Semaglutide: dosing, evidence and sources

Mechanism

Long-acting GLP-1 receptor agonism.

Regulatory status

Approved by the FDA. Marketed as OZEMPIC, RYBELSUS. Earliest approval 2019-09-20. Application NDA213051.

An approval grades as rung 1 on this site, because 21 CFR 314.126 requires adequate and well-controlled human investigations and one cannot be granted without them. It covers specific indications and doses, though, and does not transfer to other uses of the same molecule.

Reported effects

What sources associate with this compound. Reported categories, not outcomes we have graded — each would need its own citation and rung.

Weight loss
Glycemic control
Cardiovascular-risk context

Dosing on file unverified

0.1-2.4 mg weekly, cycled 12–68 weeks

Reported dose	Volume	Draw
Low — 0.1 mg	0.1 mL	10 units
High — 2.4 mg	2.4 mL	240 units

What that assumes. Assumes 2 mg in 2 mL (1000 mcg/mL) drawn on a U-100 barrel — the preset on this record, not a recommendation and not the only way to mix it. Change the vial mass, the diluent or the barrel and every number in this table changes. Run your own.

Carried from a source that labels it unverified, and reproduced with that label attached. A record of what is reported, not a recommendation. No citation on this page establishes it.

Reconstitution

Vial	Diluent	Concentration	Typical dose	Draw
2 mg	2 mL	1000 mcg/mL	100 mcg	10 units

mass ÷ diluent = concentration; dose ÷ concentration = volume; volume × the syringe factor = units on the barrel (100 for U-100, 40 for U-40). Run your own numbers.

Reported adverse effects

Nausea

Very common (>10%)onset: First weeks; often improves with timereported reversible
Vomiting

Common (1-10%)onset: Dose escalation periodsreported reversible
Diarrhea

Common (1-10%)onset: First weeksreported reversible
Constipation

Common (1-10%)onset: Ongoingreported reversible
Delayed gastric emptying

Mechanism-linkedonset: Dose-dependentreported reversible
Pancreatitis (rare but serious)

Rare (<0.1%)onset: Any timereversibility not on file
Gallbladder events including cholelithiasis

Uncommononset: With rapid weight lossreversibility not on file
Injection site reactions

Common (1-10%)onset: Immediatereported reversible

Literature on file 5

human RCT
FDA approval NDA213051 graded on: an FDA approval (NDA213051), which requires adequate and well-controlled human investigations — “NDA213051”

Not graded

4 citations whose study design could not be read from the title. Left ungraded rather than guessed at.

Identity

Space-filling 3D model of Semaglutide, carbon grey, nitrogen blue, oxygen red — Built from the SMILES on this record — the atoms, bonds and stereochemistry are exact. The shape is **one computed low-energy pose**, not a measured structure: a flexible peptide in solution has no single conformation. The skeletal formula below claims connectivity and nothing more, which is what we actually know.

2D chemical structure of Semaglutide — Built from the SMILES on this record — the atoms, bonds and stereochemistry are exact. The shape is **one computed low-energy pose**, not a measured structure: a flexible peptide in solution has no single conformation. The skeletal formula below claims connectivity and nothing more, which is what we actually know.

