Comparing Wegovy vs. Ozempic

Patricia Weiser, PharmD
·9 min read
1

Medically reviewed by Lindsay Cook, PharmD

For people looking to treat and manage their type 2 diabetes, or for those looking to accelerate weight loss that is associated with type 2 diabetes, hypertension (high blood pressure), or high cholesterol, the use of prescription medication is a viable treatment strategy.

For this purpose, healthcare professionals may recommend Wegovy (semaglutide) or Ozempic (semaglutide). Both are brand-name medications for weight loss management.

While you may have heard of these drugs before or know someone prescribed Wegovy or Ozempic, you likely have questions or concerns over which drug best suits your or a loved one's needs.

To address these questions, this article will highlight the similarities and differences between Wegovy and Ozempic, including their approved indications (conditions for which a drug can be used) and off-label uses.

Getty Images / Douglas Cliff
Getty Images / Douglas Cliff

Overview of Wegovy and Ozempic

Wegovy and Ozempic are brand-name prescription medications with the same drug class—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 demonstrated that the drug effectively controlled blood sugar in adults with type 2 diabetes. Semaglutide was also shown to help people lose weight.

Healthcare providers may 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 what the FDA approved it for.

In 2021, the FDA approved semaglutide under the brand name Wegovy for weight loss in adults experiencing overweight or obesity when used along with proper diet and exercise.

Differences: Wegovy vs. Ozempic

Ozempic and Wegovy have key differences and several similarities. They differ mainly in their FDA-approved indications and typical dosages.

How They Work

Both Wegovy and Ozempic are GLP-1 agonists containing semaglutide.

Semaglutide works by prompting the pancreas to produce more insulin, which reduces 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.

Indications

Ozempic is FDA-approved for the following uses:

  • To control blood sugar levels in adults with type 2 diabetes, along with diet and exercise

  • To reduce the risk of severe health problems, such as heart attack and stroke, in adults with both type 2 diabetes and heart disease

Wegovy is approved for chronic (long-term) weight management in certain people, including:

  • Adults with an initial body mass index (BMI) of 30 or greater

  • Adults with an initial 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

  • Children 12 and older with a BMI in the 95th percentile or higher for their age

Additionally, Wegovy is FDA-approved to reduce the risk of serious heart problems in adults with obesity or who are overweight and for weight loss.



Understanding BMI

BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.





Related: Medicare Coverage for Off-Label Ozempic to Lose Weight

Administration

Both Wegovy and Ozempic are once-weekly subcutaneous injections (injections given under the skin), but Wegovy has a higher maximum dosage than Ozempic.

You or a caregiver will inject it under the skin of your abdomen, thigh, or upper arm. Wegovy and Ozempic can be given any time on the same day of the week, such as every Sunday.

Wegovy’s starting dose in adults is 0.25 milligrams (mg) once weekly for four weeks. Your healthcare provider will increase your dose every four weeks until you reach the target dose of 2.4 milligrams once weekly.

Wegovy’s starting dose in children is 0.25 milligrams once weekly for four weeks. Your child’s healthcare provider will increase the dose every four weeks until the target dose of 1.7 or 2.4 milligrams once weekly is reached.

Ozempic’s starting dose is 0.25 milligrams once weekly for four weeks. Then your healthcare provider will raise your dosage to 0.5 milligrams once weekly.

If your blood sugar levels are still too high at the 0.5 milligrams dose; your healthcare provider may increase your dose to 1 or 2 milligrams once weekly. The maximum amount of Ozempic is 2 milligrams.

Which Is More Effective?

Both Wegovy and Ozempic have been evaluated extensively in separate clinical trials, with research that reflects the following:

In a test of Wegovy in adults without diabetes, those who received Wegovy lost an average of 12.4% of their initial body weight compared to those who received a placebo.

Another study assessed Wegovy in adults with diabetes, displaying a 6.2% decrease in their initial body weight compared to those who received a placebo.

