semaglutide (Wegovy)

General information

• Primary label indications include: Chronic weight management (with diet and exercise) in adults and certain adolescents with obesity or overweight with weight-related comorbidities (label).
• Class: Adjunctive therapy
• Common US brands: WEGOVY
• Typical dose range: Typical: titrate to 2.4 mg subcutaneously once weekly for maintenance (0.25 mg weekly for 4 weeks → 0.5 mg weekly for 4 weeks → 1 mg weekly for 4 weeks → 1.7 mg weekly for 4 weeks → 2.4 mg weekly) (label).
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2026-02-12

Dosing & forms

• Forms/strengths: Single-dose pens for subcutaneous injection once weekly (label).; Dose strengths support gradual titration to 2.4 mg once weekly maintenance (label).
• Frequency: Typical: titrate to 2.4 mg subcutaneously once weekly for maintenance (0.25 mg weekly for 4 weeks → 0.5 mg weekly for 4 weeks → 1 mg weekly for 4 weeks → 1.7 mg weekly for 4 weeks → 2.4 mg weekly) (label).
• Typical range: Typical: titrate to 2.4 mg subcutaneously once weekly for maintenance (0.25 mg weekly for 4 weeks → 0.5 mg weekly for 4 weeks → 1 mg weekly for 4 weeks → 1.7 mg weekly for 4 weeks → 2.4 mg weekly) (label).

Mechanism (brief)

Weekly injectable [[GLP-1]] receptor agonist (semaglutide 2.4 mg) indicated for chronic weight management (with diet and exercise). In mental health care it is most often discussed as a tool for obesity and antipsychotic-associated metabolic risk rather than for direct psychiatric indications.

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

Monitoring highlights

• Weight/BMI and waist circumference trend; document baseline and track response over time (clinical).
• Screen for disordered eating and monitor intake/hydration during titration (clinical).
• Monitor for symptoms of pancreatitis and gallbladder disease (persistent severe abdominal pain, vomiting) (label).
• Monitor for new or worsening depression, suicidal thoughts/behaviors, and unusual mood changes; discontinue if symptoms develop (label).
• Monitor for dehydration and renal function concerns when significant GI losses occur (label/clinical).

Sources

• WEGOVY (semaglutide) injection prescribing information — DailyMed (2026)
• Once-weekly semaglutide in adults with overweight or obesity — New England Journal of Medicine (2021)
• 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)