Weight loss injections: GLP-1 medicines
GLP-1 medicines are prescription only in Malta, and they differ from one another in what they are authorised for. Wegovy and Saxenda are authorised for weight management, while Ozempic is authorised for type 2 diabetes. Mounjaro acts on a second receptor as well as on the GLP-1 receptor. This page sets out the active substance behind each brand, what a doctor assesses before continuing treatment, which side effects are common and who pays for what.
What GLP-1 medicines are and how they work
GLP-1 is a hormone released by the gut after eating. These medicines imitate it: they slow the emptying of the stomach, strengthen the feeling of fullness, reduce appetite and improve the control of blood sugar. Tirzepatide, the substance in Mounjaro, acts on the GIP receptor as well as on the GLP-1 receptor.
Most of them are given as an injection under the skin, once a week for semaglutide and tirzepatide and once a day for liraglutide. Semaglutide also exists as a tablet, marketed as Rybelsus.
The effect depends on continuing the treatment and on what happens alongside it, meaning eating and physical activity. The dose is raised in steps at the beginning, which is how the commonest side effects are kept manageable, and the steps are set by the doctor.
These are not appetite suppressants sold over the counter, and they are not interchangeable with one another. Each brand has its own authorised indication, its own dosing and its own injection device.
Which medicine is authorised for which purpose
Wegovy contains semaglutide and is authorised for weight management. Saxenda contains liraglutide and is authorised for weight management as well. Mounjaro contains tirzepatide. There is more on /medicines/wegovy/, /medicines/saxenda/ and /medicines/mounjaro/.
Ozempic contains the same active substance as Wegovy, semaglutide, but it is authorised for type 2 diabetes and not for weight loss. What differs is the authorised indication and the strengths available, not the molecule. See /medicines/ozempic/ and /diabetes-and-blood-sugar/.
Victoza, Trulicity and Rybelsus are GLP-1 medicines used in type 2 diabetes. Naming a brand does not mean it suits you: the choice belongs to a doctor who knows your history, your weight, your other conditions and your other medicines.
Whether a brand is on the market in Malta at a given moment is a separate question from whether it is authorised in the European Union. The Medicines Authority publishes which medicines are authorised and marketed here, and a pharmacy may not have a particular presentation in stock.
What the doctor assesses before continuing treatment
For a repeat the doctor needs to know which medicine you take, at which strength, on which schedule, who started it and when, and which dose step you have reached. Weight and height at the start and now matter too, because the reason for continuing is read from the course of the treatment rather than from a single figure.
Your history matters: thyroid disease and a family history of medullary thyroid carcinoma, previous pancreatitis, gallstones, severe disease of the stomach or bowel, diabetic retinopathy, kidney or liver disease, pregnancy, breastfeeding and plans for pregnancy. Some of those are reasons not to continue at all.
Other medicines count as well, above all insulin and sulfonylureas, because combining them changes the risk of low blood sugar. Slower emptying of the stomach can also change how other tablets are absorbed, which is why the whole list is asked for.
A first GLP-1 prescription is not a repeat. Starting this treatment needs an examination, measurements and a conversation about goals, and it cannot be done from a questionnaire. There is more about the numbers themselves on /health-guide/obesity-and-bmi/.
Side effects and what to report
The commonest side effects come from the digestive system: nausea, vomiting, diarrhoea, constipation, abdominal pain, reflux and loss of appetite. They are usually strongest after a dose increase and ease as the body adjusts.
Vomiting or diarrhoea that goes on can lead to dehydration, which matters more when you also take medicines that act on the kidneys. Drinking enough and telling a doctor early is the sensible response, not pushing through it.
Severe and persistent abdominal pain, particularly pain reaching through to the back and accompanied by vomiting, needs urgent medical attention. Sudden pain high on the right side of the abdomen, yellowing of the skin or the eyes, or a general state that is worsening quickly are also reasons to seek care without delay.
The full list of side effects, including the rare ones, is in the leaflet in the box and in the product information published by the European Medicines Agency. Do not change the dose on your own because of a side effect: report it, so that the plan can be changed on purpose.
What the treatment costs and who pays
Two costs are separate here. The medicine is paid for at the pharmacy, at the price that pharmacy charges, and the price depends on the brand, the strength and the pack. We do not sell medicines and we cannot know what a particular pharmacy will charge, so a pharmacy is the right place to ask.
Our fee is for the doctor's review. For weight loss medicines the route is /weight-loss/ and the review costs 29,90 €; priority handling is an extra 9,90 €, which means a place in the queue and not a promised date.
Whether a medicine is provided by the public system in Malta is settled under the Government Formulary List and through the Pharmacy of Your Choice scheme, known as POYC. That decision is not ours. Our service is not covered by the public system, and a medicine dispensed against our document is paid for privately.
There is more about what the fee covers, and about what it does not cover, on /blog/online-prescription-cost-malta/.
What happens when treatment stops
Appetite and the feeling of fullness return to roughly what they were before, and regaining weight after stopping is common. That is the nature of the treatment rather than a personal failure, and it is worth knowing before starting.
