Every once in a while a new drug hits the market with such impact that it becomes an overnight sensation. Perhaps it offers treatment for a previously untreatable condition, provides a safer or simpler alternative to pre-existing medication, or is simply more effective than any other drug in its niche.
Semaglutide is one such drug that falls into the third category. It has recently created a lot of buzz due to its reputation for weight loss management. But it’s a superstar in other realms as well.
Semaglutide is the active ingredient in a number of brand-name prescription medications. It is a glucagon-like peptide-1 (GLP-1) receptor agonist that controls blood sugar levels. Semaglutide medications are primarily used to treat patients with Type 2 Diabetes and related cardiovascular diseases but can also promote healthy weight loss in patients with obesity or other weight-related conditions.
Below is an overview of three of the latest semaglutide medications that have taken the pharmaceutical world by storm. Ozempic, Wegovy, and Rybelus have all demonstrated encouraging outcomes in clinical trials and are all currently in high demand.
Ozempic Vs. Wegovy Vs. Rybelus
Ozempic, Wevogy, and Rybelus are all prescription semaglutide medications manufactured and distributed by Novo Nordisk in Denmark. While Ozempic and Wegovy come as injectable pens prefilled with liquid medication, Rybelus is in tablet form. All three medications help to manage blood sugar but are all approved for slightly different purposes.
Ozempic is an injectable semaglutide prescription medication approved by the FDA to treat Type 2 Diabetes in adults. It improves blood sugar control while decreasing the risk of major cardiovascular events. As a non-insulin diabetes medication, Ozempic works with the body’s natural ability to lower blood sugar levels by promoting the pancreatic release of insulin. It also prevents the liver from producing and releasing higher glucose levels and slows down food leaving the stomach.
Typically, Ozempic is administered once per week subcutaneously (under the skin of the stomach, abdomen, thigh, or upper arm). It’s most effective when accompanied by healthy lifestyle shifts such as diet and exercise.
Wegovy is a weekly semaglutide injection (prescription only) approved by the FDA to manage obesity and promote healthy weight loss. It functions the same way as Ozempic but is usually prescribed at a slightly higher dose (2.4 mg). Wegovy slows down digestive processes and promotes feelings of satiety.
Wegovy is administered subcutaneously, under the skin of the stomach, abdomen, thigh, or upper arm) and is most effective when complemented by healthy lifestyle changes such as diet and exercise.
Rybelsus is a semaglutide medication that’s taken daily in tablet form. It helps lower blood sugar levels in patients with Type 2 Diabetes and is most effective when complemented with healthy lifestyle changes such as diet and exercise. Rybelsus is taken first thing in the morning at least 30 minutes before any food or other medications.
It’s important to swallow Rybelsus tablets whole without crushing, cutting, or chewing them. They must be taken at the same time and in the same way every day.
If your doctor is considering a semaglutide prescription for you, they will carefully weigh the risks and benefits. Though semaglutide can be a game-changer for glycemic regulation, cardiovascular disease, and weight loss, there are certain circumstances that may render it a poor or dangerous option.
Here’s a list of questions to help you keep appropriate precautions in mind:
- Have you had a past allergic reaction to semaglutide or any of the other ingredients in the medication?
- Do you have a personal or family history of:
- Diabetic Retinopathy
- Gallbladder problems
- Kidney disease
- Digestion problems?
- Do you regularly consume alcohol? (Alcohol while on semaglutide can result in dangerously low blood sugar.)
- Are you on any other medications (including herbal products)?
- Are you pregnant, breastfeeding, or planning to get pregnant? (Semaglutide is not approved for pregnant or breastfeeding women and should be discontinued by women and men at least 2 months before trying to conceive.)
- Do you have a personal or family history of thyroid cancer? (Semaglutide has been associated with the development of thyroid c cell tumors in rodents, but the risk to humans is unknown.)
- Have you or anyone in your family ever had Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2)?
Semaglutide medications may cause acute kidney injury and can result in low blood sugar if combined with alcohol or certain other medications. Low blood sugar can also result from a delayed or missed snack/meal or increased exercise while on semaglutide.
While taking semaglutide, it’s always recommended to wear a medical ID, in case of an emergency. It’s also recommended to plan travel carefully and seek out medical counseling for a more detailed perspective regarding how semaglutide may impact your future.
How Semaglutide Works
People who live with Type 2 Diabetes and/or obesity often produce lower-than-normal levels of the incretin hormone glucagon-like peptide-1 (GLP-1). GLP-1 plays an important role in blood sugar management and, along with other incretin hormones produced naturally by the small intestine, signals the body when food has been consumed and is ready to be metabolized. Ultimately, these signals result in feelings of satiety or fullness.
Semaglutide essentially imitates the effects of natural GLP-1. Along with helping to regulate blood sugar levels and communicating feelings of satiety to your brain, endocrine, and digestive systems, it also slows down the speed of food traveling through your digestive tract.
