Medication · US & Canada
Semaglutide, explained
By Joshua Nichvolodoff · Fact-checked against sources November 2, 2026 · Next review due May 1, 2027
Clinical review: not yet reviewed by a clinician. How review works · Editorial policy
Semaglutide is a GLP-1 receptor agonist made by Novo Nordisk. It is one molecule sold under several brand names, each authorized for different uses — so "semaglutide" on its own doesn't tell you what a product is approved for[1][2][3].
Which product is which
| Item | Form | Main use | Canada |
|---|---|---|---|
| Ozempic | Weekly injection | Type 2 diabetes | Authorized |
| Wegovy | Weekly injection | Weight management; heart risk | Authorized |
| Wegovy tablets | Daily tablet | Weight management; heart risk | Applied for, Dec 2025 |
| Rybelsus | Daily tablet | Type 2 diabetes | Authorized |
| Generic semaglutide | Weekly injection | Depends on the reference brand | Authorized from 2026 |
Generic semaglutide in Canada
Health Canada authorized Dr. Reddy's generic semaglutide on April 28, 2026 — the first in the G7[4] — followed by Apotex's on May 1, 2026[11]. On June 29, 2026 it authorized Sevmia, the first generic for weight management, and said generics are pharmaceutically equivalent to the brand[9]. See Sevmia, Apo-Semaglutide and generic semaglutide in Canada.
Safety warning on the label
US semaglutide labels carry a boxed warning about the risk of thyroid C-cell tumours, and the medicine should not be used by people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN 2)[5][12]. For side effects, see the side-effects guides.
The trials behind it
Three major semaglutide trials. Each card shows what happened in both groups, the design limits, and who paid for the study.
Study: STEP 1[13]
Does weekly semaglutide 2.4 mg, with lifestyle support, lead to more weight loss than placebo in adults with obesity or overweight and no diabetes?
- Who was in it
- 1,961 adults with a BMI of 30 or more, or 27 or more with a weight-related condition, without diabetes
- What they got
- Semaglutide 2.4 mg injection once a week, plus lifestyle intervention
- Compared with
- Placebo, plus the same lifestyle intervention
- How long
- 68 weeks
- What happened
- Average body-weight change: −14.9% on semaglutide vs −2.4% on placebo. 4.5% vs 0.8% stopped treatment because of stomach-related side effects.
- Limits
- People with diabetes were excluded
- 68 weeks: no long-term or heart outcomes
- Did not test what happens after stopping
- Funded by
- Novo Nordisk
Summary by Joshua Nichvolodoff, from the published paper — not written by the study's authors. Clinical review: not yet reviewed by a clinician.
Study: SELECT[14]
Does semaglutide 2.4 mg reduce heart attacks, strokes and cardiovascular deaths in people with heart disease and overweight or obesity, without diabetes?
- Who was in it
- 17,604 adults aged 45 or older with established cardiovascular disease, BMI 27 or more, without diabetes
- What they got
- Semaglutide 2.4 mg injection once a week, on top of standard care
- Compared with
- Placebo, on top of standard care
- How long
- Average follow-up of 39.8 months
- What happened
- Heart attack, stroke or cardiovascular death: 6.5% on semaglutide vs 8.0% on placebo. 16.6% vs 8.2% stopped treatment because of side effects.
- Relative effect
- Hazard ratio 0.80 (95% CI 0.72–0.90)
- Limits
- Only people who already had cardiovascular disease
- Many people stopped the study drug
- Funded by
- Novo Nordisk
Summary by Joshua Nichvolodoff, from the published paper — not written by the study's authors. Clinical review: not yet reviewed by a clinician.
Study: SUSTAIN-6[15]
Does weekly semaglutide change the risk of heart attack, stroke or cardiovascular death in people with type 2 diabetes at high cardiovascular risk?
- Who was in it
- 3,297 adults with type 2 diabetes at high cardiovascular risk, on standard care
- What they got
- Semaglutide 0.5 mg or 1 mg injection once a week
- Compared with
- Placebo
- How long
- 104 weeks
- What happened
- Heart attack, stroke or cardiovascular death: 6.6% on semaglutide vs 8.9% on placebo. Diabetic eye (retinopathy) complications were more common with semaglutide.
- Relative effect
- Hazard ratio 0.74 for the combined heart outcome
- Limits
- Designed to show safety (non-inferiority); the benefit was not the pre-planned test
- Relatively small and short for a heart-outcomes trial
- Funded by
- Novo Nordisk
Summary by Joshua Nichvolodoff, from the published paper — not written by the study's authors. Clinical review: not yet reviewed by a clinician.
