Semaglutide
Semaglutide (Ozempic, Wegovy)
GLP-1 agonist — weight loss and glycemic control
About
A GLP-1 receptor agonist, FDA-approved for type 2 diabetes and obesity. One of the most effective weight-loss medications available.
Mechanism
Mimics GLP-1, increases insulin, suppresses glucagon, slows gastric emptying, reduces appetite.
Dosage
Draw to 12.5 units on a U-100 insulin syringe
2 mg · 1 mL BAC
When to take: Same day each week. Timing relative to meals matters little.
Reconstitution
Vial size (mg): 2 mg · BAC water (mL): 1 mL · Concentration: 2 mg/mL
Store refrigerated after reconstitution, 30 days.
Dosing reference
Units to draw at the typical dose range, per vial size.
| Vial | Water | Typical draw |
|---|---|---|
| 2 mg | 1 mL | 12.5–125 units |
| 5 mg | 1 mL | 5–50 units |
| 10 mg | 1 mL | 2.5–25 units |
| 20 mg | 1 mL | 1.5–12.5 units |
| 50 mg | 1 mL | 0.5–5 units |
Benefits
- 15-20% weight loss (STEP trials)
- Improved glycemic control
- Lowered HbA1c
- Reduced cardiovascular risk (SELECT trial)
- Reduces appetite and 'food noise'
Side effects
- Nausea (common initially)
- Diarrhea / constipation
- Reflux
- Fatigue
- Rare: gallstones, pancreatitis
Gender notes
Cautions
- Medullary thyroid carcinoma (history)
- MEN 2 syndrome
- Pregnancy
- History of pancreatitis
Research
- STEP 1: Semaglutide 2.4 mg for obesity
New England Journal of Medicine · 2021
Landmark RCT, 1961 participants. 14.9% weight loss at 68 weeks vs 2.4% placebo.
- SELECT Trial: Cardiovascular outcomes
New England Journal of Medicine · 2023
20% reduction in MACE (cardiovascular events) in obese patients without diabetes.