semaglutide (Ozempic)

Adjunctive therapy

Brands: OZEMPIC

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Quick answers

What is semaglutide (Ozempic)?
Ozempic is a once-weekly injectable form of semaglutide, a GLP-1 receptor agonist used for type 2 diabetes and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease (label).
What is OZEMPIC?
OZEMPIC is a brand name for semaglutide (Ozempic).
What is OZEMPIC (semaglutide (Ozempic)) used for?
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). No FDA-approved psychiatric indications.
What drug class is OZEMPIC (semaglutide (Ozempic))?
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.
What strengths does OZEMPIC (semaglutide (Ozempic)) come in?
Prefilled multi-dose pen for subcutaneous injection once weekly (label).

Snapshot

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
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

Type 2 diabetes mellitus (adjunct to diet/exercise) and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease (label). No FDA-approved psychiatric indications.

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Clinical Highlights

Ozempic is a once-weekly injectable form of semaglutide, a GLP-1 receptor agonist used for type 2 diabetes and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease (label). It is not a psychiatric medication and has no FDA-approved psychiatric indications; any “mental health” relevance is typically indirect (e.g., addressing obesity/diabetes that complicate treatment, or supporting metabolic recovery after weight-gain–promoting psychotropics) (clinical).

In serious mental illness care, GLP-1 therapies are most often discussed in the context of antipsychotic-associated weight gain and metabolic syndrome. Evidence is strongest for the GLP-1 class overall, including a randomized trial with liraglutide in clozapine/olanzapine-treated schizophrenia spectrum patients and a growing review literature (JAMA/Review).
The most common adverse effects are gastrointestinal (nausea, vomiting, diarrhea, constipation), particularly during dose escalation; gradual titration improves tolerability (label/clinical).
The compare view, evidence feed, and print page help place Ozempic next to other metabolic options and track key safety themes.

Dosing & Formulations

Ozempic is a prefilled multi-dose pen for subcutaneous injection once weekly. It is not interchangeable with Wegovy dosing without careful re-titration (label). Typical titration is 0.25 mg once weekly for 4 weeks (starter dose; not intended for glycemic control), then 0.5 mg once weekly. If additional glycemic control is needed, the dose may be increased to 1 mg once weekly and up to 2 mg once weekly (label).

Choose a consistent weekly day. If a dose is missed, administer as soon as possible within 5 days; otherwise skip the missed dose and resume the regular schedule (label).
Injection sites include the abdomen, thigh, or upper arm; rotate sites (label).
In practice, severe nausea/vomiting often prompts slower escalation or a temporary dose step-down rather than abrupt discontinuation (clinical).

Monitoring & Risks

Boxed warning: risk of thyroid C-cell tumors in rodents; Ozempic is contraindicated with personal/family history of MTC or MEN2 and patients should be counseled on neck mass/hoarseness/dysphagia symptoms (label). Acute pancreatitis and gallbladder disease have been reported; evaluate severe or persistent abdominal pain and discontinue if pancreatitis is suspected (label).

Hypoglycemia risk increases when combined with insulin or sulfonylureas; medication reconciliation and dose adjustments are often needed in complex diabetes regimens (label/clinical).
Diabetic retinopathy complications were observed in a cardiovascular outcomes trial; patients with a history of diabetic retinopathy should be monitored (label).
Dehydration from vomiting/diarrhea can worsen renal function; monitor volume status and renal function when clinically indicated (label/clinical).

Drug Interactions

Semaglutide delays gastric emptying; absorption of some oral drugs can be affected during dose escalation. Review narrow-therapeutic-index agents and time-sensitive oral regimens (clinical). When combined with other glucose-lowering medications, the main interaction risk is hypoglycemia (especially insulin or sulfonylureas), so coordination with the prescriber managing diabetes therapy is important (label/clinical).

If severe GI adverse effects occur, monitor for changes in exposure or tolerability of oral psychotropics (e.g., short half-life sedatives or dose-dependent agents), even when no direct pharmacokinetic interaction is expected (clinical).
Major CYP-mediated interactions are not expected (peptide metabolism), but polypharmacy review is still essential (clinical).

Practice Notes

In serious mental illness care, GLP-1 therapy is best framed as one component of a broader metabolic plan (diet, activity, sleep, tobacco, and psychiatric medication review) rather than a stand-alone fix (clinical). For antipsychotic-associated weight gain, weigh medication adjustments and non-pharmacologic supports in parallel; weight-loss therapy should not compromise psychiatric stability (clinical).

Consider screening for disordered eating and ensure weight-loss goals are safe and appropriate; monitor for excessive appetite suppression and dehydration (clinical).
Nausea management basics (often helpful during titration) include smaller meals, slower eating, hydration, and avoiding high-fat meals around dose increases (clinical).
Cost and coverage frequently determine access; documenting metabolic comorbidities and prior weight-loss attempts can help with insurance workflows (clinical).

References

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)