Half-life

165 h

Tmax

24 h

Category

glp1

Also known as: sema, Ozempic, Wegovy, Rybelsus

Semaglutide is a long-acting GLP-1 receptor agonist originally developed by Novo Nordisk. It works by binding to and activating the GLP-1 receptor, which slows gastric emptying, augments glucose-dependent insulin secretion, and suppresses glucagon release. The molecule is acylated with a C18 fatty-acid side chain that binds reversibly to albumin, extending its terminal half-life to approximately 165 hours and enabling once-weekly subcutaneous dosing. Clinically, it is used for glycaemic control in type 2 diabetes and for chronic weight management under the brand names Ozempic and Wegovy. Common rotation sites include the abdomen, thigh, and upper arm. Regular tracking of dose timing, injection site, and gastrointestinal side effects is recommended to manage tolerance and adherence.

Mechanism

A long-acting GLP-1 receptor agonist. It binds the GLP-1 receptor, which in research is associated with enhanced glucose-dependent insulin secretion, slowed gastric emptying, and reduced appetite. An acylated fatty-acid side chain promotes albumin binding, extending its half-life to allow once-weekly use.

Research summary

Studied extensively for type 2 diabetes (SUSTAIN program) and, at higher doses, for chronic weight management (STEP program). Cardiovascular outcome trials have also been reported in the literature. Marketed as Ozempic and Rybelsus for diabetes and Wegovy for weight management.

Reported side effects

Gastrointestinal effects (nausea, vomiting, diarrhea, constipation) are the most commonly reported in trials, typically during titration. Prescribing information notes warnings including risk of thyroid C-cell tumors in rodents and pancreatitis. This is not a complete safety profile.

Educational summary of published research. Not dosing guidance or medical advice.

Sources

STEP trials of semaglutide for weight management (NEJM) · New England Journal of Medicine (2021)search PubMed/NEJM for the STEP 1-8 series
SUSTAIN program (semaglutide in type 2 diabetes) · peer-reviewed clinical trial series (2016)search PubMed for SUSTAIN
Ozempic / Wegovy prescribing information · FDA prescribing information (2021)available via DailyMed / accessdata.fda.gov

References

Semaglutide once-weekly: PK/PD reviewDOI: 10.1007/s40262-019-00811-y
Semaglutide and cardiovascular outcomesDOI: 10.1056/NEJMoa1911024

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