Semaglutide in the Philippines: evidence and status

What it is

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It is the active ingredient in the brand-name medicines Ozempic, Wegovy and Rybelsus.

• Ozempic comes as a once-weekly injection and, in the US, as tablets. In the US, it is approved for adults with type 2 diabetes.
• Wegovy comes as a once-weekly injection and as daily tablets. In the US, it is approved for weight reduction and other uses listed below.
• Rybelsus is oral semaglutide. In the US, it is approved for adults with type 2 diabetes.

What each brand is approved for depends on the brand and the regulator. The section on diabetes and weight below lists each one.

Compounded semaglutide also exists. A compounded preparation is not the same product as Ozempic, Wegovy or Rybelsus.

How it works

Semaglutide acts like GLP-1, a hormone the body makes on its own. It shares 94% of its sequence with human GLP-1 and binds to and activates the GLP-1 receptor (US Ozempic label).

• Appetite. GLP-1 helps regulate appetite and how many calories you eat, and its receptor is found in several brain areas involved in appetite. The US Wegovy label says semaglutide lowers calorie intake, likely by affecting appetite. The European Medicines Agency says it increases fullness and reduces hunger, food intake and cravings.
• Blood sugar. It raises insulin release and lowers glucagon, both depending on blood sugar levels. A small delay in stomach emptying after meals also helps (US Ozempic label).
• Why it lasts a long time. It binds to albumin, a blood protein, which slows its removal by the kidneys. It also resists breakdown by the DPP-4 enzyme (US Ozempic label).
• Fat versus lean mass. The US Wegovy label says semaglutide lowers body weight with greater fat mass loss than lean mass loss.

What the research shows

Semaglutide has been tested in large randomized trials in people. Doses below are the doses tested in each trial, not dosing advice.

These are trial results; they do not predict how any one person will respond. They are not results for compounded semaglutide.

STEP 1: weight in adults without diabetes

Adults were assigned 2:1 to once-weekly semaglutide 2.4 mg injections or placebo, both with a lifestyle intervention.

The estimated treatment difference was -12.4 percentage points (95% CI, -13.4 to -11.5; P<0.001). Nausea and diarrhea were the most common adverse events, typically short-lived and mild to moderate.

STEP 2: weight in adults with type 2 diabetes

Adults with type 2 diabetes and an HbA1c of 7 to 10% were assigned to semaglutide 2.4 mg, semaglutide 1.0 mg or placebo, with a lifestyle intervention. At week 68, weight changed by -9.6% with 2.4 mg and -3.4% with placebo (difference -6.2 percentage points). At least 5% weight loss was reached by 68.8% on 2.4 mg and 28.5% on placebo.

STEP 3 and STEP 5: more support, longer follow-up

In STEP 3, both groups had a low-calorie diet for the first 8 weeks and 30 counseling visits over 68 weeks. Weight changed by -16.0% with semaglutide and -5.7% with placebo. At least 15% weight loss was reached by 55.8% and 13.2%.

STEP 5 ran for 104 weeks, about two years. Weight changed by -15.2% with semaglutide and -2.6% with placebo, and 77.1% versus 34.4% lost 5% or more.

STEP 6: adults in East Asia

STEP 6 enrolled 401 adults from Japan and South Korea. In a subset measured by CT scan, abdominal visceral fat area fell by 40.0% with semaglutide 2.4 mg and 6.9% with placebo (estimated difference -33.2%).

STEP-HFpEF: heart failure with obesity

This trial enrolled 529 people with heart failure with preserved ejection fraction and a BMI of 30 or more. The Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score rose by 16.6 points with semaglutide 2.4 mg and 8.7 with placebo (difference 7.8 points). Six-minute walk distance changed by 21.5 m versus 1.2 m. Serious adverse events occurred in 13.3% versus 26.7%. These are trial outcomes only. The approved uses for each brand are listed in the diabetes and weight section below.

SUSTAIN-6 and SELECT: heart outcomes

In SUSTAIN-6, people with type 2 diabetes took once-weekly semaglutide (0.5 mg or 1.0 mg) or placebo. The main outcome, the first of a heart attack that was not fatal, a stroke that was not fatal, or cardiovascular death, occurred in 6.6% on semaglutide and 8.9% on placebo (hazard ratio 0.74; 95% CI, 0.58 to 0.95; P<0.001 for noninferiority). Retinopathy complications, an eye problem, were more common with semaglutide (hazard ratio 1.76).

In SELECT, adults 45 or older with existing cardiovascular disease and a BMI of 27 or more, but no diabetes, took semaglutide 2.4 mg or placebo. The same type of main outcome occurred in 6.5% versus 8.0% (hazard ratio 0.80; 95% CI, 0.72 to 0.90; P<0.001). Adverse events led 16.6% on semaglutide to stop for good, versus 8.2% on placebo.

