The Ultimate Canada Guide to Semaglutide (Wegovy): Cost, Access, Safety & Alternatives

A complete Canadian guide for semaglutide (Wegovy): how it works, cost, access, safety, risks and alternatives. Everything you need to know before you talk to a doctor.

If you’re reading this, chances are you or someone you care about is exploring semaglutide in Canada—maybe for weight loss, maybe because your doctor mentioned it. It’s a powerful tool, but it comes with complexity: approvals, costs, risks, and alternatives. This guide walks you through everything in a Canadian context, so you can make informed decisions or have better conversations with your healthcare team.

Here’s what we’ll cover:

• What semaglutide is and how it works
• How it’s approved and available (or not) in Canada
• Real costs, insurance, and how to get it
• Safety, side effects, and risks
• Alternatives (from lifestyle changes to surgery)
• Practical steps to start and manage treatment
• Common FAQs

Let’s begin with the fundamentals.

What Is Semaglutide & How It Works

Semaglutide belongs to a class of drugs called GLP-1 receptor agonists. GLP-1 is a hormone your body naturally produces after meals; it helps control blood sugar, slows gastric emptying (makes food stay in your stomach longer), and reduces appetite.

Pharmaceutical versions like Ozempic, Wegovy, and Rybelsus mimic that hormone—but in a stronger, controlled, long-acting way.

• Ozempic is generally used for type 2 diabetes (lower doses).
• Wegovy is the higher-dose version approved specifically for weight management.
• Rybelsus is an oral (tablet) form of semaglutide, but its use in weight loss is limited compared to injectables.

How it helps with weight loss:

1. Reduces appetite — you feel full sooner and eat less.
2. Slows digestion — food moves more slowly through your gut.
3. Modulates insulin and glucose regulation — helps prevent big blood sugar spikes that drive cravings.

In clinical trials, people on semaglutide for obesity often lost 15–20% of their body weight (vs placebo) over 68 weeks, depending on adherence, starting weight, and lifestyle support. The efficacy is what has made it a front-runner in medical weight management.

One nuance: the dose matters. The weight-loss dose (2.4 mg weekly, as marketed by Wegovy) is significantly higher than the diabetes dose (e.g. 0.5–1.0 mg). Not every semaglutide product is interchangeable.

Health Canada Approval & Availability in Canada

Getting the drug approved is one step; making it broadly available is another. Canada’s system is more cautious than some, especially around newer therapies for obesity.

• Health Canada has approved semaglutide 2.4 mg (Wegovy) for chronic weight management. Obesity Canada marked this as a major milestone in obesity care.
• However, some proposed indications—like for metabolic dysfunction-associated steatohepatitis (MASH)—are still under review, and safety/efficacy have not been established.
• Provinces may or may not list it on their public drug plans (e.g. PharmaCare in BC lists it as non-benefit in their weight-loss drug table). According to a 2025 BC provincial drugs table, Wegovy is among drugs listed under “non-benefit” for public coverage.
• Sometimes approval doesn’t immediately mean easy access — limitations may include doctor availability, supply constraints, prescribing criteria, or coverage rules.

Another regulatory point: Health Canada has cautioned against unauthorized compounding of semaglutide. That is, creating home-made or synthetic versions of GLP-1 drugs without authorization is not legally permitted. Pharmacists or clinics offering “cheap compounded semaglutide” may be operating in a legally gray area.

So while semaglutide (Wegovy) is approved, real access depends heavily on your province, your benefit plan, and your clinician’s willingness to prescribe.

Cost, Insurance & Private Clinics in Canada

Cost is often the biggest barrier. Here’s what the current landscape looks like:

Out-of-Pocket Costs

Without insurance, a monthly supply of Wegovy in Canada typically ranges:

• Starter doses (0.25 mg to 1.0 mg): CAD 300–350
• Maintenance doses (1.7 mg to 2.4 mg): CAD 400–500

These numbers come from Canadian pharmacy sources updating 2025 pricing. These costs can vary by province, pharmacy markup, and availability. (See “How Much Does Wegovy Cost in Canada Without Insurance?” for a pricing snapshot.)

Novo Nordisk also offers a Wegovy savings program: patients new to the program pay CAD 299 for a one-month supply, then CAD 499/month thereafter (for 28-day supply) under specific terms. But note: these offers may exclude government beneficiaries or have eligibility criteria.

