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

Differences Between Wegovy and Ozempic

Wegovy and Ozempic both contain the same active ingredient (semaglutide) but differ in their FDA-approved indications, dosing, and insurance coverage - Wegovy is specifically approved for weight management while Ozempic is approved for type 2 diabetes treatment.

Key Differences

• FDA-approved indications:

  • Wegovy (semaglutide 2.4 mg) is FDA-approved for chronic weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity 1
  • Ozempic (semaglutide) is FDA-approved for the treatment of type 2 diabetes 2

• Dosing:

  • Wegovy is administered at a higher maximum dose (2.4 mg once weekly) specifically for weight management 1
  • Ozempic is typically prescribed at lower doses (up to 1.0 mg once weekly) for glycemic control in diabetes 3

• Cardiovascular indications:

  • Wegovy received FDA approval in 2024 to reduce the risk of cardiovascular death, heart attack, and stroke in adults with obesity or overweight and cardiovascular disease 1
  • Ozempic has shown cardiovascular benefits in diabetes patients but has different approved cardiovascular indications 1

Clinical Efficacy

• Weight loss efficacy:

  • Wegovy (2.4 mg) demonstrated 14.9% mean weight loss at 68 weeks in the STEP 1 trial (vs 2.4% with placebo) 1
  • Ozempic at the diabetes dose (1.0 mg) showed lower weight loss percentages compared to the higher Wegovy dose 3

• Cardiovascular outcomes:

  • Wegovy reduced major cardiovascular events to 6.5% compared with 8% in the placebo group in a large cardiovascular outcomes trial 1
  • Both medications have shown reductions in cardiovascular events, with semaglutide reducing the risk of cardiovascular death by 20% in the SELECT trial 1

Practical Considerations

• Insurance coverage:

  • Insurance coverage often differs between the two medications, with many insurers not covering semaglutide for weight management alone 2
  • This has led some clinicians to prescribe Ozempic off-label for weight loss despite it not being FDA-approved for this indication 2

• Supply issues:

  • The popularity of semaglutide for weight loss has created supply problems affecting both products 4
  • This has made it difficult for some diabetes patients to obtain their needed medications 2

Common Side Effects (both medications)

• Gastrointestinal effects:

  • Both medications commonly cause gastrointestinal side effects including nausea, vomiting, and diarrhea 1
  • Gradual dose titration helps mitigate these adverse effects 1

• Rare but serious adverse events:

  • Both medications have been associated with increased risk of pancreatitis and gallbladder disease 1
  • Careful monitoring is recommended with either medication 4

Clinical Implications

• Duration of therapy:

  • Both medications require long-term use to maintain benefits 1
  • After cessation of semaglutide treatment, significant weight regain occurs (11.6% of lost weight regained after stopping treatment) 1

• Prescription decisions:

  • For patients with diabetes who need weight loss, Ozempic may be more accessible through insurance 2
  • For patients with obesity without diabetes, Wegovy is the FDA-approved choice but may have insurance coverage limitations 2

Remember that while both medications contain the same active ingredient, using the appropriate FDA-approved product for the intended indication is important for proper patient care and insurance coverage.