Wegovy is both. The brand began as a once-weekly injection, and on December 22, 2025 the FDA approved Wegovy tablets under a separate application, classified as a new dosage form of the same drug.[1] The pill is semaglutide, the same molecule as the pen, swallowed once a day and stepped up to a 25 mg maintenance tablet. Whether a daily tablet or a weekly pen suits a given person better is its own argument, made in the route comparison; this page covers the tablet itself: what it is licensed for, how it is taken, what it did in its pivotal trial, and what it costs.
What the FDA approved
The tablet is sold in four strengths: 1.5, 4, 9 and 25 mg.[1] Its label carries two uses, each alongside a reduced-calorie diet and increased physical activity. One is reducing excess body weight and keeping it off long term in adults with obesity, or in adults with overweight and at least one weight-related condition. The other is lowering the risk of major cardiovascular events in adults with established cardiovascular disease and either obesity or overweight.[2]
The pen’s list is longer. The label states that the tablet’s safety has not been established in pediatric patients or in MASH, the liver indication the injection holds.[2] How the Wegovy and Ozempic labels divide the same molecule between them, tablets included, is laid out in the brand comparison.
The 90-day climb to 25 mg
The label sets a fixed ladder of 30-day steps: 1.5 mg for days 1 through 30, 4 mg for days 31 through 60, 9 mg for days 61 through 90, and 25 mg from day 91 onward. The slow start exists to reduce gastrointestinal reactions, and a prescriber may delay a step for someone who is not tolerating the current one. If the 25 mg maintenance tablet cannot be tolerated, the label points toward switching to the injection at 1.7 mg weekly.[2]
Two rules differ from the pen. No more than one tablet is taken in a day, and a missed tablet is simply skipped, with the next one taken the following day; the injection instead has a two-day window for a late dose.[2] Moving between forms is defined too: someone on the 2.4 mg injection starts 25 mg tablets one week after the last shot, and someone coming off 25 mg tablets takes the first 2.4 mg injection the next day.[2] The injectable ladder, rung by rung, is in the dose guide.
The morning routine the label requires
The tablet is taken in the morning on an empty stomach with water, up to four ounces, and no other liquid. It is swallowed whole, never split, crushed, chewed or dissolved. After it, a wait of at least 30 minutes comes before any food, any other drink, or any other oral medicine.[2] Those conditions are not etiquette; the formulation depends on them to get a peptide across the stomach wall, and the absorption experiments behind each rule are covered in the article on the two semaglutide routes.
The interaction that matters most in practice is thyroid replacement. In a drug interaction study with the semaglutide tablet, total thyroxine exposure after a levothyroxine dose rose 33% (90% CI, 1.25 to 1.42), and the label advises closer monitoring of oral drugs with a narrow therapeutic index.[2] Anyone whose other morning pill is levothyroxine has a scheduling question to settle with a prescriber, and the wider list is in the oral-medications article.
How much weight: OASIS 4 against STEP 1
The tablet’s weight indication rests on OASIS 4, which enrolled adults without diabetes at a body-mass index of 30 or higher, or 27 or higher with an obesity-related complication, and randomized them 2:1 to the 25 mg tablet or placebo, measuring weight at week 64.[3] On the label’s intention-to-treat analysis of 307 people, weight changed −13.6% on the tablet and −2.4% on placebo, a difference of −11.2 points (95% CI, −13.6 to −8.8).[2]
The pen’s reference trial is STEP 1, which gave weekly semaglutide 2.4 mg or placebo to adults with overweight or obesity for 68 weeks.[4] In the same label, its 1,961 participants changed −14.9% against −2.4%, a difference of −12.4 points (95% CI, −13.3 to −11.6).[2] The two placebo arms landed on the same figure, and the placebo-adjusted difference between the formats is a little over one point. They are separate trials of different lengths, never run against each other, and the estimand detail behind the tablet’s number is in the OASIS 4 breakdown.
Where the gap actually sits
An average of 13.6% against 14.9% suggests the tablet does slightly less for everyone. The label’s responder rows describe something else. The share losing 15% or more was 47.0% on the tablet and 47.9% on the injection, under a point apart. The share losing 20% or more was 27.9% against 30.2%.[2]
The separation is at the bottom. The share reaching 5% was 76.3% on the tablet and 83.5% on the injection, and the share reaching 10% was 59.8% against 66.1%.[2] Put the other way, roughly 24% of tablet-treated participants failed to lose 5% of their weight, against about 17% on the pen. The top of the distribution looks alike; what the tablet adds is a larger group who barely moved.
One candidate explanation sits in the same label, which records wider variability in blood semaglutide levels on the tablet than on the injection.[2] Whether that spread produces the extra non-responders has not been tested in any published analysis, and cross-trial responder rates carry the same caveat as the averages. The practical reading is narrower: a three-month check on whether the scale has moved is more informative on this formulation than an average suggests.
Side effects, and who stopped
The label states that the types and frequency of common adverse reactions on the 25 mg tablet were similar to those on the injection, where nausea ran 44% against 16% on placebo, diarrhea 30% against 16% and vomiting 24% against 6%.[2] Severe gastrointestinal reactions were reported in 2% of tablet-treated patients and none on placebo. Gallstones appeared in 2.5% on the tablet against 1% on placebo.[2] The class-wide picture is in what the trials recorded.
The stopping figures run against expectation. Permanent discontinuation for an adverse reaction was 6.9% against 5.9%, but the share who stopped the study drug for any reason was 18% on the tablet and 25.5% on placebo.[2] More people abandoned the inactive tablet than the active one. The label also carries the class’s boxed warning about thyroid C-cell tumors, and the drug is contraindicated with a personal or family history of medullary thyroid carcinoma or with MEN 2.[2]
What it costs without insurance
Novo Nordisk’s self-pay price varies by dose: $149 for a month of 1.5 mg, $199 for 4 mg, and $299 for 9 mg or 25 mg, with a month defined as one bottle of 30 tablets. The pen’s self-pay price is $349 a month for doses from 0.25 to 2.4 mg after a limited introductory offer. With commercial insurance, the savings offer brings the monthly cost to as little as $25, capped at $100 of savings a month and excluding government beneficiaries.[5]
The headline figure buys 30 days. Because the label keeps nobody on 1.5 mg past day 30, the price doubles by day 61 and stays at $299 from the third month on. A first year on schedule comes to $3,338: $149, then $199, then ten months at $299. Twelve months of the pen at its standing $349 is $4,188 before any introductory discount. One more line in the label bears on the bill: the fallback for someone who cannot tolerate 25 mg is the 1.7 mg injection, which sits at the higher price.[2][5]
Cash prescriptions can be filled through Novo’s NovoCare Pharmacy and shipped to the door.[5] Whether coverage or cash comes out cheaper depends on the plan, and that comparison is worked through in the coverage article, with the manufacturer programs and their exclusions in the savings-card guide.
What is not the Wegovy pill
Wegovy tablets are prescription-only, and the prescription can come from any licensed prescriber, in person or by telehealth. A tablet or dissolving form described as oral semaglutide by a cash-pay seller is usually a compounded preparation, not Wegovy. Compounded drugs are not FDA-approved and are not reviewed by the FDA for safety, efficacy or quality before they are dispensed, and none was in OASIS 4 or STEP 1. The products sold that way, priced on their own oral offering, are on the oral semaglutide board, and the regulatory gap is set out in the compounding article.
The 25 mg tablet is also not the 50 mg tablet sometimes cited for oral semaglutide’s weight loss, which was studied in OASIS 1 and never brought to market; that trial is covered in the OASIS 1 article.