How fast it works and what to expect over time

Weight loss in the trials started early and built up over many months.

• Early weeks. In STEP 1, the European Medicines Agency reports that weight loss occurred early and continued throughout the 68-week trial.
• Dose build-up. On the US Wegovy injection label, the dose for the branded injection rises every 4 weeks, and the maintenance dose starts at week 17. This is the label schedule, not a schedule for compounded semaglutide. Your doctor sets your dose.
• Plateau. In the 104-week STEP 5 trial, mean body weight fell until week 68 and then reached a plateau. On placebo, weight fell less and plateaued after about 20 weeks.
• Continuing vs stopping (STEP 4). In STEP 4, people who reached the maintenance dose by week 20 and stayed on semaglutide lost a further 7.9% from week 20 to week 68.

These are trial results; they do not predict how any one person will respond.

What happens if you stop

In the trials, weight went back up on average after stopping.

• STEP 1 extension. At week 68, semaglutide 2.4 mg and the lifestyle program were stopped, and 327 people were followed for one more year. People who had taken semaglutide regained 11.6 percentage points by week 120. They ended 5.6% below their starting weight, versus 0.1% for placebo. The authors concluded that people regained two-thirds of their prior weight loss, and most heart and metabolic improvements moved back towards where they started.
• STEP 4. After a 20-week run-in on semaglutide, people switched to placebo gained 6.9% of body weight over the next 48 weeks. People who continued lost a further 7.9%.

The STEP 1 extension authors wrote that the findings suggest ongoing treatment is required to maintain improvements in weight and health.

Ozempic, Wegovy and Rybelsus: diabetes vs weight

The brands contain the same active ingredient but are approved for different uses.

The Philippine column draws on the Philippine package insert for Ozempic (linked from FDA Philippines Verification Portal record BR-1326), the Philippine package insert for Wegovy (linked from record BR-1468) and the Philippine package insert for Rybelsus (linked from record BR-1411). One of the four Ozempic inserts, linked for BR-1346, lists only the type 2 diabetes indication. The Wegovy leaflet linked for the single-dose pens (BR-1473) covers adults only.

The US Ozempic kidney use rests on the FLOW trial, which the US label presents as its kidney outcomes trial. FLOW (NEJM 2024) followed 3,533 adults with type 2 diabetes and chronic kidney disease for a median of 3.4 years. Major kidney disease events were 24% lower with semaglutide 1 mg than with placebo (hazard ratio 0.76).

The US Wegovy uses all go with a reduced-calorie diet and more physical activity. For Ozempic and Rybelsus, the blood sugar use is as an add-on to diet and exercise.

In the European Union, Wegovy is approved for weight management in adults with a BMI of 30 kg/m2 or more, or 27 to under 30 kg/m2 with at least one weight-related condition.

The US Wegovy label says using Wegovy tablets or injection together with other semaglutide products or any other GLP-1 receptor agonist is not recommended.

How it is taken and stored

Ozempic and Wegovy injections are given once a week under the skin. This section describes the branded products as their labels do. It is not instructions for compounded semaglutide, and your doctor sets your dose and explains how to take it.

Injections (US Ozempic and Wegovy labels)

• Once weekly, on the same day each week, at any time of day, with or without meals.
• Injected under the skin of the abdomen, thigh or upper arm. The US Ozempic label says to use a different injection site each week when using the same body area.
• Ozempic should look clear and colorless. An Ozempic pen must never be shared, even if the needle is changed.
• Wegovy comes as single-dose pens, single-dose syringes, or a FlexTouch pen holding 4 weekly doses. Ozempic comes as multi-dose pens or single-dose prefilled syringes.
• The EU Wegovy product information says it should not be given into a vein or a muscle.

Wegovy tablets (US Wegovy label)

• Once daily, in the morning, on an empty stomach, with up to 4 ounces of water.
• Swallowed whole, not split, crushed, chewed or dissolved.
• Wait at least 30 minutes before eating, drinking or taking other oral medicines.

Storage on the Philippine package inserts (branded products registered in the Philippines)

Storage on the US labels. For the Ozempic pen and Wegovy FlexTouch pen after first use, the US labels allow 56 days rather than 6 weeks. The Philippine package insert applies to products registered in the Philippines.

The US labels say not to freeze the injections or use them if frozen, and to protect them from heat and light. Ozempic pens and Wegovy FlexTouch pens are stored with no needle attached, with a new needle for each injection.

The dose schedule on the US labels

The US labels for Ozempic and Wegovy injections set out a step-up schedule. This is the label schedule, your doctor sets your dose, and it is not a schedule for compounded semaglutide.

