Ozempic vs Wegovy

Key differences

Ozempic and Wegovy are one molecule under two FDA labels, which set different uses, doses, devices and side effect rates.¹²

Approved uses: diabetes or weight

Ozempic's label covers adults with type 2 diabetes only. It lists three uses: lowering blood sugar with diet and exercise, cutting the risk of major cardiovascular events in those with established heart disease, and cutting kidney risks in those with chronic kidney disease.¹ Weight loss is not an approved use.¹

Wegovy's label pairs every use with a reduced-calorie diet and more physical activity. For long-term weight reduction it is approved in adults with obesity, adults with overweight plus at least one weight-related condition, and, as an injection only, children 12 and older with obesity.² It is not approved to treat type 2 diabetes.²

Each label also has a heart indication, for a different group. Ozempic's rests on SUSTAIN 6, a trial of 3,297 adults with type 2 diabetes and high cardiovascular risk. Heart attack, stroke or cardiovascular death occurred in 6.6% on Ozempic and 8.9% on placebo.¹ Wegovy's rests on SELECT, which followed 17,604 adults with established cardiovascular disease (a prior heart attack, stroke or peripheral artery disease) and a BMI of 27 or more, none with diabetes. Those events occurred in 6.5% on Wegovy and 8% on placebo.² FDA approved this use on March 8, 2024, and called Wegovy the first weight loss medicine also approved to lower that risk.¹⁰

The kidney and liver uses each sit on one label only. Lowering kidney risks in type 2 diabetes with chronic kidney disease is an Ozempic use, based on the FLOW trial of 3,533 adults.¹ Treating noncirrhotic MASH, a fatty liver disease, in adults with moderate to advanced liver scarring (F2 to F3 fibrosis) is a Wegovy injection use under accelerated approval.²

Dose: same start, different ceiling

Both injections start at 0.25 mg once a week for 4 weeks. Both labels say the slow climb lowers the risk of stomach and bowel side effects.¹² After that the schedules split. Ozempic settles at 0.5 mg, 1 mg or 2 mg, and 2 mg is the maximum.¹ Wegovy keeps stepping up every 4 weeks to a maintenance dose of 1.7 mg or 2.4 mg. For weight reduction, adults who tolerate 2.4 mg for at least 4 weeks may go up to 7.2 mg (the Wegovy HD pen) if more weight loss is clinically indicated.² In every case, the prescriber sets the dose.

STEP 2 tested the two doses side by side. It enrolled 1,210 adults with type 2 diabetes and overweight or obesity and gave semaglutide 1.0 mg (an Ozempic dose), 2.4 mg (the Wegovy dose) or placebo for 68 weeks.⁷⁸ Observed mean weight loss was 7.2% on 1.0 mg, 9.9% on 2.4 mg and 3.3% on placebo.⁸

Missed doses follow different rules. A missed Ozempic dose can be taken within 5 days.¹ A missed Wegovy injection is taken only if the next one is more than 2 days away. After 2 or more missed weeks in a row, the Wegovy label says to restart the dose climb at a lower step.²

Devices, tablets and storage

The standard Ozempic pen is multi-dose. Each 3 mL pen holds four weekly maintenance doses, needs a flow check before its first injection and is thrown away 56 days after first use.¹ Most Wegovy pens are single-dose: the dose is preset and the needle stays hidden. The exception is the FlexTouch pen, which holds four 2.4 mg doses.² Before the cap comes off, a Wegovy single-dose pen can be kept at 46 to 86°F for up to 28 days if needed.²

Both names now include a daily tablet. Ozempic tablets of 1.5, 4 and 9 mg are for type 2 diabetes and sit on the same FDA application as Rybelsus.⁶⁹ Wegovy tablets of 1.5, 4, 9 and 25 mg were approved on December 22, 2025, for weight reduction and heart risk in adults only.⁵² Both are taken each morning on an empty stomach with up to 4 ounces of plain water, then at least 30 minutes pass before any food, drink or other oral medicine.⁹²

Side effects at each dose

The labels list the same kinds of side effects, mostly in the stomach and gut, at different rates. In Ozempic's diabetes trials, nausea affected 15.8% on 0.5 mg and 20.3% on 1 mg, against 6.1% on placebo.¹ In Wegovy's adult weight trials at 2.4 mg, nausea affected 44% against 16% on placebo, and diarrhea 30% against 16%.² The trials used different doses and patients, so the gap reflects both.

Hair loss is recorded differently. The Wegovy label reports it in 3.3% on 2.4 mg against 1% on placebo, more often in women, and links it to weight reduction.² The Ozempic label lists hair loss among reports received after approval, with no known rate.¹

What they share

The molecule acts the same way in both. Semaglutide raises insulin and lowers glucagon only when blood sugar is high, slows stomach emptying and has a half-life of about one week.¹ Both injections go under the skin of the abdomen, thigh or upper arm on the same day each week, at a new spot each time.¹²

Both labels carry a boxed warning for thyroid C-cell tumors, which semaglutide caused in rodents; whether it does so in people is unknown.¹² Neither is used by people with a personal or family history of medullary thyroid carcinoma or with MEN 2.¹² Both say to stop at least 2 months before a planned pregnancy.¹² The Wegovy label does not recommend using it with other semaglutide products, Ozempic included, or with any other GLP-1 receptor agonist.² Every marketed product under both names is prescription only.³⁴⁵⁶

Which page to read next

For each medicine's full label facts, read the Ozempic profile and the Wegovy profile. Step-by-step schedules are in Ozempic dosage and Wegovy dosage, and trial side effect tables in Ozempic side effects and Wegovy side effects. The molecule itself is covered in the semaglutide profile. Related pairs include semaglutide vs Wegovy and Mounjaro vs Wegovy, and the GLP-1 comparisons page lists the rest.