Medically reviewed by Femi Aremu, PharmD
For people seeking to treat and manage their type 2 diabetes, or for those seeking to accelerate weight loss associated with type 2 diabetes, hypertension (high blood pressure), or high cholesterol, the use of prescription medications it is a valid treatment strategy.
For this purpose, healthcare professionals may recommend Wegovy (semaglutide) or Ozempic (semaglutide). Both are brand name drugs for weight loss management.
While you may have heard of these medications before or know someone who has prescribed Wegovy or Ozempic, you likely have questions or concerns about which medication is best for you or a loved one.
To answer these questions, this article will highlight the similarities and differences between Wegovy and Ozempic, including approved indications (conditions for which a drug can be used) and off-label uses.
Overview of Wegovy and Ozempic
Wegovy and Ozempic are brand-name prescription drugs in the same drug class as glucagon-like peptide-1 (GLP-1) agonists. GLP-1 is a hormone that causes your body to produce more insulin and makes you feel full. These drugs also contain the same active ingredient: semaglutide.
However, Wegovy and Ozempic are approved by the Food and Drug Administration (FDA) for different indications and dosages.
The FDA originally approved semaglutide under the name Ozempic in 2017 after clinical trials showed that the drug effectively controlled blood sugar in adults with type 2 diabetes. Semaglutide has also been shown to help people lose weight.
Healthcare professionals can prescribe Ozempic off-label for weight loss.
Off-label prescribing is when a healthcare provider prescribes a drug to treat or prevent a condition other than the one the FDA has approved it for.
In 2021, the FDA approved semaglutide under the brand name Wegovy for weight loss in overweight or obese adults when used in conjunction with appropriate diet and exercise.
Differences: Wegovy vs. Ozempic
Ozempic and Wegovy have key differences and several similarities. They differ mainly in FDA-approved indications and typical dosages.
How do they work
Both Wegovy and Ozempic are semaglutide-containing GLP-1 agonists.
Semaglutide works by prompting the pancreas to produce more insulin, which lowers blood sugar. Semaglutide promotes weight loss by increasing the effects of GLP-1 in your body, making you feel full more quickly than usual and, in turn, decreasing your food intake.
Directions
Ozempic is approved by the FDA for the following uses:
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To control blood sugar levels in adults with type 2 diabetes, together with diet and exercise
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To reduce the risk of serious health problems, such as heart attack and stroke, in adults with type 2 diabetes and heart disease
In contrast, Wegovy is FDA approved for weight loss. Specifically, Wegovy is approved for chronic (long-term) weight management in some people, including:
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Adults with an initial body mass index (BMI) of 30 or greater
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Adults with a baseline BMI of 27 or greater who have been diagnosed with at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol
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Children 12 years of age and older with a BMI in the 95th percentile or higher for their age
BMI is an outdated and biased measure that doesn’t take into account several factors, such as body composition, ethnicity, race, gender, and age. Despite being an imperfect measure, BMI is still widely used today in the medical community because it is an inexpensive and quick method of analyzing potential health status and outcomes.
Administration
Both Wegovy and Ozempic are once-a-week subcutaneous injections (injections given under the skin), but Wegovy has a higher maximum dosage than Ozempic.
You or an assistant will inject it under the skin of your abdomen, thigh, or upper arm. Wegovy and Ozempic can be given at any time on the same day of the week, such as every Sunday.
The starting dose of Wegovys in adults is 0.25 milligram (mg) once a week for four weeks. Your doctor will increase your dose every four weeks until you reach your target dose of 2.4 milligrams once a week.
The starting dose of Wegovys in children is 0.25 milligram once a week for four weeks. Your child’s healthcare provider will increase the dose every four weeks until you reach a target dose of 1.7 or 2.4 milligrams once a week.
The starting dose of Ozempics is 0.25 milligram once a week for four weeks. Then your doctor will increase your dosage to 0.5 milligram once a week.
If your blood sugar levels are still too high at a dose of 0.5 milligrams; your doctor may increase your dose to 1 to 2 milligrams once a week. The maximum amount of Ozempic is 2 milligrams.
Which is more effective?
Both Wegovy and Ozempic have been extensively evaluated in separate clinical trials, with research reflecting the following:
In a test of Wegovy in adults without diabetes, those who received Wegovy lost an average of 12.4 percent of their starting body weight compared to those who received a placebo.
Another study evaluated Wegovy in adults with diabetes, showing a 6.2 percent decrease in their baseline body weight compared to those who received a placebo.
The studies for Ozempic looked at the safety and effectiveness of drugs for managing type 2 diabetes, with weight loss as an added benefit.
