Wegovy is a brand-name injectable prescription medication containing semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. It is FDA-approved for chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition, and to reduce cardiovascular risk in adults with established cardiovascular disease and obesity or overweight. It is also approved for weight management in adolescents aged 12 and older with obesity.
How It Works
Wegovy contains semaglutide, a molecule that closely mimics GLP-1, a hormone your body naturally releases after eating. According to the FDA-approved prescribing information (NDA 215256), semaglutide works through three primary pathways:
Semaglutide activates GLP-1 receptors in the hypothalamus, the brain region that regulates appetite and food intake. This reduces hunger signals and increases feelings of fullness (satiety), leading people to eat less food and consume fewer calories.
The drug slows how quickly food empties from the stomach into the small intestine (gastric emptying). This extends the physical sensation of fullness after meals and moderates the rise in blood sugar following eating.
Semaglutide stimulates insulin release from the pancreas in a blood-sugar-dependent manner and suppresses glucagon, a hormone that raises blood sugar. This helps regulate glucose levels, though Wegovy is not approved specifically to treat type 2 diabetes.
Wegovy is administered once weekly by subcutaneous injection. Its half-life of approximately one week, as stated in the FDA label, allows for this convenient dosing schedule. The dose is escalated gradually over 16–20 weeks to reach the maintenance dose of 2.4 mg weekly, a schedule designed to minimize gastrointestinal side effects.
Side Effects by Week
| Time Period | Common Side Effects | What Helps |
|---|---|---|
| Weeks 1–2 (0.25 mg dose) |
Nausea (most common), mild stomach upset, decreased appetite, occasional vomiting or diarrhea. Reported in STEP 1 trial (Wilding et al., NEJM 2021) in majority of patients initiating therapy. | Eating smaller meals; avoiding high-fat or spicy foods; staying upright after eating; taking injection on a consistent day each week. |
| Weeks 3–4 (still 0.25 mg) |
Nausea may persist or peak; constipation becomes more prevalent; some patients report fatigue, burping, or acid reflux. FDA label lists constipation occurring in up to 24% of patients. | Increasing dietary fiber and water intake; gentle physical activity; over-the-counter antacids as tolerated (consult prescriber); allowing body to adjust before dose escalation. |
| Months 2–3 (0.5–1.0 mg doses) |
Nausea typically subsides for many patients as the body adapts; constipation may continue; diarrhea episodes; headache; dizziness reported in STEP trials. Hair thinning (telogen effluvium) may begin. | Continuing dietary adjustments; ensuring adequate protein intake to support muscle mass; reporting persistent symptoms to prescriber; dose escalation can be delayed per FDA label if side effects are not tolerated. |
| Long-Term (maintenance 2.4 mg) |
Most GI side effects diminish significantly by 20 weeks per STEP 1 data. Injection site reactions (bruising, redness) possible. Gallbladder issues (cholelithiasis) reported. Muscle loss (lean mass reduction) documented in STEP trials. | Rotating injection sites per FDA label instructions; resistance exercise to preserve lean mass; regular follow-up with prescriber; abdominal pain should be evaluated promptly for gallbladder issues. |
Most Common Side Effects
The following side effects were reported in ≥5% of Wegovy-treated patients in STEP clinical trials and are listed in the FDA-approved prescribing information (NDA 215256):
- Nausea: The most frequently reported side effect, occurring in up to 44% of patients in STEP 1 (Wilding et al., NEJM 2021), typically most intense during dose escalation and decreasing over time.
- Diarrhea: Reported in approximately 30% of participants in STEP 1, generally mild to moderate in severity and transient in nature.
- Vomiting: Occurred in up to 24% of Wegovy-treated patients in STEP 1, most common during the early dose escalation phase.
- Constipation: Reported in approximately 24% of patients per FDA labeling, and can persist longer than other gastrointestinal side effects throughout treatment.
- Abdominal pain: Reported in approximately 20% of patients in STEP trials; can range from mild cramping to more significant discomfort requiring evaluation.
- Headache: Reported in approximately 14% of Wegovy-treated patients in STEP 1, typically mild and not requiring discontinuation.
- Fatigue: Reported in approximately 11% of patients in STEP clinical trials, particularly during the initial weeks of treatment.
- Dyspepsia (indigestion): Reported in approximately 9% of patients per FDA prescribing information; includes bloating, burping, and upper abdominal discomfort.
- Dizziness: Reported in approximately 8% of patients across STEP trials, sometimes associated with reduced caloric intake or postural changes.
- Injection site reactions: Redness, bruising, or discomfort at injection site reported in approximately 6–7% of patients per FDA label.
- Hair loss (alopecia): Reported in approximately 3% of patients in STEP trials; generally attributed to rapid weight loss (telogen effluvium) rather than direct drug effect per FDA label discussion.
- Hypoglycemia in patients without diabetes: Not commonly reported in non-diabetic patients, but blood sugar fluctuations can occur, particularly if eating is significantly reduced.
Serious Side Effects
The following serious side effects carry FDA Black Box Warning status or are designated as serious adverse events in the Wegovy prescribing information (NDA 215256). Seek immediate medical attention if any occur:
- 🔴 [BLACK BOX WARNING] Thyroid C-Cell Tumors: Semaglutide caused thyroid C-cell tumors in rodent studies at clinically relevant exposures per FDA label. It is unknown whether Wegovy causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. Wegovy is contraindicated in patients with a personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Patients should report neck lumps, hoarseness, difficulty swallowing, or shortness of breath immediately.
- 🔴 Acute Pancreatitis: Serious cases of acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, have been reported with GLP-1 receptor agonists per FDA label. Wegovy should be discontinued if pancreatitis is suspected. Symptoms include severe and persistent abdominal pain radiating to the back, with or without vomiting.
- 🔴 Acute Gallbladder Disease: In STEP 1, cholelithiasis (gallstones) was reported in 1.6% of Wegovy patients versus 0.7% of placebo patients (Wilding et al., NEJM 2021). Cholecystitis was also reported. Rapid weight loss increases gallstone risk. Severe abdominal pain, especially upper right quadrant, requires prompt evaluation.
- 🟠 Hypoglycemia with Concomitant Insulin or Sulfonylureas: Per FDA label, the risk of hypoglycemia is increased when Wegovy is used with insulin secretagogues (e.g., sulfonylureas) or insulin. Consider dose reduction of these agents. Symptoms include sweating, confusion, shakiness, and rapid heartbeat.
- 🟠 Acute Kidney Injury: FDA label reports acute kidney injury, sometimes requiring dialysis, in patients using GLP-1 receptor agonists, usually in association with dehydration from gastrointestinal side effects. Patients should maintain adequate hydration, especially during periods of vomiting or diarrhea.
- 🟠 Severe Allergic Reactions (Hypersensitivity): Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with semaglutide per FDA label. Wegovy is contraindicated in patients with known hypersensitivity to semaglutide. Discontinue immediately if hypersensitivity reactions occur and seek emergency care.
- 🟠 Diabetic Retinopathy Complications: In patients with type 2 diabetes and pre-existing diabetic retinopathy, rapid improvement in glycemic control has been associated with worsening retinopathy per FDA label (this effect has been observed across the semaglutide class). Prescribers should consider this risk in diabetic patients.
- 🟡 Heart Rate Increase: Mean increases in resting heart rate of 1–4 beats per minute were observed in Wegovy-treated patients in STEP trials per FDA label. The clinical significance of this finding is not established, but patients with known cardiac conditions should be monitored.
- 🟡 Suicidal Behavior and Ideation: FDA label states that depression, suicidal ideation, or suicidal behavior has been reported in patients treated with weight management products. Monitor for new or worsening depression or suicidal thoughts, especially in patients with a history of depression or mental illness.
Managing Side Effects
Nausea
Nausea is the most commonly reported reason for dose delays or discontinuation per STEP trial data. The FDA-approved dose escalation schedule — increasing the dose every 4 weeks over 16–20 weeks — was specifically designed to reduce nausea severity. Per the FDA label, the dose escalation can be extended if nausea is not tolerated. Practical strategies include eating smaller, more frequent meals; choosing bland, low-fat foods (crackers, toast, rice); avoiding lying down immediately after eating; and staying well hydrated. If nausea is severe and persistent, discuss anti-nausea medications with your prescriber.
Constipation
Constipation is reported in up to 24% of patients per FDA labeling and may persist throughout treatment. Because semaglutide slows gastric motility, proactive measures are important. Gradually increasing dietary fiber (vegetables, whole grains, legumes) and fluid intake to at least 8 cups of water daily is widely documented in clinical practice guidance. Gentle physical activity can support bowel regularity. If constipation is severe or accompanied by abdominal pain, notify your prescriber, as this can occasionally mimic more serious conditions.
Vomiting
Vomiting occurred in up to 24% of patients in STEP 1 (Wilding et al., NEJM 2021). Prolonged vomiting can lead to dehydration and electrolyte imbalance, which in turn increases the risk of acute kidney injury per FDA label. Maintain hydration with small, frequent sips of water or electrolyte solutions. If you cannot keep fluids down for more than 24 hours, seek medical attention. Your prescriber may recommend temporarily staying at your current dose rather than escalating, per FDA label guidance.
Diarrhea
Diarrhea reported in approximately 30% of STEP 1 participants is typically transient but can contribute to dehydration. Avoiding high-fat, greasy, or heavily spiced foods may reduce episodes. Staying well hydrated is critical. The FDA label notes that dehydration from gastrointestinal side effects has been associated with acute kidney injury in patients using GLP-1 receptor agonists, making fluid replacement a priority.
Injection Site Reactions
The FDA-approved prescribing information instructs patients to rotate injection sites with each weekly injection among the abdomen, thigh, or upper arm. Using a new needle with each injection, allowing the pen to reach room temperature before injecting (approximately 30 minutes out of the refrigerator), and avoiding injecting into areas that are bruised, red, or irritated can reduce local reactions. Do not inject into muscle or a vein.
Hair Loss
Hair thinning reported in STEP trials is generally attributed to telogen effluvium — a temporary form of hair shedding triggered by significant physiological stress such as rapid weight loss — rather than a direct pharmacological effect of semaglutide, as discussed in the FDA label. Adequate protein intake (to support hair follicle health during weight loss) and consultation with a dermatologist may be appropriate. Hair regrowth typically occurs as weight stabilizes, though this timeline varies.
Fatigue
Fatigue reported in approximately 11% of patients in STEP trials may be related to reduced caloric intake, altered meal timing, or the body's adaptation to lower energy availability. Ensuring nutritional adequacy — particularly adequate protein and micronutrient intake — is important. Fatigue that is severe, sudden, or accompanied by other symptoms (such as yellowing of skin or eyes, or abdominal pain) should be evaluated by a prescriber promptly, as it can occasionally signal more serious conditions including pancreatitis or liver issues.
Cost and Access in 2026
Cash Price (No Insurance)
The list price of Wegovy in the United States is approximately $1,349 per month (four pens of the prescribed dose) as of early 2026, based on Novo Nordisk's published wholesale acquisition cost. Actual pharmacy prices vary and may be higher. Prices can differ significantly by pharmacy and region.
Novo Nordisk Savings Program
Novo Nordisk offers a savings card program for commercially insured patients, which may reduce out-of-pocket costs significantly (historically as low as $0–$25/month for eligible patients). Eligibility requirements and program terms change; visit NovoCare.com or call 1-833-NOVO-411 for current program details. This program is not available to patients using Medicare, Medicaid, or other federal/state insurance programs.
Insurance Coverage
Insurance coverage for Wegovy varies widely. As of 2026, many commercial health plans cover Wegovy with prior authorization, typically requiring documentation of BMI ≥30 (or ≥27 with a qualifying comorbidity) and previous weight management attempts. The 2024 FDA cardiovascular indication (SELECT trial, Lincoff et al., NEJM 2023) has prompted some insurers to broaden coverage criteria. Medicare Part D began covering anti-obesity medications for cardiovascular indications under provisions of the Inflation Reduction Act implementation, but coverage details vary by plan. Always verify coverage directly with your insurer.