Brand pages
Ozempic · Wegovy · Oral semaglutide. Each brand page lists its US and Canadian status with sources.
General information, not medical advice. Which product and dose is right for you is a decision for you and your prescriber. Light Years earns nothing from any product named here.
Log each dose and see when the next one is due, on your device. Open my tracker or browse the other guides.
Sources
- OZEMPIC (semaglutide) injection — prescribing information. U.S. Food and Drug Administration (FDALabel), June 1, 2026. https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/adec4fd2-6858-4c99-91d4-531f5f2a2d79/spl-doc. Accessed November 2, 2026. Back to the text
- WEGOVY (semaglutide) injection and WEGOVY tablets — prescribing information. U.S. Food and Drug Administration (FDALabel), June 2026. https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/ee06186f-2aa3-4990-a760-757579d8f77b/spl-doc. Accessed November 2, 2026. Back to the text
- RYBELSUS and OZEMPIC (semaglutide) tablets — prescribing information. U.S. Food and Drug Administration (FDALabel), January 2026. https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/27f15fac-7d98-4114-a2ec-92494a91da98/spl-doc. Accessed November 2, 2026. Back to the text
- Canada becomes the first G7 country to approve a generic version of semaglutide. Health Canada, April 28, 2026. https://www.canada.ca/en/health-canada/news/2026/04/canada-becomes-the-first-g7-country-to-approve-a-generic-version-of-semaglutide.html. Accessed November 2, 2026. Back to the text
- FDA approves first treatment to reduce risk of serious heart problems specifically in adults with obesity or overweight. U.S. Food and Drug Administration, March 8, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or. Accessed November 2, 2026. Back to the text
- Ozempic (semaglutide injection) product monograph. Health Canada Drug Product Database / Novo Nordisk Canada, April 14, 2026. https://pdf.hres.ca/dpd_pm/00084255.PDF. Accessed November 2, 2026. Back to the text
- WEGOVY (semaglutide injection) product monograph (authorized December 10, 2025). Health Canada Drug Product Database / Novo Nordisk Canada, December 10, 2025. https://pdf.hres.ca/dpd_pm/00082777.PDF. Accessed November 2, 2026. Back to the text
- Rybelsus (semaglutide tablets) product monograph. Health Canada Drug Product Database / Novo Nordisk Canada, July 13, 2026. https://pdf.hres.ca/dpd_pm/00085311.PDF. Accessed November 2, 2026. Back to the text
- Canada approves first generic semaglutide for weight loss. Health Canada, June 29, 2026. https://www.canada.ca/en/health-canada/news/2026/06/canada-approves-first-generic-semaglutide-for-weight-loss.html. Accessed November 2, 2026. Back to the text
- Wegovy weight-loss pill and Canada. Global News, December 24, 2025. https://globalnews.ca/news/11590292/wegovy-weight-loss-pill-canada. Accessed November 2, 2026. Back to the text
- Canada approves second generic semaglutide, the first G7 country to do so. Health Canada, May 1, 2026. https://www.canada.ca/en/health-canada/news/2026/05/canada-approves-second-generic-semaglutide-the-first-g7-country-to-do-so.html. Accessed November 2, 2026. Back to the text
- FDA approves fourth product under national priority voucher program, higher dose of Wegovy. U.S. Food and Drug Administration, March 19, 2026. https://www.fda.gov/news-events/press-announcements/fda-approves-fourth-product-under-national-priority-voucher-program-higher-dose-semaglutide. Accessed November 2, 2026. Back to the text
- Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine, March 18, 2021. https://pubmed.ncbi.nlm.nih.gov/33567185/ · DOI 10.1056/NEJMoa2032183 · PMID 33567185. Accessed November 2, 2026. Back to the text
- Semaglutide and cardiovascular outcomes in obesity without diabetes (SELECT). New England Journal of Medicine, December 2023. https://pubmed.ncbi.nlm.nih.gov/37952131/ · DOI 10.1056/NEJMoa2307563 · PMID 37952131. Accessed November 2, 2026. Back to the text
- Semaglutide and cardiovascular outcomes in patients with type 2 diabetes (SUSTAIN-6). New England Journal of Medicine, November 10, 2016. https://pubmed.ncbi.nlm.nih.gov/27633186/ · DOI 10.1056/NEJMoa1607141 · PMID 27633186. Accessed November 2, 2026. Back to the text
Figures marked “as reported” are historical: they show what the source said on that date, not today's price or rule.
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