Semaglutide is 95% the same as human GLP-1. Its three primary effects on the body are:
- To increase the release of insulin when blood sugar is elevated
- To reduce glucose released from liver stores into circulation
- To decrease appetite
How Is Semaglutide Taken?
Semaglutide can be taken in different ways, depending on what form of the medication you’ve been prescribed:
Taking Ozempic & Wegovy
Ozempic and Wegovy are both injectable medications. The best injection sites are the stomach (abdomen), thigh, or upper arm. Recommended best practice is to rotate injection sites each week. If you do opt to use the same site more than once in a row, use a different part of the site to reduce irritation in the area as a whole.
Ozempic and Wegovy are injected subcutaneously (under the skin) and should never be injected intramuscularly (into a muscle) or intravenously (into a vein).
While it’s possible to inject Ozempic or Wegovy and insulin at the same site, the two medications should never be mixed and should be injected in different areas of the site. Don’t use the same needle to inject semaglutide and insulin. Also, never inject more than one semaglutide medication at a time.
In consultation with your doctor, you’ll be shown how to cleanse the injection site, attach a clean needle to the pen, select the correct dose using the dose counter dial (Ozempic only), inject the semaglutide, safely dispose of the needle, and properly store any remaining medication for future injections.
Rybelsus comes in tablet form and must be taken on an empty stomach each morning before you’ve consumed any food, liquid, or other medications (including vitamins and herbal products).
This medication should be taken with a sip of water (no more than 4 ounces) and must be swallowed whole (do not split, crush, or chew it). You may eat and drink after 30 minutes have passed, and eating within 30-60 minutes of taking Rybelsus is recommended.
Rybelsus should be taken the same way at the same time every day to maximize its efficacy.
For all three semaglutide drugs (Ozempic, Wegovy, and Rybelsus), the standard dosing protocol involves starting the medication at a low (non-therapeutic) dosage to build up a tolerance and reduce side effects. The initial dosage is then increased over a period of time until the desired outcome is achieved.
The dosing schedule recommended for you by your doctor will be determined by your personal needs and response to the medication. Your healthcare provider will observe you carefully to ensure that treatment is progressing appropriately.
The information outlined below provides an overview of available doses and standard dosing protocols for each medication, but remember to always follow the specific plan laid out for you by your healthcare provider.
Ozempic pens come in three strengths, which are each injected once weekly:
- Ozempic 0.25 mg or 0.5 mg dose (2 mg/1.5 mL subcutaneous pen injector)
- Ozempic 1 mg dose (4 mg/3 mL subcutaneous pen injector)
- Ozempic 2 mg dose (8 mg/3 mL subcutaneous pen injector)
A standard weekly administration schedule for Ozempic is outlined below, but remember to follow the specific plan laid out for you by your own doctor and pay close attention to any adverse reactions:
- Begin with a dose of 0.25 mg once weekly for 4 weeks.
- Increase your dosage to 0.5 mg once weekly for 4 more weeks.
- After 4 weeks on a 0.5 mg once weekly dose, your doctor will assess your glycemic control. You may remain on a 0.5 mg once weekly dose or your dose may be increased to 1 mg or even 2 mg once weekly.
Wegovy pens come in five strengths, which are each injected once weekly:
- Wegovy 0.25 mg dose
- Wegovy 0.5 mg dose
- Wegovy 1 mg dose
- Wegovy 1.7 mg dose
- Wevogy 2.4 mg dose
A standard weekly administration schedule for Wegovy is outlined below, but remember to follow the specific plan laid out for you by your own doctor and pay close attention to any adverse reactions:
- Begin with a dose of 0.25 mg once weekly for 4 weeks.
- Increase your dosage to 0.5 mg once weekly for 4 more weeks.
- Increase your dosage to 1 mg once weekly for 4 weeks.
- Increase your dosage to 1.7 mg once weekly for 4 weeks.
- Increase your dosage to 2.4 mg once weekly, and maintain this dosage long-term.
Rybelsus tablets come in three strengths, which are each taken orally once per day in the morning:
- Rybelsus 3 mg dose
- Rybelsus 7 mg dose
- Rybelsus 14 mg dose
A standard administration schedule for Rybelsus is outlined below, but remember to follow the specific plan laid out for you by your own doctor and pay close attention to any adverse reactions:
- Begin with a dose of 3 mg once daily for 30 days.
- Increase your dosage to 7 mg once daily for 30 days.
- After 30 days on a 7 mg daily dose, your doctor will assess your glycemic control. You may remain on a 7 mg daily dose, or your dose may be increased to 14 mg per day.
If You Miss a Dose
Despite your best efforts, you may occasionally miss a dose of medication. If this happens, don’t panic. While it’s always best to take medication on time, following the protocols below should allow your body to adjust to the disruption as smoothly as possible:
Ozempic Missed Dose
Ozempic is typically self-injected once per week, on the same day of the week, with or without a meal. A missed dose should be taken as soon as possible, any time up until 5 days after the day it was originally supposed to be administered. After 5 days have passed, the dose is skipped entirely, and the next dose is taken on the correct day of the following week. If two or more doses are missed consecutively, contact your doctor to find out if a dosage adjustment will be needed.