Molecular weight: 4114
Molecular formula: C187H291N45O59
CAS number: 910463-68-2
PubChem CID: 56843331
ChEMBL: CHEMBL2108724
InChI key: DLSWIYLPEUIQAV-CCUURXOWSA-N
Sequence: HXEGTFTSDVSSYLEGQAAKEFIAWLVRGRG
SMILES: CC[C@H](C)[C@@H](C(=O)N[C@@H](C)C(=O)N[C@@H](CC1=CNC2=CC=CC=C21)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCNC(=N)N)C(=O)NCC(=O)N[C@@H](CCCNC(=N)N)C(=O)NCC(=O)O)NC(=O)[C@H](CC3=CC=CC=C3)NC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CCCCNC(=O)COCCOCCNC(=O)COCCOCCNC(=O)CC[C@H](C(=O)O)NC(=O)CCCCCCCCCCCCCCCCC(=O)O)NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(=O)N)NC(=O)CNC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC4=CC=C(C=C4)O)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(=O)O)NC(=O)[C@H](CO)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CC5=CC=CC=C5)NC(=O)[C@H]([C@@H](C)O)NC(=O)CNC(=O)[C@H](CCC(=O)O)NC(=O)C(C)(C)NC(=O)[C@H](CC6=CN=CN6)N
InChI: InChI=1S/C187H291N45O59/c1-18-105(10)154(180(282)208-108(13)159(261)216-133(86-114-89-200-119-50-40-39-49-117(114)119)170(272)218-129(82-102(4)5)171(273)228-152(103(6)7)178(280)215-121(53-44-72-199-186(192)193)162(264)201-91-141(242)209-120(52-43-71-198-185(190)191)161(263)204-94-151(257)258)230-172(274)131(83-111-45-33-31-34-46-111)219-167(269)126(64-69-149(253)254)214-166(268)122(51-41-42-70-195-144(245)98-290-79-78-289-76-74-197-145(246)99-291-80-77-288-75-73-196-139(240)66-61-127(183(285)286)211-140(241)54-37-29-27-25-23-21-19-20-22-24-26-28-30-38-55-146(247)248)212-158(260)107(12)206-157(259)106(11)207-165(267)125(60-65-138(189)239)210-142(243)92-202-163(265)123(62-67-147(249)250)213-168(270)128(81-101(2)3)217-169(271)130(85-113-56-58-116(238)59-57-113)220-175(277)135(95-233)223-177(279)137(97-235)224-179(281)153(104(8)9)229-174(276)134(88-150(255)256)221-176(278)136(96-234)225-182(284)156(110(15)237)231-173(275)132(84-112-47-35-32-36-48-112)222-181(283)155(109(14)236)227-143(244)93-203-164(266)124(63-68-148(251)252)226-184(287)187(16,17)232-160(262)118(188)87-115-90-194-100-205-115/h31-36,39-40,45-50,56-59,89-90,100-110,118,120-137,152-156,200,233-238H,18-30,37-38,41-44,51-55,60-88,91-99,188H2,1-17H3,(H2,189,239)(H,194,205)(H,195,245)(H,196,240)(H,197,246)(H,201,264)(H,202,265)(H,203,266)(H,204,263)(H,206,259)(H,207,267)(H,208,282)(H,209,242)(H,210,243)(H,211,241)(H,212,260)(H,213,270)(H,214,268)(H,215,280)(H,216,261)(H,217,271)(H,218,272)(H,219,269)(H,220,277)(H,221,278)(H,222,283)(H,223,279)(H,224,281)(H,225,284)(H,226,287)(H,227,244)(H,228,273)(H,229,276)(H,230,274)(H,231,275)(H,232,262)(H,247,248)(H,249,250)(H,251,252)(H,253,254)(H,255,256)(H,257,258)(H,285,286)(H4,190,191,198)(H4,192,193,199)/t105-,106-,107-,108-,109+,110+,118-,120-,121-,122-,123-,124-,125-,126-,127+,128-,129-,130-,131-,132-,133-,134-,135-,136-,137-,152-,153-,154-,155-,156-/m0/s1

Classified as

GLP-1 Receptor Agonismmechanism: This is the most common mechanism on the site, and each downstream effect carries its own rung rather than inheriting the receptor's. The rubric at /evidence/rubric is what keeps them separate.
Glucose Homeostasispathway: The readings a record may cite cover different windows: a fasting glucose is one moment, HbA1c reflects roughly the previous three months, a continuous monitor's average is neither. Comparing across them is a common error.
Subcutaneousroute: This is the route the reconstitution arithmetic assumes. Mass divided by diluent volume gives concentration, dose divided by concentration gives volume, and volume in mL multiplied by 100 gives units on a U-100 barrel: 5 mg in 2 mL is 2.5 mg/mL, and 0.25 mg comes out at 0.1 mL, which is 10 units.

Also called

Semaglutide

Notes unverified prose

FDA-approved; STEP trials; PMID: 33567185; STEP-HFpEF program; PMID: 41290376

Not on file 0

All 8 tracked fields hold a value on this record: molecular weight and formula, CAS number, PubChem CID, amino-acid sequence, SMILES, InChI and InChI key.

Counted from the record itself, not from what a source said it was missing. 136 of 185 records still have at least one empty.

Listed prices 2

What 2 shops we track listed for Semaglutide, read from their own public catalogues on 2026-08-12. We take no commission on these and they are not ranked by any payment — how vendors are scored.

Listed in CAD
Vendor	Size	Price	Per mg
Panda Peptide	5 mg	$44.99 CAD	$9.00/mg

Listed in USD
Vendor	Size	Price	Per mg
GenX Peptides	5 mg	$65.00 USD	$13.00/mg

Prices are the vendor's own listing, reproduced with the date we read it — never converted between currencies, and compared per milligram only where the vendor states the vial size.