Prescription only
Semaglutide
Sold as Ozempic, Rybelsus, Wegovy.
What the label states
Semaglutide has no labelled dose range, because a range is a property of a product and the FDA does not approve molecules. Five approved semaglutide products carry five different maxima: Ozempic injection — 2 mg once weekly; Wegovy injection — 7.2 mg once weekly; Rybelsus tablets — 14 mg once daily; Ozempic tablets — 9 mg once daily; Wegovy tablets — 25 mg once daily. The highest is 12.5× the lowest. Two of those products — Ozempic tablets and Wegovy tablets — share the rungs 1.5 mg, 4 mg and 9 mg exactly and then diverge, so that 9 mg is a maintenance dose of one and a mid-escalation step of the other. This page therefore quotes no ladder at all; the five labelled schedules are set out side by side on the semaglutide dosage chart, and the brand pages carry each product’s own.
Quoted from the approved product label. Clinics commonly prescribe differently — more frequent, smaller injections of the same weekly total are routine — and where this site describes that, it is named as practice rather than as labelling.
- Route
- Subcutaneous once weekly, or oral once daily on an empty stomach. Both routes are approved for this molecule, which is unusual for a peptide.
- Vehicle
- A sterile aqueous solution when injected — disodium phosphate dihydrate with either sodium chloride or propylene glycol and phenol, depending on the presentation, at about pH 7.4. The tablets are not a solution: they are formulated with salcaprozate sodium (SNAC), an absorption enhancer without which an oral peptide of this size would not survive the stomach.
- Usual barrel
- None — this compound is not drawn into a syringe
- Strengths covered
- No strength page yet
Why there is no syringe
No approved semaglutide product is drawn from a vial, so there is no barrel and no units answer — which is inconvenient, because “how many units is my semaglutide dose” is the most-searched question about this molecule. Every labelled presentation is either a dial-a-dose pen reading in milligrams, a single-dose prefilled syringe that arrives filled and is not measured, or a tablet. The Ozempic Instructions for Use are explicit that the pen is read rather than counted: “Always use the dose counter and the dose pointer to see how many mg you select,” and separately, “Do not set the dose by counting the number of clicks you hear.” Any chart converting semaglutide milligrams to insulin-syringe units is describing compounded material — a lyophilised powder or a vialled solution at a concentration the compounder chose, with no approved labelling — and that concentration, not the molecule, is what determines the units. Our converter exists for exactly that case and says so.
Administration
- 1
Establish which product you have before anything else
A weekly injection, a daily tablet on an empty stomach and a weekly injection at nearly four times the first one’s ceiling are all “semaglutide”. Dose, interval, device, indication, missed-dose rule and storage all follow from the product, not the molecule.
- 2
Weekly injections: same day each week, any time of day
Both injectable labels allow the day of the week to be changed provided the two doses are far enough apart — Ozempic states at least 2 days (more than 48 hours). Injection sites are the abdomen, thigh or upper arm, rotated between doses.
- 3
Tablets: empty stomach, water only, then wait
The oral label directs taking the tablet “orally once daily on an empty stomach in the morning with water (up to 4 ounces of water)”, swallowing whole without splitting, crushing or chewing, and waiting at least 30 minutes before food, other drinks or other oral medicines. The SNAC formulation is why the timing is a dosing instruction rather than a preference.
- 4
Never share a pen
A labelled warning in its own right: “OZEMPIC pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.”
- 5
Tell anyone planning your anaesthesia
The labels carry a warning about pulmonary aspiration during general anaesthesia or deep sedation in patients on GLP-1 receptor agonists, and direct instructing patients to inform providers of any planned surgery or procedure. This is easy to forget precisely because it involves a different clinician.
- 6
Escalate on the schedule your own label sets, not a friend’s
The five approved schedules run from three steps to five, in weeks or in days, with some steps automatic and others conditional on response. The compound page does not reproduce any of them; the dosage chart sets out all five together.
Storage
- —Every injectable presentation starts refrigerated at 2–8 °C in its original carton, and none may be frozen or used after freezing.
- —In-use limits belong to the device, not the molecule: an Ozempic multi-dose pen after first use is good for 56 days at 15–30 °C or refrigerated, while an Ozempic single-dose prefilled syringe is refrigerated to its expiration date and may be held at 8–30 °C for up to 28 days.
- —Tablets have no cold chain. This page does not restate their storage, because the oral label covers two brand names jointly and does not split that section by brand.
- —Keep the pen cap on, remove and discard the needle after every injection, and store the pen with no needle attached.