For diabetes control, both Ozempic and Wegovy can improve hemoglobin A1c (HbA1c), as well as blood sugar levels in people with type 2 diabetes.
A1c is a blood test that measures your average blood sugar over the past three months.
In studies, Ozempic lowered mean A1c by 1% during clinical trials. Wegovy also significantly improved blood sugar and A1c levels in clinical trials.
Role of BMI in Semaglutide Prescribing
Wegovy is FDA-approved for weight loss in some people, including:
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Adults with obesity or an initial body mass index (BMI) of 30 or greater
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Adults with a starting BMI of 27 or greater (overweight) who have been diagnosed with at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol
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Children 12 years of age and older with a BMI in the 95th percentile or higher for their age
Unlike Wegovy, Ozempic has no specific BMI requirements. Ozempic is not approved for use in children.
Side effects and safety
Because Wegovy and Ozempic contain the same active ingredient, they can cause the same side effects and shouldn’t be used together.
It should be noted that Wegovy and Ozempic carry a boxed warning, the FDA’s strictest warning about serious side effects for the serious risk of thyroid C-cell cancers.
In studies, both drugs caused thyroid C-cell tumors in rats and mice. However, it is not known whether semaglutide causes thyroid C-cell cancers, including medullary thyroid cancer (MTC), in humans.
Common side effects
The most common side effect reported for Wegovy and Ozempic is gastrointestinal (GI) discomfort. This side effect may ease as your body adjusts to the drug.
Common side effects of Wegovy and Ozempic include:
Serious side effects
Less common but potentially serious side effects of Wegovy and Ozempic can include:
Wegovy and Ozempic are not recommended for people with a personal or family history of TCM or multiple endocrine neoplasia syndrome type 2.
Additionally, Wegovy and Ozempic should not be used by:
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People who are taking other GLP-1 agonists
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People with a past allergic reaction to semaglutide or other ingredients
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People with type 1 diabetes
It’s also not known whether Wegovy and Ozempic are safe to use in people with past or active pancreatitis (inflammation of the pancreas).
What drugs interact with Wegovy or Ozempic?
As with most medications, both Wegovy and Ozempic carry the risk of adverse interactions when taken together with other medications, including the following:
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Wegovy and Ozempic should not be taken at the same time as you should not be taking more than one GLP-1 agonist drug at a time. Examples of other GLP-1 agonists include Victoza (liraglutide) and Rybelsus (semaglutide).
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Taking Ozempic or Wegovy with certain oral diabetes medications, such as Glyset (miglitol), or insulin can cause your blood sugar to drop too low. If your doctor prescribes these medications, he or she will instruct you to monitor your blood sugar often until he sees how the treatments affect you.
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Both Wegovy and Ozempic cause a delay in gastric emptying (the time it takes for food to move through the digestive tract), which can affect the absorption and effectiveness of other medications.
Because of these interactions, talk to your doctor about all medicines you currently take before starting Wegovy or Ozempic.
Summary
Wegovy and Ozempic are similar drugs. The FDA approves these drugs for different purposes, but both can cause weight loss.
Ozempic improves outcomes in adults with type 2 diabetes, while Wegovy promotes weight loss in adults and adolescents who meet specific criteria.
Wegovy and Ozempic are meant to be used with exercise and dietary changes.
Side effects are similar, with stomach pain being the most common. Talk to a healthcare professional about trying Wegovy or Ozempic.
Frequent questions
What is Ozempic face? Can this also happen with Wegovy?
Ozempic face is a slang term that describes a possible side effect of sagging facial skin from weight loss when taking Ozempic for the first time. This side effect can also occur with Wegovy and other GLP-1 agonists.
Rapid weight loss can sometimes cause facial skin to stretch and lose its elasticity, appearing sagging or loose.
How can I store Wegovy vs. Ozempic?
Store Wegovy in the refrigerator until you’re ready to use it. Once removed from the refrigerator, Wegovy stays good at room temperature for 28 days (four weeks).
Ozempic is also stored in the refrigerator. Once removed from the refrigerator and brought to room temperature, any unused medication expires after 56 days (eight weeks).
Can Ozempic or Wegovy be used in combination with basal insulin?
Ozempic can be used in combination with basal insulin, such as Lantus (insulin glargine). However, the combination is likely to lower blood sugar. Your doctor will tell you how often to monitor your blood sugar and what to do if you experience hypoglycemia.
Also, it would be best not to inject Ozempic and insulin into the same injection site, although it may be in the same area of your body.
Wegovy has yet to be studied explicitly in people taking insulin. However, because of the known risk of low blood sugar with semaglutide, your doctor may reduce your insulin dose if you prescribe Wegovy.
They may also recommend checking your blood sugar levels more often until you see how your body responds to the combination.
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