US Ozempic label (Revised: 05/2026)

• The label says the slow start is to reduce the risk of stomach and gut side effects.
• Maintenance is 0.5 mg, 1 mg or 2 mg once weekly, based on blood sugar control. The maximum recommended dose is 2 mg once weekly.
• For type 2 diabetes with chronic kidney disease, the maintenance dose is 1 mg once weekly, after at least 4 weeks on 0.5 mg.

US Wegovy injection label (Revised: 6/2026)

• Weight reduction in adults: maintenance is 1.7 mg or 2.4 mg (recommended) once weekly. For adults who tolerate 2.4 mg for at least 4 weeks and need more weight reduction, the dose may be increased to a maximum of 7.2 mg once weekly. This 7.2 mg maximum applies to weight reduction in adults only.
• Heart risk reduction in adults: 2.4 mg (recommended) or 1.7 mg once weekly.
• Weight reduction in children 12 and older: 2.4 mg (recommended) or 1.7 mg once weekly.
• MASH in adults: 2.4 mg once weekly, which can be lowered to 1.7 mg if not tolerated.
• If a step is not tolerated, the label says to consider delaying the next increase by 4 weeks.
• In people with diabetes, the label says to monitor blood sugar before and during treatment.

This page does not give the Wegovy tablet or Rybelsus schedules.

Side effects and how common they are

Stomach and gut side effects are the most common, and they were reported more often on semaglutide than on placebo in every STEP trial below.

In STEP 2 and STEP 5, these events were mostly mild to moderate. In STEP 1, nausea and diarrhea were typically transient and mild to moderate.

Listed on the US labels in 5% or more of people:

• US Ozempic label: nausea, vomiting, diarrhea, abdominal pain and constipation.
• US Wegovy label (adults or children 12 and older): nausea, diarrhea, vomiting, constipation, abdominal pain, abnormal skin sensations (dysesthesia), headache, fatigue, indigestion, dizziness, bloating, burping, low blood sugar in people with type 2 diabetes, gas, gastroenteritis, gastroesophageal reflux disease and hair loss.

Other measured effects (US Wegovy label):

Serious warnings and who should not use it

The US Wegovy label carries a boxed warning and lists people who must not use semaglutide.

Boxed warning (US Wegovy label): in rodents, semaglutide causes thyroid C-cell tumors at exposures relevant to people. It is unknown whether it causes these tumors, including medullary thyroid carcinoma (MTC), in humans.

Who must not use it (US Wegovy label): people with a personal or family history of MTC, people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and people who have had a serious allergic reaction to semaglutide or any of its ingredients.

Other serious risks on the US labels:

• Pancreatitis (US Wegovy label): acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been seen with GLP-1 receptor agonists, including Wegovy. The label says to stop Wegovy if pancreatitis is suspected.
• Gallbladder disease (US Wegovy label): more gallstones and gallbladder inflammation, as shown above.
• Low blood sugar (US Wegovy label): people taking insulin or an insulin secretagogue, such as a sulfonylurea, may have a higher risk of hypoglycemia, including severe hypoglycemia. The label tells prescribers to consider lowering the dose of those medicines when semaglutide is started.
• Kidneys (US Wegovy label): acute kidney injury, sometimes needing dialysis, has been reported after marketing, mostly in people dehydrated by stomach and gut side effects.
• Eyes (US Wegovy label): diabetic retinopathy complications have been reported in semaglutide trials. People with a history of diabetic retinopathy should be monitored.
• Severe stomach and gut reactions (US Ozempic label): these can be severe. Ozempic is not recommended for people with severe gastroparesis.
• Allergic reactions (US Ozempic label): serious reactions such as anaphylaxis and angioedema have been reported.
• Surgery and sedation (US Ozempic label): pulmonary aspiration has been reported in people on GLP-1 receptor agonists having procedures under general anesthesia or deep sedation. Tell your healthcare providers about any planned surgery or procedure.
• Other medicines (US Ozempic label): semaglutide slows stomach emptying and may affect how oral medicines taken at the same time are absorbed.

Pregnancy (US Wegovy label): semaglutide may harm an unborn baby. The label says to stop it in pregnant patients using it for weight reduction, and to stop at least 2 months before a planned pregnancy because it stays in the body a long time.

Branded, compounded and unregistered semaglutide

Not every product sold as semaglutide is the same.

• Branded: Ozempic, Wegovy and Rybelsus are the brand-name medicines. All three are listed as registered prescription drugs in the FDA Philippines Verification Portal (see Legal status below).
• Compounded: a compounded preparation. Compounded semaglutide is not the same product as Ozempic, Wegovy or Rybelsus. The trial results on this page are not results for compounded semaglutide.
• Unregistered or fake: products without registration, and fakes such as the counterfeit Ozempic the US FDA reports.