Monitoring
| Marker | When | Why |
|---|---|---|
| Symptoms of thyroid C-cell tumour | Throughout treatment, by symptom rather than by test | Every semaglutide label directs counselling on a mass in the neck, dysphagia, dyspnoea or persistent hoarseness — and equally directs against routine screening: “Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC.” A test that is not recommended is as much a monitoring instruction as one that is. |
| Signs of acute pancreatitis | After initiation and throughout | The label directs observing for “persistent or severe abdominal pain (sometimes radiating to the back), and which may or may not be accompanied by nausea or vomiting,” and discontinuing if pancreatitis is suspected. |
| Renal function | When gastrointestinal adverse reactions cause dehydration, especially during initiation and escalation | Postmarketing reports of acute kidney injury, some requiring haemodialysis, occurred mostly in patients whose nausea, vomiting or diarrhoea led to volume depletion. The label instructs monitoring renal function in exactly that situation rather than on a fixed interval. |
| Blood glucose, if you also take insulin or a sulfonylurea | Around initiation and each dose increase | Semaglutide itself rarely causes hypoglycaemia; combined with an insulin secretagogue or insulin it can, including severely, and the labels note that reducing the dose of the other drug may be necessary. |
| Diabetic retinopathy, where there is a history of it | Monitored for progression | In a 2-year trial in type 2 diabetes at high cardiovascular risk, diabetic retinopathy complications occurred in 3.0% on Ozempic versus 1.8% on placebo, and the absolute increase was larger among those with retinopathy at baseline (8.2% vs 5.2%) than without (0.7% vs 0.4%). |
Frequently asked questions
- What is the maximum dose of semaglutide?
- The molecule does not have one. Five approved products carry five different ceilings — Ozempic injection — 2 mg once weekly; Wegovy injection — 7.2 mg once weekly; Rybelsus tablets — 14 mg once daily; Ozempic tablets — 9 mg once daily; Wegovy tablets — 25 mg once daily — and the highest is 12.5 times the lowest. Even within one brand the answer splits: Ozempic injection stops at 2 mg weekly while Ozempic tablets run to 9 mg daily. So a sentence like “I am on 9 mg of semaglutide” does not identify a treatment. Nine milligrams is the top maintenance dose of an Ozempic tablet and also the third of four rungs on a Wegovy tablet, where maintenance is 25 mg daily. To answer the question you need the brand and the dosage form, at which point the label answers it precisely.
- Is Ozempic the same drug as Wegovy?
- Same molecule, different products, and the differences are not cosmetic. Ozempic injection is approved for glycaemic control in type 2 diabetes, cardiovascular risk reduction in type 2 diabetes with established cardiovascular disease, and reducing sustained eGFR decline, end-stage kidney disease and cardiovascular death in type 2 diabetes with chronic kidney disease — and caps at 2 mg weekly. Wegovy injection is approved for weight reduction, for cardiovascular risk reduction in obesity or overweight, and for noncirrhotic MASH with F2–F3 fibrosis under accelerated approval — and goes to 7.2 mg weekly. Weight loss is not a labelled indication of Ozempic at all. That divergence is what the brand pages exist to lay out.
- How many units of semaglutide is my dose?
- For any FDA-approved semaglutide product, the question does not apply. There is no vial to draw from: the multi-dose pens are dial-a-dose devices whose counter reads in milligrams, the single-dose presentations arrive prefilled, and the oral products are tablets. The Ozempic Instructions for Use say to read the dose counter and the dose pointer and explicitly not to set the dose by counting clicks. If you are being asked to draw semaglutide into an insulin syringe, you have compounded material, its concentration was chosen by the compounder rather than by a label, and the only safe way to convert is to read the mg/mL off your own vial and do the arithmetic against it.
- Why does semaglutide have a boxed warning?
- Because of what it did to rodent thyroids, and every semaglutide label carries the same statement. The Wegovy label puts it: “In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether WEGOVY causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.” The consequence is a hard contraindication rather than a caution: semaglutide is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma, or with Multiple Endocrine Neoplasia syndrome type 2. Unlike most of what people ask about semaglutide, this genuinely is a molecule-level fact — it is identical on all five labels.
- Can I take a semaglutide tablet instead of the injection at the same milligrams?
- Not by converting the number yourself. The only switches with any labelled basis are a short list of named pairs — the label pairs 0.5 mg of Ozempic injection with 4 mg or 9 mg of Ozempic tablets one week after discontinuing the injection, for instance — and for everything else the label declines to give an equivalence, stating that “RYBELSUS and OZEMPIC tablets are not substitutable on a mg-to-mg basis.” The absence of a general conversion is the answer, not a gap in it.
Sources
- [1]FDA label — OZEMPIC (semaglutide) injection, for subcutaneous use, Novo Nordisk. DailyMed SPL version 20, effective 2026-06-01, marketing category NDA (NDA209637)
- [2]FDA label — WEGOVY (semaglutide) injection and WEGOVY (semaglutide) tablets, Novo Nordisk Pharmaceutical Industries, LP. DailyMed SPL version 19, effective 2026-06-18, marketing categories NDA (NDA215256, NDA218316)
- [3]FDA label — RYBELSUS (semaglutide) tablets and OZEMPIC (semaglutide) tablets, for oral use, Novo Nordisk. DailyMed SPL version 14, effective 2026-01-30 — one label covering two brands
Related
Educational reference, not medical advice. Dose, route and whether this compound is appropriate at all are decisions for your clinician.