Drugs similar to semaglutide: the UK medicines that work the same way

Step 1: understanding what puts these drugs in the same family

GLP-1 (glucagon-like peptide-1) is a hormone released from your gut after eating. It signals fullness to the brain, slows the rate at which the stomach empties, and helps regulate blood sugar. Medicines that mimic or amplify this signal are called GLP-1 receptor agonists, semaglutide is the best-known example for weight management, sold under the brand name Wegovy in the UK.

The NHS medicines page on semaglutide explains the mechanism clearly: it binds to GLP-1 receptors in the brain and digestive system, reducing hunger and helping people eat less at each meal. Most drugs described as "similar to semaglutide" work through the same receptor, and if you want to understand exactly which medicines fall into that category, our page covering what is considered semaglutide similar sets out the full picture. That shared pathway means they tend to produce a broadly similar side-effect profile (predominantly gastrointestinal) and require similar lifestyle changes alongside treatment.

Knowing this matters when you're comparing options, because the differences between these medicines are not about the receptor they target but about how many receptors they target, how they're taken, how quickly they act, and how much average weight loss the trial evidence shows.

Step 2: the two licensed UK medicines for weight management side by side

For weight management in UK adults, two injectable medicines currently hold a licence: semaglutide (Wegovy) and tirzepatide (Mounjaro). Semaglutide activates the GLP-1 receptor; tirzepatide activates both GLP-1 and GIP receptors simultaneously, making it the only dual agonist in this class available in the UK.

In clinical trials, both produced meaningful weight reduction. Wegovy at its 2.4 mg weekly maintenance dose showed around 15% average body-weight reduction over 68 weeks in the STEP 1 trial. The SURMOUNT-5 head-to-head trial, published in the New England Journal of Medicine in 2025, found tirzepatide produced greater average weight loss than semaglutide 2.4 mg over 72 weeks in adults with obesity and no diabetes. That gap narrows somewhat with the newer Wegovy 7.2 mg dose, which the MHRA approved in 2026 and which reported around 20.7% average loss over 72 weeks in trials.

For a fuller look at how semaglutide works as a standalone treatment, that page goes into more detail on the mechanism and schedule. The headline point here: tirzepatide and semaglutide are similar but not the same, and the clinical evidence does distinguish them. Which performs better for a specific individual depends on factors a prescriber is best placed to assess.

Step 3: medicines that contain semaglutide but are not licensed for weight loss

This is where confusion is most common. Ozempic and Rybelsus both contain semaglutide (the same active ingredient as Wegovy) but neither holds a UK licence for weight management. Ozempic is a weekly injection licensed for type 2 diabetes. Rybelsus is an oral tablet (3 mg, 7 mg, 14 mg) also licensed for type 2 diabetes. The MHRA is clear: these products are not assessed or authorised for weight loss, and prescribing them off-label in this context falls outside the licensed indications.

For readers who specifically want to understand how Ozempic compares to Wegovy, the key distinction is not the molecule but the licence, the dose range, and the clinical pathway. The question of whether they're interchangeable is one for a prescriber with full knowledge of your medical history.

Separately, in June 2026 the MHRA approved Wegovy tablets (oral semaglutide co-formulated for weight management) making it the first oral GLP-1 medicine licensed for weight loss in the UK. Its dosing schedule (1.5 mg up to 25 mg daily) differs entirely from Rybelsus, and it's taken first thing in the morning on an empty stomach before the day's first drink. If cost is part of your thinking, the Wegovy pricing context page sets out what different formats and providers typically charge.

Step 4: older weight-loss medicines and how this class differs from them

Before GLP-1 medicines arrived, the main licensed weight-management options in the UK included orlistat (a lipase inhibitor that blocks fat absorption) and, in specialist settings, older injections now largely superseded. These medicines work through entirely different mechanisms and have a different evidence base. They are not "similar" to semaglutide in any pharmacological sense, though they share the general aim of supporting weight reduction alongside diet and activity changes.

The reason the GLP-1 class attracts so much attention is the scale of weight loss seen in trials (numbers that older medicines rarely matched) and the growing evidence base around cardiovascular and metabolic outcomes. NICE's appraisals of both tirzepatide (TA1026) and semaglutide reflect that evidence in their recommendations. Understanding what sets this drug class apart from its predecessors is useful context when you're researching your options.

If you'd like to explore other medicines often described as working like semaglutide, that page covers the wider class in more depth. And if you're ready to discuss which licensed UK option might be right for your situation, our prescribers at nume review consultations the same working day.

Speak to our prescribers through a free consultation, no waiting list, no referral needed, and every assessment is carried out by a GPhC-registered Independent Prescriber.