Wegovy Pill vs Injection: Which Is Right for You?

Short answer: the Wegovy pill and the Wegovy injection contain the same medicine, semaglutide, and both are licensed in the UK for weight management. The pill is one tablet a day on an empty stomach after at least 8 hours without food, rising to 25mg; the injection is one dose a week at any time of day, with or without food, rising to 2.4mg (or 7.2mg for some adults with obesity). In their main trials, average weight loss counting everyone who started was about 14% on the 25mg tablet (OASIS 4) and about 15% on the 2.4mg injection (STEP 1), and the injection's licence also covers lowering the risk of heart attack and stroke in adults with established cardiovascular disease, which the tablet's does not.

Checked against the UK product information for both formats, October 2026. The sections below set out the differences in how you take them, the doses, the evidence, side effects and switching, so you can talk through the right format with your pharmacist.

Are the Wegovy pill and injection the same medicine?

Yes. Semaglutide is a GLP-1 receptor agonist. It acts on the parts of the brain that regulate appetite, so you feel fuller and less hungry, and it causes a minor delay in stomach emptying just after a meal. The injection delivers it once a week under the skin. The tablet delivers it once a day with an absorption enhancer, salcaprozate sodium; about 1 to 2% of the semaglutide in each tablet is absorbed, mostly in the stomach, which is why the tablet doses are so much larger. At 25mg a day, the product information reports average blood levels similar to the 2.4mg weekly injection, with more variation from person to person.

How do the doses compare?

Both start low and step up, to make stomach side effects less likely. The tablet starts at 1.5mg a day for a month, then 4mg, 9mg and the 25mg maintenance dose, with at least a month at each step. The injection starts at 0.25mg a week, then 0.5mg, 1mg and 1.7mg, four weeks each, before the 2.4mg maintenance dose; for adults with obesity, 7.2mg can follow if needed, after at least 4 weeks on 2.4mg. The tablet can stay at the previous step if needed, and an injection increase can be delayed if stomach side effects are significant. The full steps are in our Wegovy tablets dosage schedule and Wegovy injection dose schedule.

How much weight loss can you expect?

• Oral semaglutide 25mg (pill): In the OASIS 4 trial (NEJM, 2025), adults with overweight or obesity who took oral semaglutide 25mg once a day lost an average of 13.6% of their body weight over 64 weeks, compared with 2.2% on placebo, counting everyone who started treatment. About 3 in 10 lost 20% or more. Individual results vary.
• Injectable semaglutide 2.4mg: In the STEP 1 trial (NEJM, 2021), adults with obesity, or overweight with a weight-related condition, and without diabetes lost an average of 14.9% of their body weight over 68 weeks, compared with 2.4% on placebo, counting everyone who started treatment.
• Injectable semaglutide 7.2mg (higher dose): In the STEP UP trial (Lancet Diabetes and Endocrinology, 2025), adults with obesity and without diabetes lost an average of 18.7% of their body weight over 72 weeks on 7.2mg, compared with 15.6% on 2.4mg and 3.9% on placebo, counting everyone who started treatment. Among those who stayed on treatment, the averages were 20.7% and 17.5%. Individual results vary.

These figures come from separate trials in different groups of people, so they are not a direct comparison. The 7.2mg injection is the highest dose of semaglutide licensed for weight management. Our guide are Wegovy tablets as effective as the injection? looks at the trials in more detail.

How do you take the Wegovy pill compared with the injection?

The tablet has to be taken on an empty stomach, after at least 8 hours without food, so most people take it first thing in the morning. Swallow it whole with a sip of plain water (up to 120ml, about half a glass), then wait at least 30 minutes before eating, drinking anything else or taking other medicines by mouth. Food, a large drink or a shorter wait reduces how much semaglutide is absorbed. The injection has no such rule: you take it once a week at any time of day, with or without food. For some people the daily routine is easier; for others the fasting and the 30-minute wait are the deal-breaker. Step by step, see how to take the Wegovy pill.

Which one is licensed to lower heart risk?

Wegovy 2.4mg has a UK licence to reduce the risk of heart attack, stroke and cardiovascular death, for adults with established cardiovascular disease and a BMI of 27 or more, based on the SELECT trial. The tablets' UK licence covers weight management and does not include this use; their product information reports SELECT as a trial of the injection. If you have established cardiovascular disease, that may tip the balance toward the injection.

Do the pill and injection have different side effects?

Because the medicine is the same, the side effects are broadly the same: nausea, vomiting, diarrhoea, constipation and stomach pain, mostly during dose increases and mostly mild to moderate and short-lived. Both formats are titrated slowly for this reason. The tablets' product information says side effects in their main trial (OASIS 4) came at similar rates to the injection's trials, except indigestion, which fell into a higher frequency band with the tablet. Over that 64-week trial, nausea affected 46.6% of people taking the tablet (18.6% on placebo) and vomiting 30.9% (5.9% on placebo). The injection can also cause reactions where it goes in. Neither is clearly "gentler" for everyone. More on the tablet in oral semaglutide side effects.

Can you switch from the Wegovy injection to the pill?

Yes, under both licences, between the top doses. From the 2.4mg injection you can move to 25mg tablets, starting one week after your last injection, with no fresh titration; from 25mg tablets you can move to the 2.4mg injection the day after your last tablet. Because tablet absorption varies more from person to person, and the switching advice does not cover lower doses, your pharmacist decides whether and how to switch.

Wegovy pill vs injection side by side

In trials lasting 64 to 72 weeks, average weight loss counting everyone who started was about 11% with Foundayo at its highest dose, about 14% with Wegovy tablets, about 15% with Wegovy 2.4mg, about 19% with Wegovy 7.2mg and about 21% with Mounjaro 15mg. These were separate trials in different groups of people, so the figures are not a direct comparison. Individual results vary.

Who might suit the pill?

• You are needle-averse or genuinely won't self-inject long-term.
• A daily routine (like a morning tablet) fits your life better than a weekly injection.
• You can reliably go 8 hours without food beforehand and keep 30 minutes clear afterwards, before breakfast, coffee or other medicines.

Who might suit the injection?

• You want the convenience of once-a-week dosing and no daily fasting rule.
• You have established cardiovascular disease and a BMI of 27 or more: Wegovy 2.4mg has a UK licence to reduce the risk of heart attack, stroke and cardiovascular death in that group, and the tablets' licence does not include it.
• You want the option of the 7.2mg dose later, if you have obesity and need it after at least 4 weeks on 2.4mg.