Patient Assistance
Novo Nordisk's Patient Assistance Program (PAP) — administered through NovoCare — may provide Wegovy at no cost to patients who meet income eligibility requirements and lack adequate insurance coverage. Income thresholds and documentation requirements apply. Independent non-profit organizations such as the Patient Advocate Foundation and RxAssist.org maintain lists of additional assistance resources. Generic semaglutide at the 2.4 mg dose for weight management was not available in the United States as of the last updated date of this page.
Frequently Asked Questions
Q: Is Wegovy the same as Ozempic?
Both Wegovy and Ozempic contain semaglutide, but they are different FDA-approved products. Wegovy (NDA 215256) is approved for chronic weight management at a maximum maintenance dose of 2.4 mg weekly. Ozempic (NDA 209637) is approved for type 2 diabetes management at maximum doses of 1 mg or 2 mg weekly and to reduce cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. The FDA label for each product has distinct approved indications, dose escalation schedules, and labeled populations. They are not interchangeable.
Q: What happens if I miss a dose?
Per the FDA-approved prescribing information for Wegovy (NDA 215256): if a dose is missed and 5 or fewer days have passed since the scheduled dose, take the missed dose as soon as possible. If more than 5 days have passed, skip the missed dose and resume the next dose on the regularly scheduled day. Do not take two doses within 2 days of each other. If more than 2 consecutive doses are missed, contact your prescriber before restarting, as a dose reduction may be considered.
Q: Can Wegovy be used during pregnancy?
No. The FDA label for Wegovy states that it should be discontinued at least 2 months before a planned pregnancy due to the long half-life of semaglutide. Animal reproduction studies showed adverse effects on embryo-fetal development at clinically relevant doses. There are no adequate and well-controlled studies in pregnant women. Weight loss during pregnancy is not recommended. Patients who become pregnant while taking Wegovy are encouraged to enroll in the Novo Nordisk pregnancy exposure registry by calling 1-800-727-6500.
Q: Who should NOT take Wegovy?
Per the FDA prescribing information (NDA 215256), Wegovy is contraindicated in patients with: (1) a personal or family history of medullary thyroid carcinoma (MTC); (2) Multiple Endocrine Neoplasia syndrome type 2 (MEN 2); (3) known serious hypersensitivity to semaglutide or any product component; and (4) pregnancy. The FDA label also advises caution in patients with a history of pancreatitis, gallbladder disease, diabetic retinopathy, renal impairment, and those taking insulin or insulin secretagogues.
Q: Does Wegovy affect the heart?
In the SELECT trial (Lincoff et al., NEJM 2023), semaglutide 2.4 mg once weekly reduced the risk of major adverse cardiovascular events (MACE) — defined as cardiovascular death, non-fatal heart attack, or non-fatal stroke — by 20% (HR 0.80, 95% CI 0.72–0.90) compared to placebo in adults with established cardiovascular disease and overweight or obesity without diabetes, over a median follow-up of approximately 3.3 years. Based on this trial, the FDA approved an updated cardiovascular risk reduction indication for Wegovy in 2024 (NDA 215256/S-011).
Q: How is Wegovy injected and stored?
Per the FDA-approved prescribing information and Wegovy Instructions for Use, Wegovy is injected subcutaneously (under the skin) into the abdomen, thigh, or upper arm once weekly, on the same day each week, at any time of day with or without food. Each pen delivers one dose and is then discarded. Wegovy should be stored in the refrigerator (36°F to 46°F / 2°C to 8°C). Once removed from the refrigerator, it may be stored at room temperature (59°F to 86°F / 15°C to 30°C) for up to 28 days. Do not freeze. Protect from excessive heat and sunlight.
Q: What is the Wegovy dose escalation schedule?
The FDA-approved prescribing information (NDA 215256) specifies the following dose escalation schedule: Weeks 1–4: 0.25 mg once weekly; Weeks 5–8: 0.5 mg once weekly; Weeks 9–12: 1.0 mg once weekly; Weeks 13–16: 1.7 mg once weekly; Week 17 onward: 2.4 mg once weekly (maintenance dose). The FDA label states that if patients do not tolerate a dose increase, the dose escalation can be delayed for approximately 4 additional weeks. If the 2.4 mg maintenance dose is not tolerated, a dose reduction to 1.7 mg may be considered; however, long-term efficacy at doses below 2.4 mg has not been established.