WEGOVY 1.7/MG 1/PENFILL @

Indications

Approved Uses

Chronic weight management: to reduce excess body weight and maintain weight reduction long term as an adjunct to a reduced-calorie diet and increased physical activity in (a) adults with obesity, or adults with overweight with at least one weight-related comorbid condition, and (b) pediatric patients aged ≥12 years with obesity. Cardiovascular risk reduction: 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.

Off-Label Uses

Examples of off-label uses for semaglutide (not Wegovy-specific) include nonalcoholic steatohepatitis/metabolic dysfunction-associated steatohepatitis (NASH/MASH) and polycystic ovary syndrome (PCOS)-associated weight management; use should be individualized and evidence-based.

Dosage & Administration

Dosing by Condition

Chronic weight management and CV risk reduction (Wegovy): 0.25 mg SC weekly (weeks 1-4) → 0.5 mg (weeks 5-8) → 1 mg (weeks 9-12) → 1.7 mg (weeks 13-16) → 2.4 mg weekly from week 17 onward; if 2.4 mg is not tolerated, 1.7 mg weekly may be used as maintenance. (Type 2 diabetes dosing is product-specific and pertains to Ozempic/Rybelsus, not Wegovy.)

Initial Dose

0.25 mg subcutaneously once weekly for the first 4 weeks

Maintenance Dose

2.4 mg subcutaneously once weekly (after dose escalation over 16 weeks)

Maximum Dose

2.4 mg subcutaneously once weekly

Children's Dosage

Not approved for children under 12 years. Approved for adolescents aged 12-17 years for chronic weight management (BMI ≥95th percentile) using the same escalation schedule as adults

Dose Adjustment Notes

Dose escalation is used to improve GI tolerability: 0.25 mg weekly x4 weeks → 0.5 mg x4 → 1 mg x4 → 1.7 mg x4 → 2.4 mg weekly maintenance; if a dose is not tolerated, consider delaying escalation by ~4 weeks and/or maintaining at 1.7 mg if 2.4 mg is not tolerated. No routine dose adjustment is required for renal or hepatic impairment, but monitor for dehydration/AKI risk if severe GI reactions occur. If used with insulin or a sulfonylurea, consider reducing those agents to lower hypoglycemia risk.

How to Take

For subcutaneous use only: Inject Wegovy subcutaneously 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. Follow the pre-filled pen instructions for use; use one pen for one patient only.

Side Effects

Common Side Effects

Nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation (burping), hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease.

Side Effect Frequency

Very common (≥10%): nausea, vomiting, diarrhea, constipation, abdominal pain. Common (1-10%): dyspepsia, eructation, flatulence, GERD, abdominal distension, headache, fatigue, dizziness, injection-site reactions; hypoglycemia mainly when used with insulin/sulfonylurea; increased heart rate; cholelithiasis/gallbladder events. Rare/serious: acute pancreatitis, severe hypersensitivity, diabetic retinopathy complications (in patients with diabetes), acute kidney injury (usually with dehydration), and suicidal ideation/behavior; NAION has been reported post-marketing.

Safety & Warnings

Contraindications

Personal or family history of medullary thyroid carcinoma (MTC); Multiple Endocrine Neoplasia syndrome type 2 (MEN 2); known serious hypersensitivity to semaglutide or any excipients; pregnancy.

Warnings & Precautions

Boxed warning for thyroid C-cell tumors (contraindicated with personal/family history of MTC or MEN2); monitor for pancreatitis and discontinue if suspected/confirmed; evaluate for gallbladder disease; risk of hypoglycemia with insulin/secretagogues; monitor renal function in patients with severe GI reactions; hypersensitivity reactions; increased heart rate; suicidal behavior/ideation; diabetic retinopathy complications in patients with type 2 diabetes; do not coadminister with other semaglutide products or any GLP-1 receptor agonist.

Age Restriction

Approved for adults and pediatric patients aged 12 years and older; not approved for <12 years.

Drug Interactions

Drug Interactions

May increase hypoglycemia risk with insulin/insulin secretagogues (dose reduction may be needed); delays gastric emptying which may affect absorption of concomitant oral drugs; do not use with other GLP-1 receptor agonists or other semaglutide-containing products.