Wegovy Missed Dose
Like Ozempic, Wegovy is also typically self-injected once weekly. A missed dose should be taken as soon as possible, any time up until 5 days after the day it was originally supposed to be administered. After 5 days have passed, the dose is skipped entirely, and the next dose is taken on the correct day of the following week. If two or more doses are missed consecutively, contact your doctor to find out if a dosage adjustment will be needed.
Rybelsus Missed Dose
If you miss a dose of Rybelsus, simply skip the missed dose and resume your regular dosing schedule the next day. If you’ve missed several consecutive doses, contact your doctor for medical advice.
If an overdose of semaglutide occurs, contact a healthcare professional immediately. Watch for serious symptoms such as trouble breathing or loss of consciousness and call 911 if necessary. You may also wish to contact your local poison control center.
How To Store Semaglutide
Semaglutide is both expensive and in high demand. Once you’ve filled your prescription, be sure that you’re storing your medication properly and out of the reach of children:
Ozempic pens are prefilled with medication and come with several unused needles (the volume of the pen and number of needles can vary, depending on the dose your doctor has prescribed). They must be kept away from light and refrigerated between 36°F to 46°F (2°C to 8°C) before being opened. Be careful to keep Ozempic away from your refrigerator cooling element, and don’t use it if it has been frozen.
After the first dose has been administered from an Ozempic pen, it can remain refrigerated or be stored at room temperature between 59ºF to 86ºF (15ºC to 30ºC).
After 56 days, open Ozempic must be thrown away.
Wegovy pens are prefilled with medication and come in single-use doses (one needle per pen). They must be kept away from light and refrigerated between 36°F to 46°F (2°C to 8°C) before being opened. Be careful to keep Wegovy away from your refrigerator cooling element, and don’t use it if it has been frozen.
Though you’ll usually use the full dose each time you take the cap off a Wegovy pen, an open pen can remain at temperatures between 46ºF to 86ºF (8ºC to 30ºC).
After 28 days, open Wegovy must be thrown away.
Rybelsus should be stored in and dispensed from its original bottle. It should also be maintained between 68ºF to 77ºF (20ºC to 25ºC), though it can withstand limited exposure to temperatures as low as 59ºF (15ºC) and as high as 86ºF (30ºC). Rybelsus must be kept away from moisture and, for this reason, should never be stored in a bathroom.
Although Ozempic, Wegovy, and Rybelsus are all slightly different, their associated side effects are similar because semaglutide is the active ingredient in all of them.
Side effects often occur when starting semaglutide, but should decrease as your body adjusts to increased dosages.
Common side effects include:
- Stomach pain
Less common side effects include:
- Recurrent fever
- Burning feeling in the chest or stomach
- Yellow eyes or skin
Though rare, serious side effects are possible with semaglutide medications. Major warning signs to watch for include:
- Vision problems (diabetic retinopathy)
- Reduced renal function
- Severe allergic reactions such as swelling of the tongue, lips, or face, fainting, or a racing pulse.
In addition, it’s advised not to use Ozempic if you or anyone in your family has ever had Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2).
As always, discuss any concerns with your primary healthcare provider.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that, in combination with healthy lifestyle changes, is used to control blood sugar levels in patients with Type 2 Diabetes, cardiovascular disease, obesity, and other weight-related conditions.
Ozempic, Wevogy, and Rybelsus are all semaglutide medications manufactured and distributed by Novo Nordisk in Denmark. While each one is indicated for slightly different purposes, they are all in high demand. Semaglutide medications are also expensive in the U.S. (often prohibitively so), and for these reasons, many Americans seek out alternative methods for sourcing them.
One safe and affordable option is to source semaglutide medications from Canada, where pricing is much more affordable. U.S. citizens who can produce a prescription and have purchased a quantity of medication that’s reasonable for personal use (generally no more than a 90-day supply) are typically able to procure medications from Canada without any trouble.
Many patients have concerns about the potential risks of ordering pharmaceuticals from abroad. While scammy and poorly regulated services do exist, reputable distributors like Bisonpharmacy.com source only the highest quality medications from pharmacies with impeccable standards.
While FDA approval is limited to the U.S., several other countries are widely accepted by American doctors as having well-regulated pharmacies. Canada tops the list.
If you’re hoping to source high-quality Ozempic without breaking the bank, ordering Canadian Ozempic through Bisonpharmacy.com is a game-changing option. Bisonpharmacy.com is a prescription referral service that partners with reputable Canadian pharmacies to provide quality pharmaceuticals to Americans at affordable prices.
Contact Bisonpharmacy.com to fill your semaglutide prescription today!
About the Author
Ida Edlweiss Gumpal is a licensed Pharmacist and medical writer. She took her internships at Mercury Drug Corporation, Inc., a Hospital internship at De Vera Medical Center, Inc., and a Manufacturing internship at Philmed Laboratories, Inc. She has plans on attending medical school with the goal of specializing in Neurosurgery or Cardiothoracic surgery.