What the semaglutide SPC actually tells you about Wegovy

What the MHRA approval and SPC established for Wegovy

When the MHRA authorised Wegovy in the UK, Novo Nordisk submitted a dossier of evidence (clinical trials, pharmacology data and manufacturing standards) and the SPC is the condensed regulatory output of that review. It is a public document, held on the Electronic Medicines Compendium (eMC), and it carries the MHRA's formal position on every clinically relevant aspect of the medicine.

The SPC confirmed semaglutide's mechanism: it acts on GLP-1 receptors in the brain and gut, reducing appetite and slowing gastric emptying. The STEP 1 trial, which informed the original licence, reported an average body-weight reduction of around 15% over 68 weeks at the 2.4 mg maintenance dose. The SPC built those results into its indication wording: weight management, not a cosmetic or incidental outcome, in adults who meet the BMI criteria. You can read the trial detail behind that figure in the STEP 1 paper published in the New England Journal of Medicine.

In January 2026 the MHRA approved a 7.2 mg maintenance dose, initially delivered as three 2.4 mg pens per week, and a dedicated single-dose 7.2 mg pen followed in April 2026. The SPC was updated to reflect this. Trials at the higher dose reported average weight loss of around 20.7% over 72 weeks, bringing results closer to those seen with tirzepatide. These are population averages from controlled conditions, individual outcomes vary and depend on diet, activity and adherence.

The SPC dose schedule: why it starts where it does

The licensed dose pathway begins at 0.25 mg weekly for the first four weeks. That opening period is not about weight loss, the SPC is explicit on this point. It exists to let the body adjust to semaglutide before the dose climbs, reducing the likelihood of the nausea and gastrointestinal effects that are most pronounced when the medicine is introduced. The schedule then steps up through 0.5 mg, 1.0 mg and 1.7 mg, each held for roughly four weeks, before reaching 2.4 mg as the standard maintenance dose.

A prescriber decides whether and when to progress. If a dose increase brings intolerable side effects, the SPC permits staying at the previous level longer before retrying. That clinical judgement is irreplaceable, the document describes the framework, not a fixed timetable. For a fuller look at how semaglutide works at each stage, our page on semaglutide's mechanism of action goes into the pharmacology in plain language.

The SPC also specifies what happens if a dose is missed. Rather than reproducing those instructions here (because they depend on how many days have passed) it refers patients to the leaflet inside their pen, and so do we. That leaflet contains the exact wording from the SPC, translated for patients. It arrives with every order, in plain packaging, and the DPD tracking notification will have already landed on your phone before the box does.

Contraindications, cautions and what the SPC flags as requiring prescriber review

The SPC lists conditions under which semaglutide must not be used and others where it should be used only with careful clinical assessment. The absolute contraindications include a personal or family history of medullary thyroid carcinoma and Multiple Endocrine Neoplasia syndrome type 2. It is also not indicated in pregnancy, during breastfeeding, or for anyone trying to conceive, and it is not licensed for use in under-18s.

Among the cautions, pancreatitis occupies a prominent position. The MHRA issued a Drug Safety Update in January 2026 specifically highlighting acute pancreatitis as an infrequent but potentially serious risk with GLP-1 medicines, the SPC advises stopping the medicine if pancreatitis is suspected. Severe, persistent stomach pain that reaches through to the back warrants urgent medical attention. Any suspected side effect can be reported at the MHRA's Yellow Card scheme.

The SPC also addresses oral contraceptives: there is no evidence from semaglutide's clinical programme of reduced pill absorption, unlike with tirzepatide, where a four-week precautionary overlap with a non-oral method is recommended. If you have questions about how Wegovy interacts with other medicines you take, that is a conversation for your prescriber rather than something to resolve from the SPC alone. Our Wegovy overview page covers the eligibility and clinical context in accessible detail, and our FAQs address some of the questions we hear most regularly.

SPC eligibility versus what a prescriber actually assesses

The SPC defines the licensed population, BMI 30 or above, or 27 to 29.9 alongside a qualifying condition such as hypertension, type 2 diabetes, dyslipidaemia or obstructive sleep apnoea. Lower thresholds apply for some ethnic backgrounds under UK guidance. But the SPC sets a floor, not a guarantee. A prescriber weighs up medical history, current medicines, contraindications and individual circumstances before deciding whether Wegovy is appropriate for a specific person.

NICE has also issued its own recommendation for semaglutide under technology appraisal TA875, which applies to NHS-commissioned treatment and carries conditions (including a maximum treatment duration of two years and access through a specialist weight management service) that go beyond the SPC's licence wording. Private prescribing follows the SPC's licensed criteria, assessed on a case-by-case basis.

If you are considering Wegovy and want to understand whether the SPC criteria apply to you, the right next step is a clinical consultation. Our page on how Wegovy is prescribed online explains the process, and the weight-loss treatments overview puts Wegovy alongside the other licensed options, including information on semaglutide at the 2 mg dose stage for those progressing through the schedule. When you're ready, you can speak to our prescribers through a free consultation, reviewed the same day by a GPhC-registered clinician.