Semaglutide
Long-acting GLP-1 receptor agonist originally developed by Novo Nordisk.
Also known as: GLP-1, Ozempic, Wegovy
Semaglutide is a synthetic peptide that mimics glucagon-like peptide-1, a hormone released from the gut after meals. It has been studied extensively in type 2 diabetes and chronic weight management, and it is one of the most-prescribed peptide therapeutics in modern medicine.
Key facts
- Class
- GLP-1 receptor agonist
- Originator
- Novo Nordisk
- Regulatory status
- FDA approved as Ozempic (2017) and Wegovy (2021)
- Structure
- 31 amino acid peptide with fatty acid side chain
- Half-life
- Approximately 7 days (supports weekly dosing in clinical use)
What is semaglutide?
Semaglutide is a modified version of the human GLP-1 hormone. Researchers at Novo Nordisk altered two amino acids in the native GLP-1 sequence and attached a fatty acid chain that allows the peptide to bind reversibly to albumin in the bloodstream. This modification protects the molecule from rapid enzymatic breakdown and extends its half-life from minutes to roughly one week.
The compound was first approved by the FDA in December 2017 under the brand name Ozempic for adults with type 2 diabetes. A higher-dose formulation was approved in 2021 as Wegovy for chronic weight management in adults who meet specific criteria. An oral tablet form, Rybelsus, was approved in 2019.
Mechanism of action
Semaglutide binds to the GLP-1 receptor, which is expressed on pancreatic beta cells, certain neurons in the brain, and cells in the gastrointestinal tract. Activation of this receptor produces several coordinated effects that researchers believe drive the observed changes in glucose control and body weight.
- •Stimulates glucose-dependent insulin secretion from pancreatic beta cells
- •Suppresses inappropriate glucagon secretion from alpha cells
- •Slows gastric emptying, which flattens post-meal glucose spikes
- •Acts on appetite centers in the hypothalamus and brainstem to reduce hunger
Clinical trial history
The SUSTAIN program evaluated semaglutide for type 2 diabetes across multiple large randomized trials beginning in 2013. The SUSTAIN-6 cardiovascular outcomes trial, published in the New England Journal of Medicine in 2016, reported a reduction in major adverse cardiovascular events in high-risk patients with type 2 diabetes.
The STEP program (Semaglutide Treatment Effect in People with Obesity) evaluated higher-dose semaglutide for weight management. STEP 1, published in NEJM in 2021, reported an average body weight reduction of about 14.9 percent at 68 weeks among participants receiving semaglutide 2.4 mg weekly, compared with 2.4 percent in the placebo group. Subsequent STEP trials examined various subpopulations and longer durations.
Safety and regulatory context
The FDA prescribing information for Ozempic and Wegovy lists common side effects including nausea, vomiting, diarrhea, abdominal pain, and constipation, which tend to be most pronounced during dose escalation. Boxed warnings address thyroid C-cell tumors observed in rodent studies; the clinical significance in humans is uncertain, and the label contraindicates use in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Post-marketing reports have included acute pancreatitis, gallbladder disease, and acute kidney injury in the setting of severe dehydration. Semaglutide is a prescription medication in the United States and most regulated markets. Material sold as a research chemical is intended strictly for laboratory use and is not cleared for human administration.
Research sourcing
Semaglutide is listed by our research partner, GLP1 Research Lab, which supplies lyophilized peptides for laboratory use. Listings include product identifiers relevant to research documentation.
View Semaglutide listing at GLP1 Research LabAffiliate partnership. Metabolic Playbook may earn a commission on purchases made through this link at no additional cost to the researcher.