Wegovy vs. Ozempic

Wegovy and Ozempic both contain the same active ingredient (semaglutide), but they have different FDA-approved indications for use. Ozempic is FDA-approved for Type 2 diabetes and lowering cardiovascular risk in certain patients. Wegovy is FDA-approved for weight loss and, in March 2024, it became the first FDA-approved treatment to reduce the risk of major cardiovascular events in adults with overweight or obesity.

“They both contain the active ingredient semaglutide, but Wegovy’s maximum dose [2.4 mg] is higher and Wegovy comes in a single-use injectable pen,” Antoni Adamrovich, nurse practitioner and co-owner of weight loss clinic TB2.Health, told Drugwatch.

Wegovy received FDA approval as a weight loss drug in 2021. Patients without insurance pay approximately $1,349 for a month’s supply of four pen injectors. In contrast, Ozempic first received FDA approval in 2017 for Type 2 diabetes. A single Ozempic pen injector lasts four weeks and costs approximately $935 without insurance.

Despite these differences, both drugs are semaglutide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist. Among the most noteworthy are that Novo Nordisk manufactures both formulations and global supply shortages have affected the availability of both Wegovy and Ozempic.

“Ozempic and Wegovy are the same drug. The dosage for Wegovy is a little higher, but other than that, it’s the same,” Dr. Sue Decotiis, a triple board-certified weight loss physician in New York City, told Drugwatch.

Though Wegovy and Ozempic contain the same active ingredient, Wegovy is marketed for weight loss and the prevention of heart disease while Ozempic is indicated to treat Type 2 diabetes.

Ozempic and Wegovy have different intended uses; however, both medications work by slowing digestion and reducing appetite. As a result, some physicians may prescribe either for weight management. Because prescribing Ozempic for weight loss is an off-label use, many insurance companies will not cover Ozempic for weight loss.

Studies comparing Wegovy and Ozempic show both drugs are effective at helping patients diagnosed with obesity or overweight reduce their body weight, but Wegovy reduces weight more effectively than Ozempic does.

“The reason why [semaglutide] works is not just the fact that it depresses appetite, it’s that it gets insulin to work better. And that’s what GLP-1 is about. GLP-1 is a receptor that’s in the intestine and also has receptors in the brain,” Decotiis said.

Wegovy offers a slightly higher maximum dose of semaglutide than Ozempic. Patients on Wegovy may reach a maintenance dose of 2.4 mg, while Ozempic’s maximum dose is 2 mg. This higher available dose of semaglutide gives Wegovy a slight advantage over Ozempic when considering its effectiveness.

*Results achieved at the highest allowed dose of each medication.

Although designed to treat and prevent Type 2 diabetes, Ozempic can also be an effective weight management tool. Many clinicians therefore prescribe Ozempic for weight loss for individuals with Type 2 diabetes who also have overweight or obesity.

Similarly, several studies indicate that Wegovy can also be an effective option for off-label use in patients with Type 2 diabetes. It shows promise for long-term interventions and disease prevention.

Long-term clinical studies demonstrate the positive correlation between taking a 2.4 mg dosage of semaglutide combined with lifestyle modifications and reduced risk of developing Type 2 diabetes. Patients taking Wegovy at 2.4 mg may reduce the risk of Type 2 diabetes by as much as 60%.

Wegovy and Ozempic carry the same side effect profile, but the side effects of Wegovy may be more severe because Wegovy contains a higher dose of semaglutide.

According to Dr. Maria Anton, endocrinologist and educator at the Pritikin Longevity Center, “These medications have the same side effect profiles as they contain the same active ingredient. Your health care provider can help to determine which medication would be most suitable to achieve your personal health goals.”

Medication side effects often resolve over time, but as many as 10% of patients must stop taking the medication because they do not resolve. In extreme cases, patients may require hospitalization for side effects that jeopardize their overall health.

Wegovy and Ozempic side effects can range from mildly disruptive to severe. It is imperative to discuss possible adverse effects with your health care provider before beginning treatment. Based on that discussion, you can make an informed decision about whether these drugs are right for you.

Some patients who took Ozempic (semaglutide) and switched over to Mounjaro (tirzepatide), a GLP-1 and gastric insulinotropic peptide (GIP) receptor dual agonist, found they had less vomiting and nausea.

“I didn’t have vomiting with Mounjaro like I did with Ozempic. Just a little nausea and a couple of stomach cramps. It was definitely an easier start,” said Stephan T., a patient with Type 2 diabetes who is omitting his last name for privacy.

Severe Safety Concerns

Patients with extreme gastrointestinal distress, including pancreatitis and gallbladder issues, may need hospitalization to stabilize their condition. There are additional concerns about stomach paralysis and malnutrition because of extreme appetite suppression.

Another recent concern is a suspected increased risk of certain cancers with the use of GLP-1 receptor agonist drugs, including semaglutide. However, a comprehensive analysis of existing studies and real-world patient data showed no increase in pancreatic, thyroid or other abnormal growths among patients taking the drug. In fact, early research suggests that GLP-1 receptor agonists may decrease the risk of obesity-associated cancers.

Some patients have had severe reactions to semaglutide drugs. As a result, there are currently several Ozempic lawsuits against Novo Nordisk. If you’ve experienced adverse reactions while taking Wegovy or Ozempic, you may be able to seek compensation through these suits.

As with any prescription medication, your doctor will carefully weigh individual factors before making a recommendation about which drug to take. Factors such as your medical records, health history and current FDA recommendations will impact the decision.

There are alternatives if semaglutide causes too many side effects, isn’t effective or is unavailable. Patients with Type 2 diabetes have many other drug treatment options, including other GLP-1 receptor agonists like Mounjaro (tirzepatide) and Trulicity (dulaglitude). For weight loss, other options include Saxenda (liraglitude) and Zepbound (tirzepatide).

“A medical provider can help determine if a patient would benefit from these other medications and discuss risks versus benefits with the patient. Surgical options are also available and may be especially beneficial in those patients who are metabolically at risk, are severely obese and have been unsuccessful with more conservative management,” Anton said.