semaglutide (Ozempic)

Adjunctive therapy • Brands: OZEMPIC

Last reviewed: 2026-02-12

General information

Primary label indications include: Type 2 diabetes mellitus (adjunct to diet/exercise) and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease (label).
Class: Adjunctive therapy
Common US brands: OZEMPIC
Typical dose range: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Dosing & forms

Forms/strengths: Prefilled multi-dose pen for subcutaneous injection once weekly (label).; Pen presentations support maintenance doses up to 2 mg once weekly (label).
Frequency: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).
Typical range: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).

Mechanism (brief)

Weekly injectable [[GLP-1]] receptor agonist (semaglutide) indicated for type 2 diabetes and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease; also produces meaningful weight loss, which can be relevant when metabolic comorbidity complicates psychiatric treatment.

Metabolism & Half‑life

Metabolism: Proteolytic cleavage of the peptide backbone, Beta-oxidation of the fatty-acid side chain
Half‑life: Single-dose mean 168 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Weight/BMI and waist circumference trend; document baseline and track response over time (clinical).
Glycemic control (HbA1c/fasting glucose) when diabetes or prediabetes is present; avoid overly rapid de-escalation of other diabetes medications that could destabilize control (clinical).
Screen for symptoms of pancreatitis and gallbladder disease (persistent severe abdominal pain, vomiting) (label).
Monitor for dehydration and renal function concerns when significant GI losses occur (label/clinical).
For patients with diabetes and known retinopathy, monitor for progression during large glycemic shifts (label).

Sources

OZEMPIC (semaglutide) injection prescribing information — DailyMed (2026)
Semaglutide and cardiovascular outcomes in patients with type 2 diabetes — New England Journal of Medicine (2016)
Effect of liraglutide treatment on prediabetes and overweight or obesity in clozapine- or olanzapine-treated patients with schizophrenia spectrum disorder: a randomized clinical trial — JAMA Psychiatry (2017)
Therapeutic management of atypical antipsychotic-related metabolic dysfunctions using GLP-1 receptor agonists: a systematic review — Experimental and Therapeutic Medicine (2023)

General information

Primary label indications include: Type 2 diabetes mellitus (adjunct to diet/exercise) and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease (label).

Class: Adjunctive therapy

Common US brands: OZEMPIC

Typical dose range: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2026-02-12

Dosing & forms

Forms/strengths: Prefilled multi-dose pen for subcutaneous injection once weekly (label).; Pen presentations support maintenance doses up to 2 mg once weekly (label).

Frequency: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).

Typical range: Typical: 0.5–2 mg subcutaneously once weekly after titration (start 0.25 mg once weekly for 4 weeks, then 0.5 mg; increase to 1 mg and up to 2 mg once weekly if needed) (label).

Mechanism (brief)

Monitoring highlights

Weight/BMI and waist circumference trend; document baseline and track response over time (clinical).

Glycemic control (HbA1c/fasting glucose) when diabetes or prediabetes is present; avoid overly rapid de-escalation of other diabetes medications that could destabilize control (clinical).

Screen for symptoms of pancreatitis and gallbladder disease (persistent severe abdominal pain, vomiting) (label).

Monitor for dehydration and renal function concerns when significant GI losses occur (label/clinical).

For patients with diabetes and known retinopathy, monitor for progression during large glycemic shifts (label).