Semaglutide: how it works, cost and where to get it

What semaglutide is made of

The Ozempic label describes semaglutide as "a human GLP-1 receptor agonist (or GLP-1 analog)" with 94% sequence homology to human GLP-1. "The peptide backbone is produced by yeast fermentation," and the molecular weight is 4,113.58 g/mol ^[1]. That answers two common questions. It is a peptide. And it is modeled on a human hormone made in yeast, not taken from Gila monster venom.

Is GLP-1 the same as semaglutide? No. GLP-1, short for glucagon-like peptide-1, is the hormone and the name of the drug class ^[2]. Semaglutide is one drug in that class. Tirzepatide is another that also acts on a second hormone, GIP; see tirzepatide.

What semaglutide does in the body

• Acts like GLP-1. "GLP-1 is a physiological hormone that has multiple actions on glucose, mediated by the GLP-1 receptors." Semaglutide lowers blood sugar by stimulating insulin release ^[1].
• Slows the stomach. It delays early stomach emptying after meals ^[1].
• Lasts a week. Peak levels come 1 to 3 days after a shot, the half-life is about 1 week, and steady levels arrive after 4 to 5 weekly doses ^[1].

More on the class: how GLP-1 medicines work and how long they take.

The semaglutide brands

FDA-approved semaglutide products and self-pay prices (checked October 17, 2026)

Product	Approved for	Dose range	Self-pay price
Wegovy injection	Weight reduction and maintenance (adults and ages 12+); lowering heart attack, stroke and cardiovascular death risk in adults with heart disease and obesity or overweight; MASH with moderate to advanced fibrosis (accelerated approval) [2]	0.25 mg to 2.4 mg weekly; up to 7.2 mg for adults [2]	$199 for the first two fills of starter doses, then $349; 7.2 mg $399 [5]
Wegovy tablets	Weight reduction and maintenance in adults; heart risk reduction [2]	1.5 mg to 25 mg daily [2]	$149 to $299 [5]
Ozempic injection	Type 2 diabetes blood sugar control; heart risk in type 2 diabetes with heart disease; kidney outcomes in type 2 diabetes with chronic kidney disease [1]	0.25 mg to 2 mg weekly [1]	$199 intro, then $349; 2 mg $499 [3]
Ozempic tablets	Type 2 diabetes, per NovoCare; we did not review a tablet label [3]	4 mg or 9 mg [3]	$149 to $299; dose for each price not confirmed [3]

What is Rybelsus?

Novo Nordisk lists Rybelsus with Wegovy and Ozempic as its semaglutide medicines, and says the list price of all three falls to $675 a month on January 1, 2027 ^[6]. We did not recheck the Rybelsus label for this page. NovoCare now lists Ozempic tablets in 4 mg and 9 mg strengths for adults with type 2 diabetes ^[3]. For weight loss, the semaglutide pill with a weight indication is the Wegovy pill.

How much semaglutide do people take?

Doses follow the label of the product you are prescribed. Wegovy shots climb every 4 weeks: 0.25 mg, then 0.5 mg, 1 mg and 1.7 mg, with maintenance from week 17 at 1.7 or 2.4 mg; adults may go to 7.2 mg after at least 4 weeks on 2.4 mg if more weight loss is needed ^[2]. Wegovy tablets go from 1.5 mg to 4 mg, 9 mg and then 25 mg daily, a month at each step ^[2]. Ozempic starts at 0.25 mg for 4 weeks and tops out at 2 mg weekly ^[1].

When to take the shot: any time of day, on the same day each week. The site (abdomen, thigh or upper arm) and the time of day can change ^[2]. Missed-dose rules differ: Wegovy shots are skipped if the next dose is under 48 hours away, Ozempic can be taken up to 5 days late, and a missed Wegovy tablet is skipped ^[2][1].

Compounded semaglutide comes in vials where units depend on the concentration on the pharmacy label. Follow your prescriber's instructions and the pharmacy label, and ask the pharmacist. FDA has received reports of people hurt by measuring errors and by doses above the label, some needing hospital care ^[7]. If you think you took too much, call your prescriber or pharmacist now, and call 911 for severe symptoms. Guides: semaglutide dosage, how to use semaglutide, microdosing semaglutide.

Results in trials

In STEP 1, adults with obesity or overweight on semaglutide 2.4 mg lost an average of 14.9% of body weight at 68 weeks, vs 2.4% on placebo. Half (50.5%) lost at least 15% ^[4]. When people stopped, the STEP 1 extension found they regained about two-thirds of the lost weight within a year, and heart and metabolic gains mostly faded ^[8]. In SURMOUNT-5, a head-to-head trial, average loss at 72 weeks was 13.7% on semaglutide vs 20.2% on tirzepatide ^[9].

Is oral semaglutide effective? The Wegovy label says side effects of the 25 mg tablet are similar in type and frequency to the 2.4 mg shot ^[2]. In OASIS 4, the 25 mg tablet trial in 307 adults, average weight loss at 64 weeks was 13.6% vs 2.4% on placebo, counting everyone whether or not they stayed on treatment. Novo Nordisk estimates 16.6% vs 2.7% for the ideal case in which everyone had stayed on treatment ^[16]. More: semaglutide results, stopping semaglutide.

