trials. More adults treated with Wegovy® injection compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% vs 34%) and 20 bpm or more (26% vs 16%). In a clinical trial in pediatric patients aged ≥12 years with normal baseline heart rate, more patients treated with Wegovy® injection compared to placebo had maximum changes in heart rate of 20 bpm or more (54% vs 39%). Findings were similar in a trial with the Wegovy® tablets. 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
  • Pulmonary Aspiration During General Anesthesia or Deep Sedation: Wegovy® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Wegovy®

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 T2D, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis 

Drug Interactions

  • When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues or insulin to reduce the risk of hypoglycemia. The addition of Wegovy® in patients treated with insulin has not been evaluated
  • 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®. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring

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
  • Lactation: A clinical lactation study reported semaglutide concentrations below the lower limit of quantification in human breast milk. However, salcaprozate sodium (SNAC) and/or its metabolites are present in human milk. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of SNAC, an absorption enhancer for Wegovy® tablets, and because there are alternative formulations of semaglutide that do not contain SNAC that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with Wegovy® tablets
  • Pediatric: Adverse reactions with Wegovy® injection-treated pediatric patients ≥12 years with obesity were similar to those reported in adults. Pediatric patients ≥12 years treated with Wegovy® injection had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®. There are insufficient data in pediatric patients with T2D treated with Wegovy® injection for obesity to determine if there is an increased risk of hypoglycemia with Wegovy® injection treatment similar to that reported in adults.

    The safety and effectiveness of Wegovy® injection have not been established in pediatric patients to reduce the risk of major adverse CV events or to reduce excess body weight and maintain weight reduction long term in those <12 years. 

    The safety and effectiveness of Wegovy® tablets have not been established in pediatric patients
  • Geriatric: In the CV outcomes trial, patients ≥75 years reported more hip and pelvis fractures on Wegovy® injection than placebo. Patients ≥75 years (Wegovy® injection and placebo) reported more serious adverse reactions overall compared to younger adult patients
  • Type 2 Diabetes: Wegovy® tablets have not been studied for weight reduction in adults with T2D and obesity or overweight. Administration of Wegovy® injection resulted in less weight reduction in patients with T2D and obesity or overweight compared to those without T2D and obesity or overweight

Please click here for Wegovy® Prescribing Information, including Boxed Warning.

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Indications and Usage

Indications and Usage

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg and Wegovy® (semaglutide) tablets 25 mg are indicated in combination with a reduced calorie diet and increased physical activity to:  

  • Reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight
  • Reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight in the presence of at least one weight-related comorbidity 

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in pediatric patients aged 12 and older with obesity

Limitations of Use:

Concomitant use of Wegovy® tablets or Wegovy® injection with other semaglutide-containing products or with any GLP-1 receptor agonist is not recommended

