Wegovy in Canada

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Wegovy is a prescription medication designed for chronic weight management in adults experiencing obesity or those who are overweight with weight-related health problems. Wegovy contains semaglutide, an active ingredient from the GLP-1 (glucagon-like peptide-1) receptor agonists drug class. GLP-1 is a hormone that helps regulate appetite and food intake. 

Wegovy works by mimicking GLP-1 through targeting areas of the brain that control hunger. It reduces appetite, increases the sensation of fullness by slowing digestion, and controls blood sugar levels. These effects help individuals reduce their food intake and lose weight over time.

Wegovy is primarily prescribed for:

• Weight loss and weight management in adults with a body mass index (BMI) of 30 or greater, which is considered obese by Health Canada ^[2] 
• Adults with a BMI of 25 to 29.9, which is considered overweight by Health Canada, with at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol ^[2] 
• Chronic weight management in conjunction with a reduced-calorie diet and increased physical activity

By helping suppress appetite and slow digestion, Wegovy supports individuals in eating fewer calories, which leads to weight loss. This makes it effective for those who struggle to control their food intake and manage their weight through diet and exercise alone.

Before you start taking Wegovy, it’s important to know if it’s right for you. Some health conditions and medications don’t mix well with Wegovy, so always check with your doctor first. You shouldn’t take Wegovy if:

• You have a personal or family history of medullary thyroid carcinoma (MTC), a rare type of thyroid cancer that produces excess of the hormone calcitonin
• You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a genetic disorder that increases the risk of developing tumors in the endocrine glands
• You are allergic to semaglutide or any of the ingredients in Wegovy
• You are pregnant or breastfeeding
• You are taking medications that interact negatively with Wegovy such as insulin or other diabetes medications

Like most medications, Wegovy can cause side effects. It’s good to know what to expect, and if something doesn’t feel right, you should reach out to your doctor.

Common side effects of Wegovy include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Abdominal pain
• Headache
• Fatigue
• Dizziness
• Abdominal distension
• Flatulence
• Gastroenteritis
• Gastroesophageal reflux disease
• Nasopharyngitis

More serious side effects include:

• Pancreatitis
• Gallbladder problems, such as gallstones
• Increased heart rate
• Kidney problems, especially in those with pre-existing kidney conditions
• Severe allergic reactions, including swelling of the face, throat, or tongue
• Hypoglycemia in patients with type 2 diabetes, particularly when Wegovy is taken with other diabetes medications, such as insulin
• Suicidal behavior and ideation, not to be given to anyone with existing suicidal thoughts

Wegovy has been associated with an increased risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), which creates an excess of the hormone calcitonin. Those with a personal or family history of MTC or those with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should avoid taking Wegovy due to this risk. Additionally, individuals should be aware of the potential for serious side effects, such as pancreatitis or hypoglycemia, especially when Wegovy is used in combination with other diabetes medications. Individuals should discontinue at least 2 months before a planned pregnancy because of the long half-life of Wegovy.

Wegovy also delays gastric emptying and may impact absorption of concomitantly administered oral medications.

Wegovy is administered as a subcutaneous injection as an adjunct to diet and increased physical activity, on the same day each week, at any time of day, with or without meals. The injection can be given in the abdomen, thigh, or upper arm. Wegovy is typically started at a low dose and gradually increased to reduce the risk of side effects. The starting dose is 0.25mg once a week for the first 4 weeks. After 4 weeks, the dose is increased to 0.5mg, then gradually increased every 4 weeks over the course of 16 weeks. The maximum recommended dose is 2.4mg once weekly, reached after 16 weeks of dose escalation.

Wegovy has a half-life of approximately 1 week, which means it stays active in the body throughout the week, making once-weekly dosing effective. It takes about 4-5 weeks for the medication to reach steady-state levels in the body, meaning its effects become consistent after this period of regular use.

Wegovy helps with weight loss by mimicking the hormone GLP-1, which targets areas of the brain that regulate appetite and food intake. It works by slowing down how quickly your stomach empties and signaling to your brain that you’re full, reducing overall hunger and cravings. This leads to consuming fewer calories, which can result in weight loss over time. 

