WEGOVY 1 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 (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related comorbidity; and (2) pediatric patients aged ≥12 years with obesity. Additionally, to reduce the risk of major adverse cardiovascular events (CV death, nonfatal MI, nonfatal stroke) in adults with established cardiovascular disease and either obesity or overweight. Wegovy is not indicated for treatment of type 2 diabetes, and MASH is not an approved indication for semaglutide/Wegovy.

Dosage & Administration

Dosing by Condition

For Wegovy (weight management/CV risk reduction in eligible patients): start 0.25 mg SC once weekly x4 weeks, then 0.5 mg x4, 1 mg x4, 1.7 mg x4, then 2.4 mg once weekly maintenance (or 1.7 mg if 2.4 mg not tolerated). Wegovy is not dosed/indicated for glycemic control in type 2 diabetes (that indication applies to other semaglutide products).

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 occurs over approximately 16 weeks

Maximum Dose

2.4 mg subcutaneously once weekly

Children's Dosage

Not approved for children under 12 years. Wegovy is approved for adolescents aged 12 years and older with obesity (BMI ≥95th percentile) in some regions; dosing follows same escalation schedule with 2.4 mg maintenance

Dose Adjustment Notes

Standard dose escalation to improve tolerability: 0.25 mg weekly x4 weeks, then 0.5 mg x4, then 1 mg x4, then 1.7 mg x4, then 2.4 mg weekly maintenance. If a patient does not tolerate a dose during escalation, consider delaying escalation for ~4 weeks; if 2.4 mg is not tolerated, reduce to 1.7 mg (and discontinue if 1.7 mg is not tolerated). No routine dose adjustment is required for renal or hepatic impairment, but monitor clinically (e.g., dehydration-related AKI risk).

How to Take

For subcutaneous use only: Inject Wegovy under the skin once weekly on the same day each week, at any time of day, with or without meals, into the abdomen, thigh, or upper arm; rotate injection sites. Do not administer intravenously or intramuscularly. Use the pre-filled pen as directed; use a new needle for each injection and dispose of it safely after use; do not share pens or needles.

How to Prepare

Ready-to-use solution in a pre-filled pen; no reconstitution/dilution. Inspect solution (clear, colorless to slightly yellow) and do not use if discolored/particulate; if refrigerated (2-8°C per SFDA), allow to reach room temperature before injection for comfort.

Side Effects

Common Side Effects

Nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, eructation, flatulence, gastroesophageal reflux disease, fatigue, headache, dizziness, injection site reactions

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

Warnings/precautions: thyroid C-cell tumor risk (contraindicated in MTC/MEN2), acute pancreatitis (stop if suspected/confirmed), acute gallbladder disease, hypoglycemia with insulin/secretagogues, acute kidney injury (monitor with severe GI reactions/dehydration), hypersensitivity reactions, increased heart rate, suicidal behavior/ideation, and monitoring for diabetic retinopathy complications in patients with diabetes.

Age Restriction

Not approved for use in children under 12 years of age (approved for ≥12 years for chronic weight management).

Drug Interactions

Drug Interactions

Key interactions/considerations: (1) insulin/insulin secretagogues (e.g., sulfonylureas) increase hypoglycemia risk-may need dose reduction; (2) delayed gastric emptying may affect absorption of concomitant oral drugs-monitor narrow therapeutic index agents (e.g., warfarin/INR) as clinically indicated.

Interaction Severity

MAJOR/clinically significant: concomitant insulin or insulin secretagogues (e.g., sulfonylureas) increase hypoglycemia risk-consider dose reduction and monitor. MODERATE: delayed gastric emptying may affect absorption of some oral drugs; monitor drugs with narrow therapeutic index (e.g., warfarin with INR monitoring) when clinically indicated. No meaningful PK interaction with metformin.

Food Interaction

No food restrictions: administer subcutaneously with or without meals; counsel that smaller/lower-fat meals may help reduce GI adverse effects.

Special Populations

Pregnancy

Consult Doctor

Breastfeeding

Consult Doctor

Children

Not approved for children under 12 years. Wegovy is approved for adolescents aged 12 years and older with obesity (BMI ≥95th percentile) in some regions; dosing follows same escalation schedule with 2.4 mg maintenance

Elderly

Standard adult dosing; no dose adjustment required based on age alone. Use with caution in elderly patients due to increased risk of dehydration and renal impairment from gastrointestinal side effects

Kidney Impairment

No dose adjustment is recommended for patients with renal impairment; monitor renal function if severe GI reactions lead to dehydration.

Liver Impairment

No dose adjustment is recommended for patients with hepatic impairment.

Storage & Patient Advice

Preparation Instructions

Ready-to-use solution in a pre-filled pen; no reconstitution/dilution. Inspect solution (clear, colorless to slightly yellow) and do not use if discolored/particulate; if refrigerated (2-8°C per SFDA), allow to reach room temperature before injection for comfort.

Missed Dose

If a dose is missed, administer as soon as possible within 5 days after the missed dose; if more than 5 days have passed, skip the missed dose and resume on the next scheduled day. Ensure at least 48 hours between doses (do not take two doses within 2 days).

Stopping the Medicine

Discontinue if the patient cannot tolerate the maintenance dose (2.4 mg weekly) after appropriate dose-escalation attempts; stopping does not require taper, but weight regain is common and follow-up is recommended.

Patient Counseling

Counsel to inject SC once weekly on the same day (abdomen/thigh/upper arm) and rotate sites; follow the titration schedule to reduce nausea; do not share the pen and use a new needle each time; store refrigerated 2-8°C (per SFDA) and do not freeze; manage GI effects with smaller meals and hydration; recognize and seek care for severe abdominal pain (pancreatitis), RUQ pain/fever/jaundice (gallbladder disease), allergic reactions, and symptoms of thyroid tumor (neck lump/hoarseness/dysphagia); discuss hypoglycemia risk if used with insulin/sulfonylureas; and follow missed-dose instructions (within 5 days, otherwise skip).

Monitoring Requirements

Monitor: weight/BMI and waist circumference; tolerability (GI effects) and hydration status; signs/symptoms of pancreatitis and gallbladder disease; renal function if significant vomiting/diarrhea or dehydration occurs; heart rate; and in patients with diabetes or on hypoglycemia-causing agents, blood glucose (and HbA1c as clinically appropriate). Routine calcitonin/thyroid ultrasound screening is not recommended, but counsel/monitor for thyroid mass symptoms due to boxed warning.

Pharmacology

Mechanism of Action

Semaglutide is a GLP-1 receptor agonist that increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, slows gastric emptying, and reduces appetite/energy intake via central mechanisms, leading to weight loss.

Product Information

Available Dosage Forms

Solution for injection in pre-filled pen (subcutaneous)

Generic Availability

No

Diabetes Type

Not indicated for glycemic control in diabetes; for weight management

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