The trials for Ozempic looked at the drug’s safety and effectiveness 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 the trials, Ozempic lowered the average A1c by 1% during clinical trials. Wegovy also significantly improved blood sugar and A1c levels in clinical trials.

Role of BMI in Prescribing Semaglutide

Wegovy is FDA-approved for weight loss in certain people, including:

  • Adults with obesity or an initial body mass index (BMI) of 30 or greater

  • Adults with an initial 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

  • Children 12 years and older with a BMI in the 95th percentile or higher for their age

Unlike Wegovy, Ozempic does not have any specific BMI requirements. Ozempic is not approved for use in children.

Side Effects & Safety

Since Wegovy and Ozempic contain the same active ingredient, they can cause the same side effects and should not be used together.

It should be noted that Wegovy and Ozempic carry a boxed warning—the FDA’s most strict warning regarding serious side effects—for the severe risk of thyroid C-cell tumors.

In studies, both medications caused thyroid C-cell tumors in rats and mice. However, it is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans

Common Side Effects

The most common side effect reported for Wegovy and Ozempic is gastrointestinal (GI) upset. This side effect may ease as your body gets used to the medication.

Common side effects of both Wegovy and Ozempic include:

Severe Side Effects

Less common but potentially severe side effects of Wegovy and Ozempic may include:

Wegovy and Ozempic are not recommended for individuals with a personal or family history of MTC or multiple endocrine neoplasia syndrome type 2.

In addition, Wegovy and Ozempic should not be used by:

  • People who are taking other GLP-1 agonists

  • People with a past allergic reaction to semaglutide or other ingredients

  • People with type 1 diabetes

In addition, it isn’t known if Wegovy and Ozempic are safe to use in people with past or active pancreatitis (inflammation of the pancreas).

Related: 8 FDA-Approved Drugs for Weight Management

What Medications Interact With Wegovy or Ozempic?

As with most medications, both Wegovy and Ozempic carry the risk of adverse interactions if taken along with other drugs, including the following:

  • Wegovy and Ozempic should not be taken at the same time since you should not take more than one GLP-1 agonist drug at a time. Examples of other GLP-1 agonists include Victoza (liraglutide) and Rybelsus (semaglutide).

  • Taking either Ozempic or Wegovy with certain oral diabetes medications, such as Glyset (miglitol), or insulin may cause your blood sugar to drop too low. If your healthcare provider prescribes these drugs for you, they will instruct you on monitoring your blood sugar often until you see how the treatments affect you.

  • Both Wegovy and Ozempic cause a delay in gastric emptying (the time it takes for food to move through your digestive tract), which can impact the absorption and efficacy of other medications.

Because of these interactions, talk with your healthcare provider about all medicines you currently take before starting Wegovy or Ozempic.

Summary

Wegovy and Ozempic are similar medications. The FDA approves these drugs for different purposes, but both may 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 diet changes.

The side effects are similar, with stomach upset being the most common. Talk to a healthcare provider to try Wegovy or Ozempic.

Frequently Asked Questions

What is Ozempic face? Can this also occur with Wegovy?

“Ozempic face” is a slang term that describes a possible side effect of sagging facial skin due to weight loss when first taking Ozempic. This side effect also can occur with Wegovy and other GLP-1 agonists.

Rapid weight loss can sometimes cause the facial skin to stretch out and lose elasticity, appearing as sagging or loose.

How do I store Wegovy vs. Ozempic?

Store Wegovy in the refrigerator until you are ready to use it. Once you remove it from the fridge, Wegovy stays good at room temperature for 28 days (four weeks).

Ozempic is also kept in the refrigerator. Once you remove it from the fridge and it reaches room temperature, any unused drug 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 risks lowering your blood sugar. Your healthcare provider will explain how often to monitor your blood sugar and what to do if hypoglycemia occurs.

Further, it would be best not to inject Ozempic and insulin into the same injection site, though it can 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 for hypoglycemia with semaglutide, your healthcare provider might reduce your insulin dosage if they prescribe Wegovy.

They may also recommend checking your blood sugar levels more often until you see how your body responds to the combination.

Read the original article on Verywell Health.