Interaction Severity

MAJOR/clinically significant: insulin and insulin secretagogues (e.g., sulfonylureas) - increased hypoglycemia risk; consider dose reduction and monitor glucose. MODERATE: oral drugs where timing/peak exposure matters (delayed gastric emptying may affect absorption); monitor/adjust as needed, with particular caution for narrow-therapeutic-index drugs (e.g., warfarin-monitor INR when clinically indicated).

Food Interaction

No clinically relevant food interaction for Wegovy injection; it may be administered with or without meals.

Special Populations

Pregnancy

Risk Summary: Available data with Wegovy use in pregnant women are insufficient to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes.

Breastfeeding

Risk Summary: There are no data with Wegovy use in lactating women; advise not to breastfeed during treatment.

Children

Not approved for children under 12 years. Approved for adolescents aged 12-17 years for chronic weight management (BMI ≥95th percentile) using the same escalation schedule as adults

Elderly

Standard adult dosing - no dose adjustment required based on age alone; greater sensitivity in some elderly patients cannot be ruled out; monitor for GI tolerability

Storage & Patient Advice

Stopping the Medicine

Can be stopped without tapering; consult prescriber; discontinue at least 2 months before a planned pregnancy.

Overdose

Overdose may cause severe nausea/vomiting and hypoglycemia (especially with insulin/sulfonylureas); management is supportive/symptomatic with glucose monitoring and medical evaluation; no specific antidote.

Patient Counseling

Inject Wegovy (semaglutide) subcutaneously once weekly on the same day each week in the abdomen, thigh, or upper arm; rotate sites and it may be taken any time of day with or without meals. Follow the prescribed dose-escalation schedule (this product is the 1.7 mg weekly pen used as a step in titration) to reduce GI adverse effects; common early effects include nausea/vomiting/diarrhea/constipation-smaller, lower-fat meals and slower eating may help. Do not use if you or a family member has medullary thyroid carcinoma or if you have MEN2; report neck mass, dysphagia, or persistent hoarseness. Seek urgent care for severe/persistent abdominal pain (pancreatitis) or symptoms of gallbladder disease. Hypoglycemia risk is increased when used with insulin or sulfonylureas-monitor and adjust those agents as directed. Do not share pens/needles. Storage: keep unused pens refrigerated at 2-8°C (per SFDA); protect from freezing and excessive heat/light; follow local product leaflet for any allowed room-temperature in-use storage. Avoid use in pregnancy; discontinue at least 2 months before a planned pregnancy due to long half-life.

Monitoring Requirements

Monitor body weight/BMI and tolerability (GI effects). In patients with diabetes or on hypoglycemia-causing agents, monitor blood glucose (and HbA1c as clinically appropriate). Monitor for pancreatitis symptoms, gallbladder disease, dehydration/renal function if severe vomiting/diarrhea occurs, and heart rate; assess mood changes/suicidal ideation when clinically indicated.

Pharmacology

Mechanism of Action

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

Onset of Action

Pharmacologic effects begin after the first dose, but clinically meaningful weight loss typically becomes apparent over several weeks; maximal weight-loss effect is generally assessed over long-term therapy (e.g., ~1 year in pivotal trials).

Duration of Effect

Approximately 1 week; semaglutide has an elimination half-life of about 7 days, supporting once-weekly dosing.

Half-Life

Approximately 7 days (about 165-184 hours).

Bioavailability

Approximately 89% after subcutaneous administration.

Metabolism

Metabolized by proteolytic cleavage of the peptide and sequential beta-oxidation of the fatty-acid side chain; not primarily CYP-mediated.

Excretion

Eliminated as metabolites via urine and feces (approximately ~60% urine and ~30% feces), with negligible unchanged drug.

Protein Binding

>99% protein bound (primarily to albumin).

Product Information

Available Dosage Forms

Injection, solution for subcutaneous use in a pre-filled pen (Wegovy).

Composition per Dose

Each dose (0.75 mL): semaglutide 1.7 mg; excipients: disodium phosphate dihydrate, propylene glycol, phenol, water for injections, hydrochloric acid/sodium hydroxide (pH adjustment)

Generic Availability

No

OTC Alternatives

No OTC alternative

Diabetes Type

Type 2

Insulin Type

Not an insulin

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