metaboliqHow semaglutide works
Semaglutide copies GLP-1, a hormone the gut releases after a meal, and lasts about a week in the body. It slows how fast the stomach empties, increases fullness, quietens appetite and helps the pancreas release insulin when blood sugar rises.
Sources: [1]
Weekly pens and the daily tablet
The weekly pens are Ozempic, approved for type 2 diabetes, and Wegovy at 2.4 mg, the strength approved in India for chronic weight management. Emcure's Poviztra is a licensed version of Wegovy.
Rybelsus is semaglutide taken by mouth once a day. Its approved use is type 2 diabetes. It is taken on an empty stomach with a small sip of water, at least 30 minutes before food or anything else, because food stops it being absorbed.
The generic brands
The Indian patent expired in March 2026, and several companies launched their own semaglutide on 20 and 21 March. Reported prices at launch ran from about Rs 750 a week to about Rs 4,200 a month, depending on brand and strength.
The molecule is the same. What differs is the company, the pen and the strengths on offer, and each product is held to its own approved use.
What the trials found
In STEP 1, adults on 2.4 mg weekly reduced body weight by an average of 14.9% over 68 weeks, against 2.4% on placebo. In SURMOUNT-5, tirzepatide reduced body weight further than semaglutide over the same period.
Who decides, and how it is started
It is prescription-only in India, and a doctor decides whether it fits you after reading your history, your blood tests and anything else you take.
It is started at a low strength and stepped up every four weeks or so, because stepping up slowly is what keeps the stomach side effects manageable.
Sold outside an authorised pharmacy, a pen can be fake, wrongly stored or the wrong strength; the regulator has asked states to keep these products to authorised channels and their approved uses.
Sources: [13]
Why muscle matters
Body weight falls as fat and as lean tissue together. In the STEP 1 body-composition substudy, roughly 40% of the total lost was lean mass.
Muscle is what keeps blood sugar handled well, keeps you strong as you age and keeps your daily energy use up. So the plan around any treatment protects it: protein at every meal, strength training two or three times a week, and body composition measured rather than the scale alone.
Sources: [14]
What happens when it is stopped
These work while they are taken. One year after semaglutide was stopped in the STEP 1 extension, people had regained about two-thirds of what they had lost; in SURMOUNT-4, people switched from tirzepatide to placebo regained about 14% of body weight.
That is why the habits built alongside treatment, and a plan for maintenance, matter as much as the treatment itself.
Side effects
Common, and usually easing with time
- Nausea, most often in the first weeks and after each step up.
- Diarrhoea or constipation.
- Vomiting, indigestion, burping and bloating.
- Feeling full early, and less appetite.
- Tiredness, and headache.
Serious, and rare
- Pancreatitis: severe, lasting pain in the upper abdomen that may spread to the back, with or without vomiting.
- Gallbladder problems, including gallstones, which are more likely when body weight falls quickly.
- Dehydration from vomiting or diarrhoea, which can strain the kidneys.
- Low blood sugar, mainly when it is combined with insulin or a sulfonylurea.
- Allergic reactions, rare but serious.
- A history of medullary thyroid cancer or MEN 2 in you or your family is a reason it is not used.
- NAION, a sudden painless loss of vision in one eye, listed as a very rare side effect of semaglutide.
Stop and get medical help at once for severe abdominal pain, repeated vomiting, signs of an allergic reaction, or sudden changes in vision. Tell the doctor about pregnancy plans first: these are not used in pregnancy.