MetabolicFDA Approved

Semaglutide

Semaglutide (GLP-1 agonist)

Compare Semaglutide prices

Lowest $/mg across vendors

Calculate dosing

Reconstitution

Overview

Semaglutide is a GLP-1 receptor agonist used for type 2 diabetes management and chronic weight management. It mimics the incretin hormone GLP-1 to regulate appetite and glucose metabolism.

Mechanism of Action

Binds to and activates GLP-1 receptors, leading to enhanced insulin secretion, reduced glucagon secretion, delayed gastric emptying, and reduced appetite through central nervous system effects.

Research Summary

The STEP program (STEP 1–8) showed average weight loss of roughly 15% of body weight over 68 weeks with weekly 2.4 mg semaglutide. The SUSTAIN program established A1c and cardiovascular benefit in type 2 diabetes. The PIONEER program established efficacy of oral semaglutide (Rybelsus) versus placebo, sitagliptin, empagliflozin, and liraglutide. The SELECT trial (2023) showed a 20% relative reduction in major adverse cardiovascular events in adults with overweight/obesity and established cardiovascular disease but without diabetes, leading to an expanded Wegovy indication.

Dosing Information

Typical Dose

0.25-2.4mg

Range

0.25-2.4mg (titrated)

Frequency

1x/week (subcutaneous)

Route

SubQ or Oral

Duration

12+ weeks (ongoing)

Reconstitution

Pre-filled pen or compounded vial

Notes

Per FDA labels, SubQ doses are escalated every 4 weeks to minimize GI adverse effects; 0.25 mg is a starting dose only and is not effective for maintenance. Rybelsus must be taken in the morning on an empty stomach with up to 4 oz (120 mL) of plain water, then no food, drink, or other oral medications for at least 30 minutes. Administer SubQ injections in the abdomen, thigh, or upper arm on the same day each week.

Verified testing for Semaglutide

Aggregated from 104 lab-verified Certificates of Analysis uploaded directly by labs. Purity averages exclude values outside [50%, 100%] to filter unit-misreads.

COAs

104

Verified labs

Avg purity

99.64%

±0.27%

Endotoxin tested

25%

See every Semaglutide COA

Reported Side Effects

Nausea, vomiting, diarrhea, or constipation (most common; usually dose-dependent and transient)
Abdominal pain and dyspepsia
Decreased appetite and early satiety; delayed gastric emptying
Injection site reactions (SubQ forms)
Acute pancreatitis (uncommon; discontinue if suspected)
Gallbladder disease (cholelithiasis, cholecystitis)
Acute kidney injury, often secondary to dehydration from GI losses
Hypoglycemia (primarily when combined with insulin or sulfonylureas)
Diabetic retinopathy complications in patients with preexisting retinopathy

Contraindications

Personal or family history of medullary thyroid carcinoma (MTC) — FDA boxed warning based on rodent C-cell tumor findings
Multiple endocrine neoplasia syndrome type 2 (MEN 2) — FDA boxed warning
Prior serious hypersensitivity reaction to semaglutide or any product excipient
Caution (not absolute contraindication per label) with history of pancreatitis, severe gastroparesis, or diabetic retinopathy
Not recommended in pregnancy; discontinue at least 2 months before a planned pregnancy due to long half-life

Labs to monitor before & during your Semaglutide protocol

These biomarkers are commonly tracked to assess response and safety. Run baseline labs before starting, mid-cycle labs halfway through, and post-cycle labs 1–2 weeks after the final dose.

HbA1cFasting glucoseInsulinLipid panelCRPLiver enzymes

Commonly Stacked With

Tirzepatide MOTS-c

Research References

Wilding JPH, et al. STEP 1: Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384(11):989-1002. PMID 33567185.
Lincoff AM, et al. SELECT: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. New England Journal of Medicine. 2023;389(24):2221-2232. PMID 37952131.
Pratley R, et al. PIONEER 4: Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes. The Lancet. 2019;394(10192):39-50. PMID 31186120.

This platform provides informational tools only, not medical advice. This information is for educational purposes only. Consult a licensed provider.