Insurance & Public Coverage

• Currently, many provincial public drug programs do not cover Wegovy for weight management, considering it a lifestyle rather than a therapeutic drug.
• Private insurance plans may cover it, but coverage can be spotty. Some employers include specialty medication or obesity benefit riders; others do not. Approval often requires prior authorization, proof of medical necessity, or meeting BMI thresholds.
• As patent protections expire, generics may enter, which could lower costs significantly. There are reports that generic versions of semaglutide might drop the cost to as low as CAD 100 per month once they are approved.

Private Weight-Loss Clinics

Some private clinics bundle semaglutide prescriptions with weight management services (consults, follow-up, monitoring). Their markups may be higher but packaged with support. These clinics sometimes function like subscription models or pay-for-service models.

Safety, Side Effects & Risks

Before starting semaglutide (Wegovy or other formulations), it’s crucial to understand what can go wrong, how common side effects are, and how to manage them. This isn’t meant to scare you, but to help you have informed conversations with your doctor.

Common Side Effects (Mild to Moderate)

Most people experience gastrointestinal (GI) side effects, especially early on or when the dose is increased. The usual ones include:

• Nausea, vomiting
• Diarrhea or loose stools
• Constipation
• Abdominal discomfort, bloating
• Indigestion or heartburn

In large clinical trials, these GI side effects were more frequent in people on semaglutide than placebo. These tend to be transient and reduce over weeks.

In one two-year follow-up, about 82% of participants on semaglutide reported GI issues (versus ~54% in placebo). Over time, many patients report that side effects fade or become tolerable.

To mitigate them:

• Start with a low dose and gradually escalate
• Take your dose with small meals if tolerated
• Stay well hydrated
• Use medications (e.g. antiemetics or stool softeners) under medical supervision

Serious Risks & Warnings

While serious side effects are rare, you should be aware of the following and monitor for red flags.

Unauthorized / Compounded Semaglutide: especially risky

Health Canada has explicitly warned that unauthorized compounding of semaglutide (i.e. creating your own injectable versions or obtaining from compounding pharmacies) is not permitted.

The U.S. FDA has received multiple reports of dosing errors, overdoses, and adverse events tied to compounded semaglutide, especially when patients or providers miscalculate doses or draw from vials improperly. These risks underscore why using the approved formulation under medical supervision is safer.

Given all this, semaglutide is not risk-free. But for many individuals with obesity or metabolic disease, the benefit-to-risk ratio is favorable when closely monitored.

Alternatives & Complementary Strategies

Semaglutide is a tool—not a magic bullet. In many cases, combining it with other approaches gives the best outcomes, and sometimes alternative or additive options may be more suitable.

Lifestyle First: Diet, Exercise & Behavior

Before or alongside any medication:

• A moderate calorie deficit, guided by a dietitian
• High-protein, whole-food approach, with fibre and low glycemic index
• Regular physical activity: resistance + aerobic
• Behavioral support / cognitive therapy for long-term habits
• Sleep, stress, mental health are foundational

These components help maintain weight loss, counter plateaus, and reduce dependence on drugs.

Other Medications to Consider

When semaglutide isn’t suitable, or as adjuncts (under medical supervision):

• Liraglutide (Saxenda) — older GLP-1 used for weight loss
• Tirzepatide — a dual GIP/GLP-1 agonist, newer and showing strong weight results (but approval and access vary)
• Orlistat, phentermine, or older options — with lower efficacy, more side effects
• Off-label use of other medications in research settings

Any choice must involve physician oversight. Efficacy, side effect profiles, and cost vary.

Bariatric / Metabolic Surgery

For many patients with more severe obesity or comorbidities, surgery is still the gold standard:

• Procedures: gastric bypass, sleeve gastrectomy, adjustable gastric banding
• Pros: high and sustained weight loss, improvement in diabetes and other conditions
• Risks: surgical complications, long-term nutritional deficits
• Choosing surgery depends on BMI thresholds, medical history, and available resources

Future & Emerging Treatments

New options are on the horizon:

• Oral semaglutide or GLP-1 pills (some in trials)
• Novel weight-loss drugs (e.g. dual or triple hormone agonists)
• Personalized medicine approaches (genetic, gut microbiome)

In some regions, the increasing competition may drive costs down or increase options.

How to Get Semaglutide in Canada: Step by Step

Getting access to semaglutide (Wegovy or related GLP-1 drugs) in Canada is rarely a one-phone-call affair. You’ll need to navigate clinical, regulatory, and logistical steps. Below is a practical roadmap.

1. Talk with Your Doctor or Specialist

Start with your family doctor, endocrinologist, or obesity medicine specialist. Some tips:

• Bring your medical history, current medications, weight chart, lab results (if available).
• Explain why you believe semaglutide might be helpful (e.g., prior weight loss struggles, obesity-related conditions).
• Ask whether you meet eligibility based on BMI, comorbidities, or provincial/insurance rules.

