Semaglutide

Typical use cases

Dosing guidelines

Titration

Protocols commonly describe a stepwise monthly escalation to limit gastrointestinal effects, e.g. ~4 weeks each at 0.25 mg, then 0.5 mg, then 1 mg, then 1.7 mg, then 2.4 mg once weekly. Steps are typically held longer if side effects are pronounced. Educational only; not a dosing instruction.

Reconstitution

Approved pens (Ozempic/Wegovy) are pre-filled liquid solutions requiring NO reconstitution. Lyophilized research-grade powder is commonly reconstituted with bacteriostatic 0.9% sodium chloride or sterile water; the volume is chosen to give a convenient concentration (e.g. 2 mg powder in 1 mL yields 2 mg/mL). Swirl gently rather than shaking.

Injection sites

Subcutaneous injection into the abdomen, thigh, or upper arm; sites are rotated each week.

Storage & handling

Refrigerate at 2-8 C (36-46 F); protect from light and do not freeze. Approved pens may be kept at room temperature (up to ~30 C / 86 F) for a limited in-use window (about 28-56 days depending on product). Reconstituted research-grade solution is typically refrigerated and used within a few weeks.

Side effects

• Nausea Mild · Common
• Vomiting and diarrhea Moderate · Common
• Constipation and abdominal discomfort Mild · Common
• Delayed gastric emptying / gastroparesis-like effects Moderate · Uncommon
• Acute pancreatitis Severe · Rare
• Gallbladder disease (cholelithiasis/cholecystitis) Moderate · Uncommon

Research summary

Semaglutide is among the most rigorously studied GLP-1 receptor agonists, supported by an extensive human evidence base spanning the SUSTAIN program (type 2 diabetes), the STEP program (obesity/weight management), and the SELECT cardiovascular-outcomes trial. It is a 94%-homologous analogue of native human GLP-1, modified at position 8 to resist DPP-4 degradation and acylated with a C18 fatty di-acid that promotes albumin binding, yielding a half-life near 1 week. In the STEP 1 trial, once-weekly 2.4 mg subcutaneous semaglutide produced roughly 15% mean body-weight reduction in adults with overweight or obesity without diabetes, far exceeding placebo. The SELECT trial (17,604 adults with established cardiovascular disease, overweight/obesity, no diabetes) reported a roughly 20% reduction in major adverse cardiovascular events, with prespecified analyses suggesting cardioprotection partly independent of weight loss. Long-term SELECT follow-up showed weight reduction sustained to roughly 4 years and signals of kidney benefit. Limitations include high rates of gastrointestinal adverse events, frequent weight regain after discontinuation, a rodent thyroid C-cell tumor signal of uncertain human relevance, and limited very-long-term safety data; oral semaglutide formulations exist but have markedly lower, food-sensitive bioavailability. Compounded and research-grade ("gray market") semaglutide is widely used outside approved channels, where potency, purity, and sterility are not guaranteed.

Key references

• https://pubchem.ncbi.nlm.nih.gov/compound/Semaglutide
• https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
• https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8089593/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC11271387/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8736331/

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