Guide
Semaglutide, explained plainly
The drug behind Ozempic and Wegovy: how it works, what it costs, and how it compares to the newer option.
Updated 2026-09-18 · Prices verified independently
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Semaglutide is the drug most people have actually heard of. Ozempic and Wegovy are both semaglutide; the difference between them is dosing and what they are approved to treat.
A weekly injection that activates the GLP-1 receptor, slowing stomach emptying and reducing appetite signalling. In STEP-1, adults on 2.4 mg lost an average of about 14.9% of body weight over 68 weeks.
Ozempic, Wegovy and the compounded version
- Ozempic is approved for type 2 diabetes and dosed up to 2 mg.
- Wegovy is approved for weight management and dosed up to 2.4 mg.
- Compounded semaglutide is prepared by a pharmacy rather than the manufacturer, is not FDA-approved, and is what most low-cost telehealth programmes supply.
That third category is the one with the shifting legal ground — see is compounded GLP-1 still legal.
The dose ladder
0.25 mg → 0.5 mg → 1 mg → 1.7 mg → 2.4 mg, stepping up roughly every four weeks.
Side effects
Nausea, vomiting, diarrhoea and constipation, usually worst in the first weeks and after dose increases.
How it compares to tirzepatide
In the SURMOUNT-5 head-to-head trial semaglutide produced less weight loss than tirzepatide, averaging 33.1 lb (15.0 kg) against 50.3 lb (22.8 kg).
Semaglutide is meaningfully cheaper almost everywhere, which is why plenty of people choose it knowing the trial numbers. The full comparison is in tirzepatide vs semaglutide.
What it costs
Through NovoCare, Wegovy has been offered at $199/month for the first two fills through 31 December 2026, then $349/month for 0.25-2.4 mg doses. The oral form is listed between $149 and $299/month by dose. Compounded programmes start around $149 a month all in — the ranking is in best semaglutide providers.
Read next
- Tirzepatide vs semaglutide
One trial put them head to head. The result was not close — but the cheaper drug still wins for some people.
- The best semaglutide providers in 2026
17 programmes compared on what you actually pay in month two — not the teaser rate. Coreage Rx comes first.
- Tirzepatide, explained plainly
What it is, what it does to appetite, what the trials showed, and what the first three months tend to feel like.
- Is compounded GLP-1 medication still legal?
Short answer: yes, but in a much narrower form than in 2024 — and the FDA moved again this year.
- Coreage Rx semaglutide review
Best overall on true monthly cost. We checked the advertised price against what you are actually billed. True cost: $149 a month.