Falsified Wegovy tablets: Trinidad and Tobago's semaglutide alert

What the Ministry of Health said

On 3 February 2026 the Ministry of Health of Trinidad and Tobago issued a medical product alert through its Chemistry, Food and Drugs Division (CFDD) after reports that a falsified version of Wegovy tablets was in circulation¹. The product, a once-daily weight-loss tablet containing semaglutide, comes in 1.5 mg, 4 mg, 9 mg and 25 mg strengths, usually in bottles of 30². The Ministry stressed that the tablet "has only been authorised for use in the United States since December 2025" and is not registered in Trinidad and Tobago². Its main worry was illegal importation: a product with no local registration can enter regional markets only through informal channels, which raises the risk that what is sold is fake¹.

The advice was direct. Anyone holding the product should stop using it, seek guidance from a health professional and report it to the CFDD¹. Any such product found locally should be treated as unauthorised and potentially unsafe². The CFDD runs an online form for reporting suspected substandard or falsified products and adverse drug reactions¹³.

The real drug: oral semaglutide for obesity

The genuine Wegovy tablet is oral semaglutide 25 mg once daily. The US Food and Drug Administration approved it in December 2025 as the first oral GLP-1 drug for obesity, for adults with obesity or overweight with at least one weight-related condition, and also to reduce the risk of major adverse cardiovascular events, based on the SELECT trial and supporting data³¹⁴. In the OASIS 4 trial, 307 adults with overweight or obesity lost 13.6 % of body weight with oral semaglutide versus 2.2 % with placebo at 64 weeks; gastrointestinal events occurred in 74.0 % versus 42.2 %⁴. A newly launched branded pill with heavy media coverage and no local supply is exactly the kind of product counterfeiters target.

A global pattern of falsified semaglutide

The Trinidad and Tobago alert fits a pattern the World Health Organization (WHO) has documented for years. In June 2024, WHO Medical Product Alert N°2/2024 reported falsified Ozempic detected in Brazil and the United Kingdom in October 2023 and in the United States in December 2023, and noted that it "was supplied in the regulated supply chain"⁵. A day later WHO said it had seen "increased reports on falsified semaglutide products in all geographical regions since 2022" and warned that some fakes may contain undeclared ingredients such as insulin⁶.

The clinical literature now shows what that means. A review of the European EudraVigilance database found 234 reports of suspected counterfeit semaglutide between 2018 and 2025; 89.3 % of the suspected reactions were serious, and hypoglycaemia was reported more often than with genuine semaglutide⁷. In Italy, a 31-year-old woman was admitted in a hypoglycaemic coma after injecting "Ozempic" bought from a website; toxicology found that "the vial contained insulin instead of semaglutide"⁸. In the Netherlands, two people without diabetes or obesity who injected semaglutide obtained without a prescription became comatose with severe hypoglycaemia, hypokalaemia and hypothermia caused by synthetic insulin, and needed up to two days of glucose infusion⁹.

What the Food and Drugs Act says

The Food and Drugs Act, Chapter 30:01, gives the CFDD its tools. Selling an adulterated drug is an offence (section 9), and so is labelling, selling or advertising a drug in a way that is false, misleading or deceptive about its character, composition or safety (section 10). Inspectors may enter premises, take samples and seize articles (section 21) and may examine customs entries of imported drugs; if sale would break the Act, the drug "shall not be admitted" (section 22). Under section 32(2), a drug may not be imported unless it conforms to the law of the country where it was made and carries a certificate in the prescribed form. Penalties under section 33 reach TT$15,000 and three years in prison on indictment¹⁰.

The background: semaglutide in Trinidad and Tobago

The alert did not come out of nowhere. In January 2025 the Ministry referred online sales of Ozempic advertised on social media to the Trinidad and Tobago Police Service; the Ministry's principal pharmacist told a Joint Select Committee that "the advertising of the Third Schedule is definitely a breach of the Food and Drug Act"¹². Days later the Ministry said there was no red tape holding up Ozempic: Novo Nordisk's local distributor had not applied for registration, although an application for a generic version had been received¹¹. Physicians can check what is registered in the Ministry's online database, but the Ministry warns that a listing "does not constitute approval, authorisation or permission to import" or sell¹⁵.

What it means for physicians

A patient who brings in semaglutide tablets bought abroad or through social media may be holding a product that is not registered here and could be falsified. The Ministry's advice to patients is to stop and report¹. For clinicians, the WHO alerts and the case reports point to one practical lesson: unexplained hypoglycaemia in a non-diabetic patient using a "weight-loss drug" should raise the possibility of a falsified product containing insulin⁶⁸⁹. Suspected cases can be reported to the CFDD¹³.