Important Safety Information for Wegovy®

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®

Important Safety Information for Wegovy®

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®

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 Wegovy®. Observe patients carefully for signs and symptoms of acute pancreatitis, which may include persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea, or vomiting. If pancreatitis is suspected, discontinue Wegovy® and initiate appropriate management
  • Acute Gallbladder Disease: Treatment with Wegovy® is associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® injection-treated pediatric patients aged ≥12 years than in Wegovy® injection-treated adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® injection-treated patients and 0.7% of placebo treated patients, and by 2.5% of Wegovy® tablet-treated patients and 1% of placebo treated patients. Cholecystitis was reported by 0.6% of Wegovy® injection-treated adult patients and 0.2% of placebo treated patients. In a clinical trial in pediatric patients aged ≥12 years, cholelithiasis was reported by 3.8% of Wegovy® injection-treated patients and 0% placebo treated patients. Cholecystitis was reported by 0.8% of Wegovy® injection-treated pediatric patients and 0% placebo treated 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 Wegovy® injection in adult patients with type 2 diabetes (T2D) and a BMI ≥27 kg/m2, hypoglycemia was reported in more patients treated with Wegovy® versus placebo. In glycemic control clinical trials, the risk of hypoglycemia was increased when semaglutide injection or tablet was used concomitantly with insulin or an insulin secretagogue (e.g., sulfonylurea). Patients with diabetes taking Wegovy® with an insulin or insulin secretagogue may have an increased risk of hypoglycemia, including severe hypoglycemia. The use of Wegovy® in patients with type 1 diabetes or in combination with insulin has not been evaluated. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with diabetes
  • Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of the reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Wegovy® that could lead to volume depletion, especially during initiation and escalation of Wegovy®
  • Severe Gastrointestinal (GI) Adverse Reactions: Use of Wegovy® has been associated with GI adverse reactions, sometimes severe. In adult clinical trials, severe GI adverse reactions were reported more frequently among patients receiving Wegovy® than placebo. Severe GI adverse reactions were reported in 4.1% and 0.9% of Wegovy®-injection treated and placebo treated patients, respectively, and in 2% of Wegovy® tablet-treated and 0% of placebo treated patients, respectively. Severe GI adverse reactions have also been reported postmarketing with GLP-1 receptor agonists. Wegovy® is not recommended in patients with severe gastroparesis
  • 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 T2D: In a trial of adult patients with T2D and BMI ≥27 kg/m2, diabetic retinopathy was reported by 4% of Wegovy® injection-treated patients and 2.7% of placebo patients. In a glycemic control trial evaluating a dose comparable to the 9 mg dose and the 25 mg semaglutide tablet doses in patients with T2D, 1.3% and 1.9% of patients in the 9 mg and 25 mg semaglutide group, respectively, reported moderate-severe non-proliferative diabetic retinopathy events, and 0% and 0.4% reported proliferative retinopathy events, respectively. 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® injection-treated adult patients compared to placebo in clinical trials. More adults treated with Wegovy® injection compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% vs 34%) and 20 bpm or more (26% vs 16%). In a clinical trial in pediatric patients aged ≥12 years with normal baseline heart rate, more patients treated with Wegovy® injection compared to placebo had maximum changes in heart rate of 20 bpm or more (54% vs 39%). Findings were similar in a trial with the Wegovy® tablets. 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
  • Pulmonary Aspiration During General Anesthesia or Deep Sedation: Wegovy® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Wegovy®

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 T2D, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis 

Drug Interactions

  • When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues or insulin to reduce the risk of hypoglycemia. The addition of Wegovy® in patients treated with insulin has not been evaluated
  • 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®. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring

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
  • Lactation: A clinical lactation study reported semaglutide concentrations below the lower limit of quantification in human breast milk. However, salcaprozate sodium (SNAC) and/or its metabolites are present in human milk. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of SNAC, an absorption enhancer for Wegovy® tablets, and because there are alternative formulations of semaglutide that do not contain SNAC that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with Wegovy® tablets
  • Pediatric: Adverse reactions with Wegovy® injection-treated pediatric patients ≥12 years with obesity were similar to those reported in adults. Pediatric patients ≥12 years treated with Wegovy® injection had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®. There are insufficient data in pediatric patients with T2D treated with Wegovy® injection for obesity to determine if there is an increased risk of hypoglycemia with Wegovy® injection treatment similar to that reported in adults.

    The safety and effectiveness of Wegovy® injection have not been established in pediatric patients to reduce the risk of major adverse CV events or to reduce excess body weight and maintain weight reduction long term in those <12 years. 

    The safety and effectiveness of Wegovy® tablets have not been established in pediatric patients
  • Geriatric: In the CV outcomes trial, patients ≥75 years reported more hip and pelvis fractures on Wegovy® injection than placebo. Patients ≥75 years (Wegovy® injection and placebo) reported more serious adverse reactions overall compared to younger adult patients
  • Type 2 Diabetes: Wegovy® tablets have not been studied for weight reduction in adults with T2D and obesity or overweight. Administration of Wegovy® injection resulted in less weight reduction in patients with T2D and obesity or overweight compared to those without T2D and obesity or overweight

Please click here for Wegovy® Prescribing Information, including Boxed Warning.

