WEGOVY 0.25 MG INJECTION

Indications

Approved Uses

Chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity in: (1) adults with obesity, or overweight with at least one weight-related comorbidity; and (2) pediatric patients aged ≥12 years with obesity.

Dosage & Administration

Dosing by Condition

Chronic weight management (Wegovy): 0.25 mg SC once weekly x4 weeks, then 0.5 mg x4 weeks, then 1 mg x4 weeks, then 1.7 mg x4 weeks, then 2.4 mg once weekly maintenance; 1.7 mg may be used as a maintenance dose if 2.4 mg is not tolerated.

Initial Dose

0.25 mg subcutaneously once weekly for the first 4 weeks

Maintenance Dose

2.4 mg subcutaneously once weekly (for weight management); dose escalation over 16 weeks required

Maximum Dose

2.4 mg subcutaneously once weekly.

Children's Dosage

Not approved for children under 12 years.

Dose Adjustment Notes

Use gradual dose escalation to improve GI tolerability: increase every 4 weeks per schedule; if a dose is not tolerated, consider delaying escalation for ~4 weeks. No routine dose adjustment is required for renal or hepatic impairment, but monitor clinically (especially if dehydration occurs).

How to Take

Administer by subcutaneous injection once weekly into the abdomen, thigh, or upper arm; rotate injection sites. Use on the same day each week. Do not administer intravenously or intramuscularly.

Side Effects

Common Side Effects

Common adverse effects: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia/indigestion, gastroesophageal reflux/heartburn, bloating/flatulence, belching, headache, fatigue, dizziness, and injection-site reactions.

Side Effect Frequency

Very common (≥10%): nausea, diarrhea, vomiting, constipation, abdominal pain; Common (1-10%): dyspepsia, eructation (burping), flatulence, gastroesophageal reflux, headache, dizziness, fatigue, injection-site reactions; Cholelithiasis is common; Acute pancreatitis and acute kidney injury are uncommon/rare; Hypoglycemia risk is mainly when used with insulin/secretagogues.

Safety & Warnings

Contraindications

Personal or family history of medullary thyroid carcinoma (MTC), Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), prior serious hypersensitivity reaction to semaglutide or any of its excipients.

Warnings & Precautions

Boxed warning/contraindication for MTC/MEN2; monitor for pancreatitis and discontinue if suspected; evaluate for gallbladder disease if symptomatic; hypoglycemia risk with insulin/secretagogues (may require dose reduction); monitor renal function with severe GI reactions/dehydration; observe for hypersensitivity; monitor heart rate; monitor for depression/suicidal ideation and discontinue if present; not indicated for type 1 diabetes and not a substitute for insulin.

Age Restriction

Not approved for children under 12 years.

Drug Interactions

Interaction Severity

MAJOR/clinically significant: concomitant insulin or sulfonylureas-higher hypoglycemia risk; consider dose reduction and monitor glucose. MODERATE: delayed gastric emptying may affect absorption of some oral drugs (use caution with narrow therapeutic index agents; monitor as appropriate).

Food Interaction

No food restrictions (can be administered with or without meals); counsel that smaller/low-fat meals may help reduce GI adverse effects.

Special Populations

Pregnancy

Not recommended

Breastfeeding

Consult Doctor

Children

Not approved for children under 12 years.

Kidney Impairment

No dose adjustment needed in renal impairment; monitor renal function in patients with severe GI adverse reactions or dehydration risk.

Liver Impairment

No dose adjustment needed in hepatic impairment.

Storage & Patient Advice

Stopping the Medicine

Can be stopped without tapering; advise discussing with the prescriber and anticipate possible weight regain after discontinuation.

Overdose

Overdose may cause severe nausea/vomiting and can cause hypoglycemia particularly with concomitant insulin/secretagogues; management is supportive (antiemetics/fluids), monitor glucose and treat hypoglycemia as needed; seek urgent medical attention.

Patient Counseling

Inject SC once weekly on the same day each week (abdomen/thigh/upper arm) and rotate sites; follow the stepwise dose escalation every 4 weeks. Expect GI effects (nausea, vomiting, diarrhea/constipation); eat smaller/low-fat meals and maintain hydration. Store refrigerated at 2-8°C (per SFDA storage); do not freeze. Missed dose: take ASAP if >48 hours to next dose, otherwise skip. Seek care for severe/persistent abdominal pain (pancreatitis), RUQ pain/fever (gallbladder), signs of thyroid neck mass/hoarseness/dysphagia, or symptoms of hypoglycemia if on insulin/sulfonylurea.

Pharmacology

Mechanism of Action

GLP-1 receptor agonist that increases glucose-dependent insulin secretion, suppresses inappropriate glucagon, slows gastric emptying, and reduces appetite/energy intake via central pathways.

Onset of Action

Appetite reduction may begin within the first 1-2 weeks; clinically meaningful weight loss typically becomes evident over several weeks to months as dose escalates; peak concentrations occur about 1-3 days after injection.

Duration of Effect

Approximately 1 week (supports once-weekly dosing).

Half-Life

Approximately 1 week (about 7 days; ~165-184 hours).

Bioavailability

Approximately 89% (subcutaneous).

Metabolism

Metabolized by proteolytic cleavage of the peptide backbone and sequential beta-oxidation of the fatty-acid side chain; not significantly metabolized by CYP450 enzymes.

Excretion

Excreted as metabolites via urine and feces (approximately 60% urine, 40% feces); unchanged semaglutide is not expected to be excreted to a clinically relevant extent.

Protein Binding

>99% (primarily albumin).

Product Information

Available Dosage Forms

Solution for injection in pre-filled pen (subcutaneous)

Composition per Dose

Each dose (0.5 mL): semaglutide 0.25 mg; excipients: disodium phosphate dihydrate, propylene glycol, phenol, water for injections, hydrochloric acid/sodium hydroxide for pH adjustment

Generic Availability

No

OTC Alternatives

No OTC alternative

Diabetes Type

Not indicated for diabetes (Wegovy for weight management)

Insulin Type

Not an insulin

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