Treatment is therefore planned as a long-term arrangement. How long to continue, whether to change the dose and what to do about eating and activity are decided by the doctor together with the patient, and reviewed as the treatment goes on.
A pause is sometimes necessary: before certain procedures, during illness with vomiting, when pregnancy is planned or confirmed, or when side effects do not settle. A pause is a medical decision and not something to arrange alone.
Stopping and restarting is not the same as continuing. After a longer break the dose is usually built up again from a lower step, and the doctor decides how that is done.
Which medicines we never issue by this route
Cross-border prescribing has limits set by European Union law. Article 11(6) of Directive 2011/24/EU excludes medicines containing narcotic and psychotropic substances from the recognition of prescriptions issued in another Member State.
We therefore never issue opioid painkillers, benzodiazepines, Z-drug sleeping tablets, stimulants, gabapentinoids or cannabis for medical use. That also rules out older appetite suppressants belonging to the stimulant group.
We write prescriptions only for medicines authorised as medicinal products. A product bought outside a pharmacy, without an authorisation and without product information, is outside what any doctor can assess and outside what a pharmacy can dispense.
We do not sell medicines and we do not send them by post. You collect the medicine at a pharmacy using the document that reaches you by email and that you print.
What we offer and what we do not offer
We offer a medical questionnaire and a doctor's review of treatment that is already under way. The route for GLP-1 medicines is /weight-loss/ at 29,90 €, and for other long-term treatment it is /repeat-prescription/ at 24,90 €.
The document is a cross-border prescription in the format set out in the Annex to Directive 2012/52/EU, issued by lek. Damian Wojno, registered with the Polish Medical Chamber, licence no. 3211301. He is not registered with the Medical Council of Malta and does not take over the role of your family doctor. The document is not written into any Maltese state record and is not visible in myHealth.
We do not offer video calls, telephone consultations or live chat. We do not start GLP-1 treatment from a questionnaire, we do not issue medical certificates and we do not handle mental health problems.
The fee covers the doctor's review, not the issuing of a document and not the price of the medicine. If the doctor decides on medical or legal grounds that a prescription is not justified, we refund the fee, and the same applies when the assessment cannot be completed. Dispensing at the pharmacy is decided by the pharmacist, who may refuse.
Which GLP-1 medicine is authorised for weight loss?
Wegovy, which contains semaglutide, and Saxenda, which contains liraglutide, are authorised for weight management. Mounjaro contains tirzepatide. Ozempic contains the same active substance as Wegovy but is authorised for type 2 diabetes rather than for weight loss, and Victoza, Trulicity and Rybelsus are likewise used in diabetes. Which one is appropriate is a decision for a doctor who knows your history.
How much does a month of treatment cost?
We cannot give that figure. The medicine is paid for at the pharmacy and the price depends on the brand, the strength and the pack size, so a pharmacy is the right place to ask. What we can state is our own fee: the doctor's review for weight loss medicines costs 29,90 €, with priority handling for an extra 9,90 €. The fee covers the review, never the medicine.
Is it available through POYC?
That is not ours to decide. Whether a medicine is provided by the public system in Malta is settled under the Government Formulary List and through the Pharmacy of Your Choice scheme, and the Ministry for Health is the right address for questions about entitlement. Our service is not covered by the public system, and a medicine dispensed against our document is paid for privately.
Which side effects are common?
Mostly digestive ones: nausea, vomiting, diarrhoea, constipation, abdominal pain, reflux and loss of appetite, usually strongest after a dose increase. Dehydration can follow prolonged vomiting or diarrhoea. Severe persistent abdominal pain reaching through to the back needs urgent medical attention. The full list, including the rare effects, is in the leaflet in the box and in the product information published by the European Medicines Agency.
What happens when treatment stops?
Appetite and the feeling of fullness return to roughly what they were before, and regaining weight is common. The treatment is therefore planned as a long-term arrangement, with the doctor and the patient deciding together how long to continue. A pause is sometimes needed, for instance in illness with vomiting or when pregnancy is planned, and after a longer break the dose is usually built up again from a lower step.
Can a first GLP-1 prescription be issued this way?
No. Starting this treatment needs an examination, measurements and a conversation about goals, none of which can be done from a questionnaire. This route is for continuing treatment that another doctor has already started, where the dose is known and tolerated and the details are complete. For a first prescription the right route is a doctor in Malta.
Will a pharmacy dispense it?
That cannot be promised. Dispensing is a professional decision taken by the pharmacist, who checks identity and the completeness of the document and who may refuse where something is doubtful. It also depends on whether the presentation is on the market in Malta and in stock. The Medicines Authority publishes which medicines are authorised and marketed here.
What does the fee cover?
The doctor's review of your questionnaire, not the issuing of a document and not the price of the medicine at the pharmacy. For weight loss medicines the review costs 29,90 €, with priority handling for an extra 9,90 €. If the doctor decides on medical or legal grounds that a prescription is not justified, we refund the fee, and the same applies when the assessment cannot be completed.