GLP-1 / incretin
Semaglutide
Approved; generics in Canada since 2026Approved drugOzempicWegovyRybelsusSema
The most widely used GLP-1 drug, taken weekly by injection (Ozempic, Wegovy) or daily as a pill (Rybelsus). Canada became the first G7 country to approve generic semaglutide in 2026, including a generic for weight management.
- Canada
- Authorized: Ozempic, Wegovy, Rybelsus, plus generics approved from April 2026
- United States
- Approved: Ozempic, Wegovy, Rybelsus
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Not medical advice — talk to your doctor before making medical decisions.
At a glance
- Class
- GLP-1 agonist
- Mechanism
- Lowers appetite and slows stomach emptying
- Evidence
- Approved drug; heart-outcome trial (SELECT)
- Canada
- Authorized, including generics
- Us
- Approved
- Half Life
- About 7 days
- Routes
- SubQ weekly; oral daily
- Common Side Effects
- Nausea, diarrhea, constipation, vomiting
- Key Cautions
- Pancreatitis, gallbladder, dehydration
- Trial Weight Loss
- About 15% at 68 weeks (STEP-1, 2.4 mg)
What the research says
Is there a legal, regulated version in Canada?
Yes: brand Ozempic and Wegovy, and since 2026 generic versions (Sandoz, Apotex and others). Ask your pharmacist about generic pricing.
Heart benefits?
In the SELECT trial, semaglutide 2.4 mg cut major heart events by about 20% in people with heart disease and overweight, without diabetes.
Combine with tirzepatide or retatrutide?
No. Overlapping action, more side effects, no evidence of benefit.
Paired with cagrilintide?
That's CagriSema, Novo Nordisk's combination, which was filed with the FDA in Dec 2025 and isn't approved yet. See Cagrilintide.
Common side effects and cautions
- Nausea, diarrhea, constipation, vomiting and reflux are the most common, mostly in the first weeks and after each dose increase.
- Eating much less can mean losing muscle along with fat. Protein and strength training help protect it.
- Gallstones are more likely with fast weight loss.
- Slowed stomach emptying can change how oral medicines absorb, and matters before surgery or sedation. Tell the anesthetist you're on it.
- If you take insulin or a sulfonylurea, the risk of low blood sugar goes up.
- Not for use in pregnancy or with a personal or family history of medullary thyroid cancer or MEN2 (label warning for this class).
Get medical care if
- Redness, heat, swelling or pus at a site that spreads or comes with fever
- Hives, swelling of the face or throat, or trouble breathing (call 911)
- Severe stomach pain that won't go away, with or without vomiting (possible pancreatitis)
- Pain in the upper right belly, fever or yellow skin or eyes (possible gallbladder problem)
- Can't keep fluids down, very dark urine or dizziness when standing (dehydration, which can affect the kidneys)
- A lump or swelling in the neck, trouble swallowing or a hoarse voice that won't go away
Dose calculator
Doses are set with your prescriber. This converts a dose you already have into what to draw; it doesn't recommend one. Check every number against your syringe and your vial's label.
Doses left in the vial
A blend vial
Not medical advice — talk to your doctor before making medical decisions.
Sources
Researched 2026-10-27. Trial results and approval status change.
General education, not medical advice. Nothing here is a dose recommendation. Doses, schedules and changes are set with a prescriber.