What the US FDA says (page "FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss", content current as of October 1, 2026):

• The US FDA says "compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed."
• Compounded drugs "should only be used in patients whose medical needs cannot be met by an FDA-approved drug."
• It received multiple reports of adverse events, some requiring hospitalization, that may be linked to dosing errors with compounded injectable semaglutide. Patients measured and gave themselves the wrong dose, and in some cases health care professionals miscalculated doses.
• As of May 31, 2026, the US FDA had received 990 reports of adverse events associated with compounded semaglutide. It notes these are likely underreported, because state-licensed pharmacies that are not outsourcing facilities are not required to report them.
• On salt forms, semaglutide sodium and semaglutide acetate "are different active ingredients than are used in the approved drugs", and the US FDA is "not aware of any lawful basis for their use in compounding."
• It reports fraudulent compounded semaglutide with false label information, counterfeit Ozempic, and products falsely labeled "for research purposes" or "not for human consumption".
• It recommends throwing away a multiple-dose vial within 28 days after first use, even if medicine is left, and not using any injectable GLP-1 drug that arrives warm or not properly refrigerated.

US FDA policy updates on compounding:

• February 21, 2025: the US FDA said "the shortage of semaglutide injection products ... is resolved." Its period of enforcement discretion for compounded copies of semaglutide injection then ended for state-licensed (503A) pharmacies and physicians, and ran until May 22, 2025 for 503B outsourcing facilities (update dated April 28, 2025).
• April 1, 2026: "Tirzepatide and semaglutide do not currently appear on the 503B bulks list or on FDA's drug shortage list." The US FDA may consider a compounded product that combines semaglutide with another ingredient, such as vitamin B12, to be essentially a copy of a commercially available drug.

These are US FDA statements about the US market. No FDA Philippines statement on compounded or unregistered semaglutide was found: a search of the FDA Philippines website for semaglutide on October 7, 2026 returned only an unrelated advisory.

How to get semaglutide legally in the Philippines

This section is about the branded medicines Ozempic, Wegovy and Rybelsus. All three are listed as prescription drugs (Rx) in the FDA Philippines Verification Portal (checked October 7, 2026), so the legal route starts with a prescription.

• The pharmacy rule: under the Philippine Pharmacy Act (RA 10918), prescription medicines may be dispensed only by a registered and licensed pharmacist and only with a valid prescription from a physician, dentist or veterinarian. Pharmaceutical products may be made available to the public only through a retail drug outlet licensed by FDA Philippines.
• Online sellers: in February 2024, FDA Philippines told GMA News it was concerned about Ozempic sold online without a prescription and was investigating online sellers. It asks the public to report prescription drugs sold illegally online to ereport@fda.gov.ph.

How it compares with tirzepatide

Tirzepatide (Mounjaro, Zepbound) acts on two receptors, GIP and GLP-1, while semaglutide acts on the GLP-1 receptor (US Zepbound and Wegovy labels). Two open-label trials compared them head to head.

• In SURPASS-2, body weight fell more with tirzepatide, with estimated differences of -1.9 kg, -3.6 kg and -5.5 kg for the three doses.
• In SURMOUNT-5, waist size changed by -18.4 cm with tirzepatide and -13.0 cm with semaglutide.

Both trials were open-label, so participants knew which medicine they took. These are trial results; they do not predict how any one person will respond, and they do not say which medicine suits you. For more detail, see semaglutide vs tirzepatide and the tirzepatide page.

Legal status in the Philippines

This section covers the branded medicines only. An FDA Philippines Verification Portal search for semaglutide on October 7, 2026 returned 17 registration records for three brands, all classified "Prescription Drug (Rx)" and all valid on that date.

The importer and distributor for all three is Novo Nordisk Pharmaceuticals (Philippines), Inc. The Philippine package insert for Ozempic (linked from FDA Philippines Verification Portal record BR-1326) lists type 2 diabetes, and reducing the risk of major heart events in adults with type 2 diabetes and established heart disease. The Philippine package insert for Wegovy (linked from record BR-1468) covers weight management, and the Philippine package insert for Rybelsus (linked from record BR-1411) covers type 2 diabetes.

FDA Philippines advisories

No FDA Philippines advisory naming semaglutide, Ozempic, Wegovy or Rybelsus was found. Searches of the FDA Philippines website for these names on October 7, 2026 found no such advisory. The full advisories listing could not be opened, so an advisory the searches did not surface may exist.

FDA Philippines has issued advisories on unregistered tirzepatide products, a related medicine: Advisory No. 2026-0814 (July 30, 2026) and Advisory No. 2026-1020 (September 1, 2026). Both warn the public not to buy or use products that have no Certificate of Product Registration.