When taken regularly, Wegovy can lead to significant weight loss and improved overall health. Clinical studies have shown that those who used Wegovy, in combination with a healthy diet and increased physical activity, lost an average of 15% of their body weight over 68 weeks. Regular use is critical for maintaining these results. Even after individuals reach their weight loss goals, continuing Wegovy as prescribed helps to maintain weight loss and prevent weight regain ^[1].

Results with Wegovy can vary, but many people begin to notice weight loss within the first few weeks of treatment. Significant weight reduction is typically observed after several months of consistent use, especially when combined with a healthy diet and regular exercise. 

There are no specific foods or beverages you must avoid while taking Wegovy, but it’s important to focus on maintaining a balanced diet. Some people may experience nausea or digestive discomfort when starting Wegovy, so it’s best to avoid heavy, greasy, or fried foods, which could aggravate these symptoms. It’s also a good idea to limit alcohol, as it can affect blood sugar levels and appetite, potentially interfering with your weight loss progress.

Wegovy promotes weight loss in three main ways:

•  Appetite suppression: By acting on areas of the brain responsible for hunger, Wegovy helps reduce food cravings and increases the sensation of fullness
• Delayed gastric emptying: Wegovy slows the rate at which food leaves the stomach, making people feel full for longer periods
• Blood sugar regulation: While primarily aimed at weight loss, Wegovy also helps regulate blood sugar levels, which can further support weight management ^[1]

The dosing schedule for Wegovy follows a gradual increase over 16 weeks to help the body adjust to the medication:

• Weeks 1-4: 0.25 mg, once weekly
• Weeks 5-8: 0.5 mg, once weekly
• Weeks 9-12: 1 mg, once weekly
• Weeks 13-16: 1.7 mg, once weekly
• Week 17 and beyond: 2.4 mg (a maintenance dose), once weekly

Many people begin to see some weight loss within the first few weeks of using Wegovy. Clinical trials have shown that:

• By 12 weeks, most people experience an average weight loss of 5-6% of their starting body weight
• After 20 weeks, weight loss typically increases to about 8-10%
• The full effects of Wegovy can be seen after approximately 68 weeks of treatment, with an average weight loss of 15% of the starting body weight ^[1]

Yes, like all medications, Wegovy has an expiration date. Before the first use, Wegovy should be stored in the refrigerator until the expiration date listed on the packaging. If needed, prior to cap removal, the pen can be kept from 8°C to 30°C (46°F to 86°F) up to 28 days. It’s important to monitor the expiration date and properly store the medication to ensure its effectiveness.

• Contrave (naltrexone/bupropion), which affects areas of the brain involved in appetite regulation and reward
• Qsymia (phentermine/topiramate), a combination of two medications that work together to promote weight loss
• Xenical (orlistat), which blocks fat absorption in the digestive system 
• Ozempic (semaglutide), which helps lower blood sugar production

Wegovy shouldn’t be used alongside other weight loss medications unless specifically advised by your healthcare provider. Combining weight loss treatments can increase the risk of side effects and complications. 

No, Wegovy isn’t available over the counter. It’s a prescription medication, meaning it can only be obtained with a valid prescription from a licensed healthcare provider. If you’re interested in taking Wegovy, you’ll need to schedule a consultation with your doctor or a healthcare provider who can assess whether the medication is suitable for you.

In Canada, Wegovy can be prescribed by licensed medical doctors, including general practitioners, endocrinologists, and other specialists involved in obesity management. To purchase Wegovy in Canada or through online pharmacies, you must have a valid prescription. Virtual care platforms like Maple are available to help connect people with licensed Canadian healthcare providers who can evaluate eligibility and prescribe Wegovy if appropriate.

In Canada, Wegovy can be prescribed by licensed healthcare professionals, including general practitioners, endocrinologists, and other specialists who manage obesity care.

If you’re interested in Wegovy, talk to a doctor or nurse practitioner on Maple today. If they determine an online prescription for Wegovy is right for you, you can get a prescription at their discretion and have it sent to your local pharmacy or delivered to your home. We connect you with our network of doctors and nurse practitioners in minutes online, any time, 24/7, for medical advice, diagnosis and treatment. 

Sources:
[1] https://journals.sagepub.com/doi/full/10.1136/jim-2021-001952

[2] https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/healthy-weights/canadian-guidelines-body-weight-classification-adults/questions-answers-public.html