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Clinical reference for Wegovy (semaglutide) — mechanism of action, pharmacokinetics, indications, contraindications, key drug interactions, NDC codes, and FDA approval history.
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Mechanism of action
Pharmacology class
GLP-1 receptor agonist (incretin mimetic)
Semaglutide is a long-acting GLP-1 receptor agonist with 94% structural homology to native human GLP-1. It activates pancreatic GLP-1 receptors to potentiate glucose-dependent insulin secretion, slows gastric emptying, suppresses inappropriate glucagon release, and acts on hypothalamic appetite centers to reduce caloric intake.
Pharmacokinetics
- Half-life
- Approximately 7 days (enables once-weekly dosing)
- T-max
- 1–3 days post-injection
- Metabolism
- Proteolytic cleavage of the peptide backbone and beta-oxidation of the fatty acid side-chain
- Excretion
- Renal and fecal (metabolites)
- Bioavailability
- 89% (subcutaneous)
Contraindications
- Personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to semaglutide or any excipient
Key drug interactions
Not exhaustive. See the FDA label for the full interaction list.
| Interacting drug | Severity | Note |
|---|---|---|
| Insulin | major | Risk of severe hypoglycemia — consider insulin dose reduction. |
| Sulfonylureas (glyburide, glipizide) | major | Additive hypoglycemia risk. |
| Oral medications (general) | moderate | Delayed gastric emptying may reduce absorption rate of oral drugs; effect on AUC generally small. |
| Warfarin | moderate | Monitor INR more frequently when starting or titrating. |
NDC codes & AWP
Representative NDC codes
- 0169-4525-12 (0.25 mg)
- 0169-4527-12 (0.5 mg)
- 0169-4529-12 (1.0 mg)
- 0169-4531-12 (1.7 mg)
- 0169-4533-12 (2.4 mg)
AWP per month (US, 2026 estimate)
~$1,650 AWP (cash retail $1,200–$1,400)
FDA approval history
2021
Initial FDA approval for chronic weight management in adults (BMI ≥30, or ≥27 with comorbidity).
2022
Pediatric extension for adolescents 12+ with BMI ≥95th percentile.
2024
Supplemental approval for cardiovascular event risk reduction in adults with obesity + established CV disease (SELECT trial).
References
Sourcing Wegovy for your patients
Compare US telehealth and pharmacy partners that dispense Wegovy — useful when a patient asks about cash-pay options outside of their insurance formulary.
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