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  • 67 compound profiles, every source cited
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Research profile · Peptide analogue

Semaglutide

Also known as GLP-1 receptor agonist

Clinical — evidence level 4 of 4: Established clinical evidencePrescription only — UK regulatory status: Prescription-only medicine (UK)

Overview

A long-acting synthetic analogue of glucagon-like peptide-1. A prescription-only medicine in the UK.

Category
Peptide analogue
Highest evidence level identified
Established clinical evidence
Last scientifically reviewed
22 August 2026
Last regulatory review
22 August 2026

Mechanism under investigation

Semaglutide is an analogue of human GLP-1 with three deliberate modifications: a substitution at position 8 that protects it from degradation by DPP-4, a C18 fatty diacid attached via a spacer at position 26 that binds albumin tightly, and a substitution at position 34 to direct where the fatty acid attaches. The design paper reports that these changes raise albumin affinity while preserving receptor potency, producing a half-life of around a week. GLP-1 receptor activation increases glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying and reduces appetite through receptors in the brain.

Research areas

  • Metabolic research
  • Incretin biology

These are fields in which the compound has been investigated. Listing a field is not a statement that anything was demonstrated within it.

Current evidence

In-vitro evidence

Cells, tissues or biochemical systems outside a living organism.

Well characterised. The medicinal-chemistry literature documents receptor potency, albumin binding and the structure–activity reasoning behind each modification.

Animal evidence

Studies in living non-human animals.

Extensive, across the standard diabetes and obesity models, and including the rodent thyroid C-cell tumour findings that appear as a warning in the product information for the whole class.

Human observational evidence

Studies observing people without assigning an intervention.

Very large post-licensing observational literature, including population-scale cohort studies of cardiovascular, renal and safety outcomes.

Clinical-trial evidence

Studies assigning an intervention to human participants.

Extensive and of high quality. SUSTAIN-6 reported lower rates of cardiovascular events versus placebo in type 2 diabetes with established cardiovascular risk; STEP 1, in 1,961 adults with obesity, reported a mean weight reduction of around fifteen per cent over 68 weeks. The oral formulation carries its own trial programme.

Study limitations

  • The pivotal programme is manufacturer-run; independent evidence is largely observational.
  • Weight regain after stopping treatment is documented in the STEP extension data — the trials establish an effect during treatment, not a cure.
  • Gastrointestinal adverse effects are common and dose-related, and drove a measurable share of discontinuations in every large trial.
  • A retinopathy signal in SUSTAIN-6 remains the subject of continuing study and appears in the product information.
  • Trial doses and titration schedules are specific to the licensed products; nothing in the programme speaks to unsupervised use.

UK regulatory context

Prescription-only medicine (UK)

A medicine that may lawfully be supplied in the UK only against a prescription from an appropriate practitioner.

Source: Wegovy FlexTouch solution for injection in pre-filled pen — Summary of Product Characteristics (opens medicines.org.uk in a new tab) (electronic Medicines Compendium)

Regulatory classification is jurisdiction-specific. A compound authorised elsewhere is not thereby authorised in the UK, and a supplier’s description of a substance does not determine how it is classified in law. See safety and regulation for the framework and the authoritative sources.

Safety and interpretation

Semaglutide is a UK prescription-only medicine in three licensed presentations, prescribed with staged dose escalation and follow-up. Its recognised risks — gastrointestinal intolerance, gallbladder disease, pancreatitis, the class thyroid C-cell warning, and diabetic retinopathy complications in susceptible patients — are managed within that framework. The safety dataset belongs to pharmaceutical-grade product taken under supervision, and does not read across to research-grade material. Counterfeit semaglutide is an active, documented enforcement problem in the UK, which makes provenance the first safety question for any material carrying the name.

References