Five semaglutide products share the US market with different doses and approved uses

As of September 2026, five products containing semaglutide have US prescribing information: Ozempic injection, Ozempic tablets, Rybelsus tablets, Wegovy injection and Wegovy tablets ^[1][2][3]. All five deliver one molecule, but the labels set out different strengths, different schedules and different groups of patients.

The labels also move on separate tracks. The combined Rybelsus and Ozempic tablet label was last revised January 30, 2026, the Ozempic injection label June 1, 2026, and the Wegovy label covering both its injection and its tablets June 18, 2026 ^[1][2][3].

Ozempic injection is sold in single-patient-use pens that deliver four 0.25 mg doses, or four 0.5 mg, 1 mg or 2 mg doses, and in single-dose prefilled syringes at 0.25 mg, 0.5 mg and 1 mg ^[1]. Weekly shots begin at 0.25 mg and step up at four-week intervals when more blood sugar control is needed ^[1].

The oral lines use a different scale. Rybelsus comes as 3 mg, 7 mg and 14 mg tablets; Ozempic tablets as 1.5 mg, 4 mg and 9 mg ^[2]. The label states that the two are not substitutable on a mg-to-mg basis ^[2]. Each opens with a 30-day starting dose the label describes as not effective for glycemic control, then increases at day 31 and again at day 61 if needed ^[2].

Wegovy injection is listed at 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg in single-dose pens, plus a 7.2 mg pen marked Wegovy HD and a FlexTouch pen that delivers four 2.4 mg doses ^[3]. Its usual maintenance dose is 2.4 mg weekly, after four weeks at 0.25 mg ^[3]. Wegovy tablets are made in 1.5 mg, 4 mg, 9 mg and 25 mg, with 25 mg once daily given as the maintenance dose for cardiovascular risk reduction and weight reduction in adults ^[3].

Approved uses diverge as well. Ozempic injection is cleared to improve blood sugar in adults with type 2 diabetes, to cut the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to cut the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes and chronic kidney disease ^[1]. Rybelsus and Ozempic tablets are cleared for blood sugar control and for reducing cardiovascular risk in adults with type 2 diabetes at high risk for such events ^[2]. Wegovy injection covers cardiovascular risk reduction in adults with established cardiovascular disease plus obesity or overweight, weight reduction in adults and in children aged 12 and older with obesity or in adults with overweight plus at least one weight-related condition, and noncirrhotic MASH with moderate to advanced liver fibrosis, formerly called NASH, under accelerated approval ^[3]. Wegovy tablets cover cardiovascular risk reduction and weight reduction in adults only; the tablet form is not listed for patients aged 12 and older or for MASH ^[3].

All three labels carry the same boxed warning: semaglutide causes thyroid C-cell tumors in rodents, and whether it does so in humans is unknown. All three rule out use in people with a personal or family history of medullary thyroid carcinoma or MEN 2 ^[1][2][3]. Nausea, vomiting, diarrhea, abdominal pain and constipation are listed as the most common reactions in at least 5% of patients on Ozempic injection; the oral label adds decreased appetite ^[1][2].

The tablets have their own routine. They are taken once daily on an empty stomach in the morning with no more than 4 ounces of water, swallowed whole, with at least 30 minutes before food, other drinks or other oral medicines ^[2][3]. The Wegovy label states that pairing Wegovy with another semaglutide-containing product or with any other GLP-1 receptor agonist is not recommended ^[3].

Why it matters for patients

A prescription written for "semaglutide" does not by itself say whether the patient gets a weekly injection or a daily tablet, or which tablet line, and the label warns that equal milligrams of the two oral products are not equivalent ^[2]. Pharmacy substitution across these products is not addressed in the prescribing information.

The covered conditions differ by product. A person with type 2 diabetes and chronic kidney disease and a person with obesity and established cardiovascular disease may both use semaglutide, but under different labels with different listed uses ^[1][2][3]. Pricing, insurance coverage and how often clinicians switch patients between forms have not been disclosed in these labels.

What happens next

The MASH indication for Wegovy injection was granted under accelerated approval, meaning that use may depend on a confirmatory trial; no date for one has been reported ^[3]. Because the three labels carry three different revision dates, product information for these five presentations is not being updated as one set ^[1][2][3].