Is semaglutide safe? Risks and who should not take it

Common side effects of Wegovy 2.4 mg vs placebo in adult weight trials

Side effect	Wegovy 2.4 mg	Placebo
Nausea	44%	16%
Diarrhea	30%	16%
Vomiting	24%	6%
Constipation	24%	11%
Abdominal pain	20%	10%

Semaglutide carries a boxed warning for thyroid C-cell tumors seen in rodents. It is not known whether it causes them in people, and it should not be used by anyone with a personal or family history of medullary thyroid carcinoma or MEN 2 ^[2]. People with a prior serious allergic reaction to semaglutide also should not take it ^[2]. Label warnings include pancreatitis, gallbladder disease, low blood sugar (mainly with insulin or a sulfonylurea), kidney injury from fluid loss, severe stomach and bowel reactions, allergic reactions, diabetic eye complications, a faster heart rate, and breathing in stomach contents during anesthesia ^[2].

Pregnancy: Wegovy should be stopped when pregnancy is recognized, and semaglutide should be stopped at least 2 months before a planned pregnancy because it stays in the body a long time ^[2]. Breastfeeding is not recommended on Wegovy tablets ^[2]. Semaglutide slows stomach emptying and can change how oral drugs are absorbed; with the tablet, levothyroxine levels rose 33% ^[2]. See semaglutide interactions.

What semaglutide costs

Semaglutide prices, checked October 17, 2026

Route	Price	What to know	Source
Wegovy pen, NovoCare self-pay	$199 for two fills of 0.25 or 0.5 mg, then $349; 7.2 mg $399	Intro offer runs through Dec 31, 2026	[5]
Wegovy pill, self-pay	$149 (1.5 mg), $199 (4 mg), $299 (9 and 25 mg)	Sold at retail pharmacies and NovoCare	[5]
Wegovy or Ozempic with commercial coverage	As little as $25	Savings capped at $100 a month; not for government plans	[5][3]
Wegovy on Medicare	$50 copay	GLP-1 Bridge for eligible Part D enrollees; Ozempic excluded	[10][11]
List prices	Wegovy $1,349; Ozempic $1,028	Falling to $675 on Jan 1, 2027	[12][6]

What is compounded semaglutide?

Compounded semaglutide is made by a pharmacy, not Novo Nordisk. It is not FDA-approved, and FDA does not review it for safety, effectiveness or quality ^[7]. FDA declared the semaglutide shortage over on February 21, 2025, and its grace period ended April 24, 2025 for 503A pharmacies and May 22, 2025 for 503B outsourcing facilities ^[13]. FDA says semaglutide sodium and semaglutide acetate are different active ingredients with no known lawful basis for compounding ^[7]. It had received 990 adverse event reports for compounded semaglutide as of May 31, 2026 ^[7].

Why is my semaglutide red or pink? Some compounded products are blends with vitamin B12 (cyanocobalamin). In September 2026 FDA called a compounded semaglutide and cyanocobalamin product an "essentially copy" in a warning letter to Empower Pharmacy ^[14]. If the product does not match the pharmacy label's description, do not use it, and call the pharmacist. Read compounded semaglutide and research-use-only semaglutide.

Does semaglutide go bad?

Yes, on a schedule. Unopened Wegovy single-dose pens can stay out of the fridge at up to 86 F for 28 days; the FlexTouch pen is good for 56 days after first use; Wegovy tablets stay at room temperature in the original bottle ^[15]. FDA advises throwing out compounded multi-dose vials 28 days after first use and not using injectables that arrive warm ^[7]. See semaglutide storage and what to eat on semaglutide.

How to qualify and where to get it

A licensed clinician decides whether you fit a label. Wegovy is for weight and heart risk; Ozempic is for type 2 diabetes. On Medicare's GLP-1 Bridge, eligibility starts at a BMI of 35, or lower BMI thresholds with certain conditions ^[10]. Once prescribed, the self-pay offer works at local pharmacies or through NovoCare Pharmacy delivery ^[5]. Options: semaglutide near you and semaglutide online.

All semaglutide guides

• Wegovy: pen, pill, cost and how to get it
• Ozempic: what it is, how it works and what it costs
• Wegovy pill: cost by dose and how to get it
• Semaglutide cost in 2026: brand, compounded and clinic prices
• Where to get semaglutide near you
• How to get semaglutide online
• Semaglutide side effects: what is common and what is serious
• How long Semaglutide takes to work and how much weight people lose
• Semaglutide dosage: doses, schedule and units to mg
• How to use Semaglutide: injection sites, timing and missed doses
• Does Semaglutide need to be refrigerated? Storage and travel
• What to eat and drink on Semaglutide
• Semaglutide with other medicines and health conditions
• What happens when you stop Semaglutide
• Microdosing semaglutide: doses, cost and evidence
• Compounded semaglutide: cost, legality and safety
• Does insurance cover Wegovy? Plan by plan
• Does insurance cover Ozempic? Plan by plan
• Ozempic vs Wegovy
• Wegovy vs Zepbound (semaglutide vs tirzepatide)
• Wegovy pill vs injection: results, cost and side effects