What is semaglutide?

Semaglutide is a drug used to treat type 2 diabetes and obesity. This prescription medication works by increasing insulin levels in the body, which decreases blood glucose (sugar). Semaglutide also targets areas of the brain that regulate appetite and signal you to feel full, which suppresses appetite and can result in weight loss.

Semaglutide is a prescription medication, not a dietary supplement. It should only be used under the supervision of a qualified healthcare provider familiar with your medical history.

Currently, the Food and Drug Administration (FDA) has approved three semaglutide products: Ozempic®, Rybelsus®, and Wegovy®. Ozempic and Wegovy are injected under the skin once per week, and Rybelsus is taken orally, once-daily. These medications are only available with a prescription, and there are no approved generic versions.

When used in addition to diet and exercise:

  • Wegovy is approved for chronic weight management in adults and children (12 years and older) with obesity.
  • Wegovy can be used to help overweight adults who have other weight-related medical problems (such as high blood pressure, diabetes, or high cholesterol) lose weight.
  • Ozempic and Rybelsus have been approved to improve blood sugar levels in adults with type 2 diabetes.
  • Ozempic may be used to reduce the risk of stroke, heart attack, or death in adults with type 2 diabetes and known heart disease.

Can Service Members use semaglutide?

TRICARE covers anti-obesity medications if individuals meet the prior authorization (PA) criteria. Currently, service-specific and duty-specific policies are under review since outdated policies conflict with newer guidance, which is confusing for healthcare providers and Service Members.

  • For full manual PA criteria for semaglutide, please use the TRICARE Formulary Search Tool.
  • The use of semaglutide during training, deployments, or operational platforms might not be authorized. However, it might be allowed on a case-by-case basis, depending on service-specific policies and provider recommendations.
  • Service Members should discuss potential operational, training, and deployment impacts with their Department of Defense (DoD) medical officer before starting semaglutide.
  • Civilian doctors who evaluate and treat Service Members for obesity may prescribe anti-obesity medications (such as semaglutide), but should be familiar with the TRICARE coverage algorithm.
  • Service Members should use providers at their installation’s Medical Treatment Facility (MTF) whenever possible. These providers will be more knowledgeable about service-specific policies regarding semaglutide than civilian providers.
  • Service Members should ensure all their medications are recorded in their electronic military health record and work with their military Primary Care Provider to ensure their record is updated to reflect any missing prescription medications.

What are the side effects of taking semaglutide?

Common adverse reactions of semaglutide include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Dizziness
  • Headache
  • Constipation
  • Abdominal pain

What are some important warnings about semaglutide use?

  • Risk of thyroid C-cell tumors. When laboratory animals were given semaglutide, they developed tumors. It’s unknown if this medication increases the risk of tumors in humans.
  • Increased risk for: Low blood sugar and vision changes in people with type 2 diabetes, increased heart rate, pancreatitis, kidney failure, and medullary thyroid carcinoma, especially in people with a family history of this cancer.

What should consumers know about compounded or counterfit semaglutide products?

When a drug is in short supply, compounded versions may be available if they meet certain FDA requirements. According to FDA, “Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of an individual patient.” However, FDA does not approve such drugs or verify their effectiveness or safety.

FDA also states, "Patients should be aware that some products sold as ‘semaglutide’ may not contain the same active ingredient as FDA-approved semaglutide products and may be the salt formulations. Products containing these salts, such as semaglutide sodium and semaglutide acetate, have not been shown to be safe and effective…Purchasing medicine online from unregulated, unlicensed sources can expose patients to potentially unsafe products that have not undergone appropriate evaluation or approval, or do not meet quality standards." For more information, please read the FDA article about medications containing semaglutide.

Related readings

 

Updated 15 April 2024

References

Medline Plus. (2023). Semaglutide injection. from https://medlineplus.gov/druginfo/meds/a618008.html

U.S. Food & Drug. (2021). FDA approves new drug treatment for chronic weight management, first since 2014. from https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

Shu, Y., He, X., Wu, P., Liu, Y., Ding, Y., & Zhang, Q. (2022). Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system. Frontiers in Public Health, 10. doi:10.3389/fpubh.2022.996179

U.S. Food & Drug. (2017). Highlights of prescribing information: Ozempic®. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf

U.S. Food & Drug. (2021). Highlights of prescribing information: Rybelsus®. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/213051s006lbl.pdf

U.S. Food & Drug. (2022). Highlights of prescribing information: Wegovy®. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215256s005lbl.pdf

U.S. Food & Drug. (2023). Medication guide: Wegovy®. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256Orig1s006lbl.pdf

U.S. Food & Drug. (2023). Medications containing semaglutide marketed for Type 2 diabetes or weight loss. from https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss