Wegovy: what it is used for, dosage and side effects

What Wegovy is and which active substance it contains

Wegovy contains the active substance semaglutide, the same substance as the product authorised in type 2 diabetes. In the European Medicines Agency data for the Maltese market it is listed with the active substance semaglutide and the route of administration: subcutaneous. It is a pre-filled pen for injection under the skin, in an ascending series of strengths.

The difference between the products is not cosmetic. The strength range and the authorised use are different, and so is the way a doctor follows the treatment. The product authorised in diabetes is described on /medicines/ozempic/, and the form of semaglutide taken by mouth is on the Maltese list under the name Rybelsus. Using one instead of another on your own initiative is not appropriate; that decision belongs to a doctor.

The strengths and the schedule for stepping them up are in the patient information leaflet in your pack. An overview of the whole group of injectable weight medicines is in the category /weight-loss-injections/, and what the numbers used to describe weight actually mean is explained in /health-guide/obesity-and-bmi/.

The list of medicines authorised in Malta is kept by the Medicines Authority. We do not repeat strengths or intervals from the leaflet on this page, because they depend on the pack you hold and on what your doctor has decided.

Who this treatment is intended for

Wegovy is authorised for weight management in adults with obesity, and in adults who are overweight and have at least one weight related condition, such as high blood pressure, disturbed blood fats, type 2 diabetes or obstructive sleep apnoea. It is used together with a reduced calorie diet and increased physical activity.

The authorised use sets a frame, and inside that frame the assessment is individual. A doctor looks at your weight history, other conditions, everything else you take and what you have already tried. Weight measured on its own does not decide the matter; the point of the assessment is to judge whether medical treatment of weight is justified in your case at all, and whether it is safe.

This is not a medicine for cosmetic weight reduction in someone of healthy weight, and it is not a short course before a specific date. Treatment is long term, and stopping it usually means that weight returns, which is something worth knowing before you start rather than after.

For children and adolescents the assessment is entirely separate and belongs with a doctor who examines the patient in person and can follow them up. Our questionnaire is not a suitable route for a first assessment of that kind.

How semaglutide works in weight management

Semaglutide binds to GLP-1 receptors, including in the areas of the brain that regulate appetite. The practical result described by most patients is that hunger is weaker, a meal satisfies sooner and the urge to eat between meals falls away.

The substance also slows the emptying of the stomach, which reinforces the feeling of fullness and at the same time explains the digestive complaints that are most common at the start of treatment. It acts on the release of insulin and glucagon as well, which is why blood sugar can change during treatment even in someone without diabetes.

The medicine does not act on the amount of fat directly. It lowers the amount eaten, and the loss of weight follows from that, together with the changes in diet and activity that go with it. That is also why the effect is greater when those changes really happen.

The action is long lasting, so the medicine is not injected every day. The full effect is not visible at the start, because treatment begins at a low strength that is raised in steps. Whether the treatment is working and whether to continue is judged by a doctor, from measurements taken over a longer period.

Dosage and use: what the doctor decides

The dose and the schedule for raising it are set by a doctor. With this group, treatment starts low and is stepped up at set intervals until the intended dose is reached, or the highest dose the patient tolerates. Going gradually is what keeps nausea and other digestive complaints manageable.

We do not quote specific strengths or intervals here. They are in the patient information leaflet in your pack and in the instruction from the doctor who is following you, and they differ between packs.

The medicine is injected under the skin, and the injection site is changed between doses. Do not share a pen with anyone else, even after changing the needle. Storage and refrigeration rules are on the pack and in the leaflet.

If you miss an injection, follow the leaflet for your own pack rather than doubling up. If a longer break has occurred, a doctor may decide to go back to a lower strength and step up again, because tolerance falls during a break. Do not stop and restart the treatment on your own.

Side effects and when to contact a doctor

The most common side effects are digestive: nausea, vomiting, diarrhoea, constipation, burping, heartburn and a feeling of bloating. They are strongest after a step up in dose and settle for most people. Smaller portions, eating slowly and avoiding very fatty or very sweet food all help.

Headache, tiredness, dizziness, hair thinning and reactions at the injection site are also described. Gallstones and inflammation of the gallbladder are recognised risks, and the risk rises with rapid weight loss, so pain in the right upper abdomen is a reason to contact a doctor.