Important Safety Information for Wegovy®

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®

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 Wegovy®. Observe patients carefully for signs and symptoms of acute pancreatitis, which may include persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea, or vomiting. If pancreatitis is suspected, discontinue Wegovy® and initiate appropriate management
  • Acute Gallbladder Disease: Treatment with Wegovy® is associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® injection-treated pediatric patients aged ≥12 years than in Wegovy® injection-treated adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® injection-treated patients and 0.7% of placebo treated patients, and by 2.5% of Wegovy® tablet-treated patients and 1% of placebo treated patients. Cholecystitis was reported by 0.6% of Wegovy® injection-treated adult patients and 0.2% of placebo treated patients. In a clinical trial in pediatric patients aged ≥12 years, cholelithiasis was reported by 3.8% of Wegovy® injection-treated patients and 0% placebo treated patients. Cholecystitis was reported by 0.8% of Wegovy® injection-treated pediatric patients and 0% placebo treated 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 Wegovy® injection in adult patients with type 2 diabetes (T2D) and a BMI ≥27 kg/m2, hypoglycemia was reported in more patients treated with Wegovy® versus placebo. In glycemic control clinical trials, the risk of hypoglycemia was increased when semaglutide injection or tablet was used concomitantly with insulin or an insulin secretagogue (e.g., sulfonylurea). Patients with diabetes taking Wegovy® with an insulin or insulin secretagogue may have an increased risk of hypoglycemia, including severe hypoglycemia. The use of Wegovy® in patients with type 1 diabetes or in combination with insulin has not been evaluated. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with diabetes
  • Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of the reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Wegovy® that could lead to volume depletion, especially during initiation and escalation of Wegovy®
  • Severe Gastrointestinal (GI) Adverse Reactions: Use of Wegovy® has been associated with GI adverse reactions, sometimes severe. In adult clinical trials, severe GI adverse reactions were reported more frequently among patients receiving Wegovy® than placebo. Severe GI adverse reactions were reported in 4.1% and 0.9% of Wegovy®-injection treated and placebo treated patients, respectively, and in 2% of Wegovy® tablet-treated and 0% of placebo treated patients, respectively. Severe GI adverse reactions have also been reported postmarketing with GLP-1 receptor agonists. Wegovy® is not recommended in patients with severe gastroparesis
  • 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 T2D: In a trial of adult patients with T2D and BMI ≥27 kg/m2, diabetic retinopathy was reported by 4% of Wegovy® injection-treated patients and 2.7% of placebo patients. In a glycemic control trial evaluating a dose comparable to the 9 mg dose and the 25 mg semaglutide tablet doses in patients with T2D, 1.3% and 1.9% of patients in the 9 mg and 25 mg semaglutide group, respectively, reported moderate-severe non-proliferative diabetic retinopathy events, and 0% and 0.4% reported proliferative retinopathy events, respectively. 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® injection-treated adult patients compared to placebo in clinical trials. More adults treated with Wegovy® injection compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% vs 34%) and 20 bpm or more (26% vs 16%). In a clinical trial in pediatric patients aged ≥12 years with normal baseline heart rate, more patients treated with Wegovy® injection compared to placebo had maximum changes in heart rate of 20 bpm or more (54% vs 39%). Findings were similar in a trial with the Wegovy® tablets. 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
  • Pulmonary Aspiration During General Anesthesia or Deep Sedation: Wegovy® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Wegovy®

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 T2D, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis 

Drug Interactions

  • When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues or insulin to reduce the risk of hypoglycemia. The addition of Wegovy® in patients treated with insulin has not been evaluated
  • 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®. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring

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
  • Lactation: A clinical lactation study reported semaglutide concentrations below the lower limit of quantification in human breast milk. However, salcaprozate sodium (SNAC) and/or its metabolites are present in human milk. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of SNAC, an absorption enhancer for Wegovy® tablets, and because there are alternative formulations of semaglutide that do not contain SNAC that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with Wegovy® tablets
  • Pediatric: Adverse reactions with Wegovy® injection-treated pediatric patients ≥12 years with obesity were similar to those reported in adults. Pediatric patients ≥12 years treated with Wegovy® injection had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®. There are insufficient data in pediatric patients with T2D treated with Wegovy® injection for obesity to determine if there is an increased risk of hypoglycemia with Wegovy® injection treatment similar to that reported in adults.

