What is the difference between Wegovy (semaglutide) and Ozempic (semaglutide)?

Difference Between Wegovy and Ozempic

Wegovy and Ozempic are both semaglutide medications, but Wegovy is FDA-approved for weight management at a higher dose (2.4mg weekly), while Ozempic is approved for type 2 diabetes management at lower doses (up to 1mg weekly). 1

Key Differences

Indication and Dosing

• Ozempic:

  • FDA-approved for type 2 diabetes management
  • Available in doses of 0.25mg, 0.5mg, and 1mg for weekly subcutaneous injection
  • Primary focus is glycemic control in diabetes patients 1

• Wegovy:

  • FDA-approved for chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related comorbidity
  • Higher dose of 2.4mg weekly subcutaneous injection
  • Recently approved to reduce cardiovascular events in adults with established cardiovascular disease and obesity/overweight 2

Cardiovascular Benefits

• Wegovy has specific FDA approval for cardiovascular risk reduction:

  • In a large trial with over 17,600 participants, Wegovy reduced major cardiovascular events to 6.5% compared to 8% in the placebo group 2
  • Specifically approved to reduce risk of cardiovascular death, heart attack, and stroke in adults with obesity or overweight and cardiovascular disease 2, 3

• Ozempic:

  • Has shown cardiovascular benefits in diabetes patients, but not specifically FDA-approved for cardiovascular risk reduction in non-diabetic patients 2

Mechanism of Action

Both medications contain identical active ingredient (semaglutide) and work through the same mechanism:

• GLP-1 receptor agonist with 94% sequence homology to human GLP-1 1
• Stimulates insulin secretion and reduces glucagon secretion in a glucose-dependent manner
• Delays gastric emptying, which contributes to glucose control and satiety 2
• Reduces appetite and food intake, leading to weight loss

Clinical Considerations

Efficacy

• Weight Loss:
  • Wegovy (2.4mg) produces greater weight loss than Ozempic's lower doses
  • In clinical trials, Wegovy achieved 15-18% body weight reduction 4
  • Ozempic at 1mg weekly produces significant but less pronounced weight loss 5

Side Effects

Both medications share similar side effect profiles, with gastrointestinal effects being most common:

• Nausea, vomiting, diarrhea
• Delayed gastric emptying (important perioperative consideration) 2
• Risk of residual gastric content despite fasting 2

Important Precautions

1. Gastric Emptying: Both medications significantly delay gastric emptying, which may increase aspiration risk during procedures requiring anesthesia 2
2. Pregnancy: Both should be discontinued at least 2 months before planned pregnancy due to long washout period 1
3. Hypoglycemia: Low risk when used alone, but may increase hypoglycemia risk when combined with insulin or sulfonylureas 2

Practical Implications

Prescription Considerations

• Insurance Coverage:
  • Ozempic is typically covered for diabetes but may not be for weight loss
  • Wegovy is specifically indicated for weight management but may have more limited coverage 4

Perioperative Management

• Consider extended fasting periods before procedures due to delayed gastric emptying
• Studies show increased residual gastric content in patients on semaglutide despite prolonged fasting 2

Off-Label Use

• Ozempic is sometimes prescribed off-label for weight loss at doses lower than Wegovy 6
• This practice has contributed to shortages affecting patients with diabetes who need the medication

In summary, while Wegovy and Ozempic contain the same active ingredient (semaglutide), they differ in their FDA-approved indications, dosing, and specific evidence for cardiovascular risk reduction, with Wegovy being specifically developed and approved for weight management and cardiovascular risk reduction in non-diabetic patients with obesity.