Stop the medicine and seek medical help in the case of severe and persistent abdominal pain, especially spreading to the back and with vomiting, or signs of an allergic reaction such as swelling of the face, lips or throat and difficulty breathing. In an emergency in Malta, call 112.

Low blood sugar is not typical when the medicine is used alone, but the risk rises where it is combined with insulin or a sulfonylurea for diabetes. Information on how often each effect occurs is in the patient information leaflet for your pack.

Interactions, alcohol and when the medicine is not suitable

Slower stomach emptying can affect how medicines taken by mouth are absorbed. For most of them it makes no practical difference, but for medicines with a narrow margin of safety a doctor takes it into account. Bring a complete list of what you take, including products bought without a prescription, supplements and herbal preparations.

Where the same person also uses insulin or a sulfonylurea, a doctor usually adjusts those doses and advises measuring blood sugar more often. Oral contraceptives are worth mentioning in the assessment as well, because severe vomiting and diarrhoea can reduce how well they are absorbed.

Alcohol adds calories, loads the pancreas and makes digestive complaints worse, which are the most common problem with this treatment. It also lowers blood sugar in a delayed way, so the combination is not neutral even though the two are not directly incompatible.

This treatment is not suitable in pregnancy, when planning a pregnancy or while breastfeeding, and effective contraception during treatment is part of what a doctor discusses. A past inflammation of the pancreas, serious disease of the digestive system, gallbladder disease, an eating disorder and a family history of rare thyroid and endocrine disease all need to be raised before a prescription, not after.

Prescription status, cover and the price at the pharmacy

Wegovy is prescription only. A pharmacy does not supply it without a prescription, and the decision to prescribe belongs to a doctor after an assessment of your medical information. We do not sell medicines and we do not ship them; our service is a medical assessment and the issuing of a document.

Whether medicines used in weight management are covered by the public health service in Malta, and on what terms, is decided by the health authorities. Our service is private and is not covered by them. The price of the medicine at the pharmacy and our fee are therefore two separate items.

The price of the medicine depends on the pack and on the strength reached, and it changes over time, so we do not quote it here. A pharmacy will tell you the current amount, and a pharmacy is the only lawful source of supply. Buying this medicine outside a pharmacy carries a real risk of a falsified product; the article /blog/online-prescription-cost-malta/ explains how the fee for an assessment and the price of a medicine relate to each other.

What we can do and what the fee covers

Our model is a medical questionnaire that a doctor reviews asynchronously, from your answers and any records you attach. There is no video call, no phone call and no live chat with a doctor. A questionnaire cannot replace a physical examination, so a first prescription for this kind of treatment needs a doctor who examines you and then follows you up over time.

If a doctor has already started your treatment and this is a continuation, you can ask for an assessment at /weight-loss/ for 29,90 €. Priority handling is available for an extra 9,90 €, which is not a promise of a deadline. What a doctor looks for when renewing is described in /blog/repeat-prescription-without-a-visit/.

If the doctor issues a prescription, you receive the document by email as a PDF in the standard EU cross-border format set out in Directive 2012/52/EU; its recognition in another member state is governed by Directive 2011/24/EU. There is no code and the document is not entered in any Maltese state health record, so you go to the pharmacy with a printout or with the PDF on screen, together with photo identification. A pharmacy in Malta may dispense it; the decision rests with the pharmacist, who can refuse, for example where the medicine is not available locally. What a pharmacy checks is explained in /blog/eu-prescription-maltese-pharmacy/.

The fee covers the doctor's assessment, not the issuing of a document. If the doctor declines on medical or legal grounds, we refund the fee. If we ask you for medical records, you have at least 7 days to reply. We then send a reminder and extend the deadline on request, and where the assessment still cannot be completed we close the request and refund the fee. The assessment is carried out by Damian Wojno, a doctor registered in Poland, licence no. 3211301, MEDINOW Sp. z o.o. He is not registered with the Medical Council of Malta, which keeps the register of doctors practising here. Narcotic and psychotropic substances are excluded from cross-border prescriptions under Article 11(6) of Directive 2011/24/EU, and semaglutide is not in that group.