    The safety and effectiveness of Wegovy® injection have not been established in pediatric patients to reduce the risk of major adverse CV events or to reduce excess body weight and maintain weight reduction long term in those <12 years. 

    The safety and effectiveness of Wegovy® tablets have not been established in pediatric patients
  • Geriatric: In the CV outcomes trial, patients ≥75 years reported more hip and pelvis fractures on Wegovy® injection than placebo. Patients ≥75 years (Wegovy® injection and placebo) reported more serious adverse reactions overall compared to younger adult patients
  • Type 2 Diabetes: Wegovy® tablets have not been studied for weight reduction in adults with T2D and obesity or overweight. Administration of Wegovy® injection resulted in less weight reduction in patients with T2D and obesity or overweight compared to those without T2D and obesity or overweight

Please click here for Wegovy® Prescribing Information, including Boxed Warning.

Indications and Usage

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg and Wegovy® (semaglutide) tablets 25 mg are indicated in combination with a reduced calorie diet and increased physical activity to:  

  • Reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight
  • Reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight in the presence of at least one weight-related comorbidity 

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in pediatric patients aged 12 and older with obesity

Limitations of Use:

Concomitant use of Wegovy® tablets or Wegovy® injection with other semaglutide-containing products or with any GLP-1 receptor agonist is not recommended

Indications and Usage

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg and Wegovy® (semaglutide) tablets 25 mg are indicated in combination with a reduced calorie diet and increased physical activity to:  

  • Reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight
  • Reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight in the presence of at least one weight-related comorbidity 

Wegovy® (semaglutide) injection 1.7 mg or 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in pediatric patients aged 12 and older with obesity

Limitations of Use:

Concomitant use of Wegovy® tablets or Wegovy® injection with other semaglutide-containing products or with any GLP-1 receptor agonist is not recommended

Important Safety Information for Wegovy®

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®

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 Wegovy®. Observe patients carefully for signs and symptoms of acute pancreatitis, which may include persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea, or vomiting. If pancreatitis is suspected, discontinue Wegovy® and initiate appropriate management
  • Acute Gallbladder Disease: Treatment with Wegovy® is associated with an increased occurrence of cholelithiasis and cholecystitis. The incidence of cholelithiasis and cholecystitis was higher in Wegovy® injection-treated pediatric patients aged ≥12 years than in Wegovy® injection-treated adults. In clinical trials in adult patients, cholelithiasis was reported by 1.6% of Wegovy® injection-treated patients and 0.7% of placebo treated patients, and by 2.5% of Wegovy® tablet-treated patients and 1% of placebo treated patients. Cholecystitis was reported by 0.6% of Wegovy® injection-treated adult patients and 0.2% of placebo treated patients. In a clinical trial in pediatric patients aged ≥12 years, cholelithiasis was reported by 3.8% of Wegovy® injection-treated patients and 0% placebo treated patients. Cholecystitis was reported by 0.8% of Wegovy® injection-treated pediatric patients and 0% placebo treated 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 Wegovy® injection in adult patients with type 2 diabetes (T2D) and a BMI ≥27 kg/m2, hypoglycemia was reported in more patients treated with Wegovy® versus placebo. In glycemic control clinical trials, the risk of hypoglycemia was increased when semaglutide injection or tablet was used concomitantly with insulin or an insulin secretagogue (e.g., sulfonylurea). Patients with diabetes taking Wegovy® with an insulin or insulin secretagogue may have an increased risk of hypoglycemia, including severe hypoglycemia. The use of Wegovy® in patients with type 1 diabetes or in combination with insulin has not been evaluated. Inform patients of the risk of hypoglycemia and educate them on the signs and symptoms. Monitor blood glucose in patients with diabetes
  • Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of the reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Wegovy® that could lead to volume depletion, especially during initiation and escalation of Wegovy®
  • Severe Gastrointestinal (GI) Adverse Reactions: Use of Wegovy® has been associated with GI adverse reactions, sometimes severe. In adult clinical trials, severe GI adverse reactions were reported more frequently among patients receiving Wegovy® than placebo. Severe GI adverse reactions were reported in 4.1% and 0.9% of Wegovy®-injection treated and placebo treated patients, respectively, and in 2% of Wegovy® tablet-treated and 0% of placebo treated patients, respectively. Severe GI adverse reactions have also been reported postmarketing with GLP-1 receptor agonists. Wegovy® is not recommended in patients with severe gastroparesis
  • 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 T2D: In a trial of adult patients with T2D and BMI ≥27 kg/m2, diabetic retinopathy was reported by 4% of Wegovy® injection-treated patients and 2.7% of placebo patients. In a glycemic control trial evaluating a dose comparable to the 9 mg dose and the 25 mg semaglutide tablet doses in patients with T2D, 1.3% and 1.9% of patients in the 9 mg and 25 mg semaglutide group, respectively, reported moderate-severe non-proliferative diabetic retinopathy events, and 0% and 0.4% reported proliferative retinopathy events, respectively. 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® injection-treated adult patients compared to placebo in clinical trials. More adults treated with Wegovy® injection compared with placebo had maximum changes from baseline of 10 to 19 bpm (41% vs 34%) and 20 bpm or more (26% vs 16%). In a clinical trial in pediatric patients aged ≥12 years with normal baseline heart rate, more patients treated with Wegovy® injection compared to placebo had maximum changes in heart rate of 20 bpm or more (54% vs 39%). Findings were similar in a trial with the Wegovy® tablets. 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
  • Pulmonary Aspiration During General Anesthesia or Deep Sedation: Wegovy® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Wegovy®

