Semaglutide Alternatives: Real Options When Ozempic or Wegovy Aren’t Right

Semaglutide, known by brand names like Ozempic and Wegovy, has taken center stage for type 2 diabetes and weight loss. But not everyone can take it, whether due to side effects, insurance, or supply hiccups. So, what’s out there if you’re looking for a substitute that actually works?

Several medications act like semaglutide by targeting the GLP-1 hormone. Liraglutide (Victoza, Saxenda) is a big one. Both are injected, both can lower blood sugar and support weight loss, but liraglutide is usually taken daily, while semaglutide is weekly. If you ever wished your injection routine was less hassle, daily shots might be a dealbreaker. Still, for some, the gradual effect and steadier results of liraglutide do the trick.

Dulaglutide (Trulicity) is another weekly shot sharing similar perks—lower blood sugar, decent weight loss, and a pretty friendly side effect profile. Its pen is easy to use, especially if you dislike fiddly devices. Exenatide (Bydureon) and lixisenatide (Adlyxin) round out the GLP-1 family, though their popularity has dipped because the newer drugs tend to work better for weight loss and have fewer stomach problems.

Maybe needles just aren’t your thing. DPP-4 inhibitors, like sitagliptin (Januvia) or saxagliptin (Onglyza), are oral meds aiming for similar blood sugar control—just with a weaker weight loss punch. These are a safe pick if you mainly want steady glucose numbers with fewer digestive complaints. Metformin also stays in the game: it’s inexpensive, oral, and time-tested—some even use it alongside GLP-1 drugs.

For folks focused on obesity without diabetes, phentermine-topiramate (Qsymia) or naltrexone-bupropion (Contrave) offer prescription weight loss routes. They work differently in the brain, not on gut hormones, so they sidestep the harsh GI side effects semaglutide sometimes brings. Just keep in mind, these aren’t first-choice for diabetes and have their own safety quirks.

Cost is a sore spot with any of these, especially if your insurance is picky. Generics, like metformin or even older injectables, can sometimes sidestep sticker shock. If you’re after price savings, online pharmacy shopping is one way to compare options. Stick with trusted names and always check for pharmacy accreditation to avoid sketchy sources.

What about supplements or herbal fixes? Right now, there’s no supplement that mimics semaglutide’s hormone effect. Some people talk about berberine or fiber supplements for blood sugar, but don’t expect miracles—think of those as small support boosters, not replacements.

Bottom line: if semaglutide isn’t a fit, you’re not out of luck. Real options exist in both shots and pills, and different choices may work better depending on your health goals, comfort with injections, and budget. Always run changes past your doctor—they can help pick the safest and most effective route for you.