Some doctors are cautious about prescribing GLP-1 drugs for weight loss, especially if they’re more familiar with them for diabetes. Having guideline references (such as the Canadian Adult Obesity Clinical Practice Guideline) can help.

2. Required Baseline Tests & Screening

Before prescribing, many physicians will require baseline labs and screenings to ensure safety. Common tests include:

• Complete blood count (CBC)
• Liver function tests (ALT, AST)
• Kidney function (creatinine, eGFR)
• Lipid profile, fasting glucose / HbA1c
• Thyroid function (TSH, T4)
• Pancreatic enzymes (amylase, lipase) in certain cases
• Screening for past history of pancreatitis, gallbladder disease, or thyroid cancer

In specific cases, an ophthalmology exam may be warranted (if you already have diabetic retinopathy). Monitoring gastrointestinal health is also critical, given semaglutide’s effect on gastric motility.

3. Prescription & Insurance / Benefit Approval

Once your doctor agrees, the next steps are:

• They issue a prescription for the appropriate semaglutide dose (often starting low).
• If you have private insurance or drug benefits, your clinician or pharmacist may submit a prior authorization or special authorization request to the insurer. That may require justification (e.g., previous weight loss failure, BMI threshold, comorbidities).
• If public drug plans in your province cover it (rare, but possible in some cases), you must follow that province’s application pathway.
• Some telehealth / virtual platforms (like Felix) allow you to get a GLP-1 prescription online in Canada (with a licensed clinician) and ship to your home, though coverage and eligibility are variable.
• Be cautious of clinics or services promising semaglutide without full clinical oversight — this may risk safety or legality.

4. Dosing & Titration Plan

Semaglutide dosing typically begins low and increases gradually to reduce side effects. For Wegovy (2.4 mg weekly target), a common schedule is:

This stepped approach comes from the product information and safety guidance for semaglutide use in weight management.

If you experience significant side effects, your prescriber may delay a dose increase or maintain at a lower dose for longer.

A few practical tips:

• If you miss a weekly injection (less than 5 days late), inject as soon as you remember and resume your usual schedule. If more than 5 days lapse, skip it and pick up on your next scheduled day.
• Changing the “day of week” for your injection is allowed, but allow at least 48 hours between doses.
• Always inspect your pen or vial for clarity, check expiry dates, and avoid using damaged or cloudy drug solutions.

5. Monitoring & Follow-Up

Once you’re on semaglutide, monitoring is key for safety and effectiveness. Your doctor should plan regular check-ins and tests.

Typical monitoring schedule:

• Every 3 months: weight, BMI, vital signs
• Every 3–6 months: metabolic labs (glucose, lipids, liver, kidney)
• As needed: pancreatic enzymes if symptoms warrant
• Annual or periodic: thyroid monitoring (if risk factors), ophthalmology (if retinopathy)
• Symptom checks at every visit: abdominal pain, nausea, gallbladder symptoms, GI issues

In Canada, monitoring frameworks for GLP-1s are gaining traction. For instance, clinicians are encouraged to follow safety protocols as GLP-1 use spreads, and real-world safety monitoring programs exist for Ozempic/semaglutide.

6. What to Expect Over Time

Understanding what typical progress looks like helps manage expectations.

• Early weeks: weight loss is often faster in the first 12–20 weeks, due to appetite suppression and reduced calorie intake.
• Mid-term (6–12 months): many people hit plateaus. That’s where lifestyle, nutritional adjustments, and behavioral support matter most.
• Long term: some weight regain is possible if therapy stops or lifestyle changes aren’t sustained.
• Adjustment: your clinician may adjust the dose, add adjunctive supports, or re-evaluate if semaglutide is still effective.

It’s also important to remember that GLP-1 therapy is adjunctive — it works best when combined with diet, activity, and behavioral interventions.

Conclusion

Semaglutide (especially in the form of Wegovy) has changed the conversation around medical weight management in Canada. It offers a potent tool for many who struggle with obesity. But it’s not a guarantee, nor is it the only path forward.

Here are the key takeaways:

• Though approved, access and coverage in Canada remain limited.
• Safety is manageable when monitored, but risks are real — pancreatitis, thyroid issues, GI effects, and more.
• Alternatives and supports (diet, exercise, counseling) are crucial for durability.
• Getting semaglutide often means navigating clinicians, labs, prior authorizations, and insurance criteria.

If you’re considering this path, the best move is to start a conversation with a physician familiar with obesity medicine. Ask about your eligibility, risks, and how it fits into your overall health plan.

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