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 T2D, flatulence, gastroenteritis, gastroesophageal reflux disease, and nasopharyngitis 

Drug Interactions

  • When initiating Wegovy®, consider reducing the dose of concomitantly administered insulin secretagogues or insulin to reduce the risk of hypoglycemia. The addition of Wegovy® in patients treated with insulin has not been evaluated
  • 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®. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring

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
  • Lactation: A clinical lactation study reported semaglutide concentrations below the lower limit of quantification in human breast milk. However, salcaprozate sodium (SNAC) and/or its metabolites are present in human milk. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of SNAC, an absorption enhancer for Wegovy® tablets, and because there are alternative formulations of semaglutide that do not contain SNAC that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with Wegovy® tablets
  • Pediatric: Adverse reactions with Wegovy® injection-treated pediatric patients ≥12 years with obesity were similar to those reported in adults. Pediatric patients ≥12 years treated with Wegovy® injection had greater incidences of cholelithiasis, cholecystitis, hypotension, rash, and urticaria compared to adults treated with Wegovy®. There are insufficient data in pediatric patients with T2D treated with Wegovy® injection for obesity to determine if there is an increased risk of hypoglycemia with Wegovy® injection treatment similar to that reported in adults.

    The safety and effectiveness of Wegovy® injection have not been established in pediatric patients to reduce the risk of major adverse CV events or to reduce excess body weight and maintain weight reduction long term in those <12 years. 

    The safety and effectiveness of Wegovy® tablets have not been established in pediatric patients
  • Geriatric: In the CV outcomes trial, patients ≥75 years reported more hip and pelvis fractures on Wegovy® injection than placebo. Patients ≥75 years (Wegovy® injection and placebo) reported more serious adverse reactions overall compared to younger adult patients
  • Type 2 Diabetes: Wegovy® tablets have not been studied for weight reduction in adults with T2D and obesity or overweight. Administration of Wegovy® injection resulted in less weight reduction in patients with T2D and obesity or overweight compared to those without T2D and obesity or overweight

Please click here for Wegovy® Prescribing Information, including Boxed Warning.

References

  1. Wegovy® [package insert]. Plainsboro, NJ: Novo Nordisk Inc.
  2. Friedrichswen M, Breitschaft A, Tadayon S, Wizert A, Skovgaard D. The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes Obes Metab. 2021;23:754-762.
  3. Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083-2091.
  4. Cleveland Clinic. Nausea and vomiting. Cleveland Clinic website. Accessed November 15, 2025. https://my.clevelandclinic.org/health/symptoms/8106-nausea--vomiting
  5. MedlinePlus. When you have nausea and vomiting. MedlinePlus website. Accessed November 15, 2025. https://medlineplus.gov/ency/patientinstructions/000122.htm
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