Semaglutide

(Glucagon-Like Peptide-1)

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  • Molecular Formula: C187H291N45O59
  • Molecular Weight: 4114
  • Synonyms: Semaglutide,910463-68-2, NN9535, Ozempic, Rybelsus, NN 9535, NNC 0113-0217, NN-9535, Semaglutide [USAN:INN], Rybelsus (oral semaglutide),
  • CAS Number: 910463-68-2
  • PubChem CID: 56843331
  • GTPL9724 Ozempic (injectable semaglutide) CHEBI:167574 EX-A2424 AC-32580 NNC-0113-0217 Rybelsus;Ozempic;NN9535;OG217SC;NNC 0113-0217

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Semaglutide (Glucagon-Like Peptide-1) Overview

Semaglutide, GLP-1, short for glucagon-like peptide-1 is a short, naturally occurring peptide hormone just 30-31 amino acids in length. Its primary physiologic function is to lower blood sugar levels by naturally enhancing insulin secretion. It also plays roles in protection beta cell insulin stores by promoting insulin gene transcription and has been linked with neurotrophic effects in the brain and central nervous system.
In the GI system, GLP-1 has been shown to significantly decrease appetite by delaying gastric emptying and reducing intestinal motility. Preliminary research has shown impacts of GLP-1 in the heart, fat, muscles, bones, liver, lungs, and kidneys as well.

The primary focus of GLP-1 research has been in the realm of diabetes treatment/prevention as well as appetite suppression. Secondary research focuses on the potential cardiovascular benefits of the peptide. More recent, and thus less robust, research focuses on the ability of GLP-1 to stave off neurodegenerative disease. Though this latter area of research is newest, it is also the fast-growing area of GLP-1 study now that the peptide has been revealed to slow or prevent the accumulation of amyloid beta plaques in the setting of Alzheimer’s disease.

Semaglutide is a glucagon-like peptide-1 receptor agonist. It increases the production of insulin, a hormone that lowers the blood sugar level. It also appears to enhance growth of β cells in the pancreas, which are the sites of insulin production.

In short, it inhibits glucagon, which is a hormone that increases blood sugar. It additionally reduces food intake by lowering appetite and slows down digestion in the stomach. In this way it reduces body fat.

GLP-1 Structure

GLP-1 Structure

Source: PubChem

Sequence: HXEGTFTSDV SSYLEGQAAK EFIAWLVRGR G
Molecular Formula: C187H291N45O59
Molecular Weight: 4113.64 g/mol
PubChem CID: 56843331

CAS Number: 910463-68-2

Synonyms: GLP-1, proglucagon (72-108), glucagon-like peptide-1, Semaglutide

Semaglutide GLP-1 research

The Incretin Effect of GLP-1

Perhaps the most important effect that GLP-1 has, according to Dr. Holst, is referred to as the “incretin effect.” Incretins are a group of metabolic hormones, released by the GI tract, that cause a decrease in blood glucose (sugar) levels. GLP-1 has been shown to be one of the two most important hormones (the other being GIP) to stimulate the incretin effect in rodent models. Though GIP circulates at levels roughly 10 times higher than that of GLP-1, there is evidence that GLP-1 is the more potent of the two molecules, particularly when levels of blood glucose are quite high.

A GLP-1 receptor has been identified on the surface of pancreatic beta cells, making it clear that GLP-1 directly stimulates the exocytosis of insulin from the pancreas. When combined with sulfonylurea drugs, GLP-1 has been shown to boost insulin secretion enough to cause mild hypoglycemia in up to 40% of subjects[1]. Of course, increased insulin secretion is associated with a number of trophic effects including increased protein synthesis, reduction in the breakdown of protein, and increased uptake of amino acids by skeletal muscle.

GLP-1 and Beta Cell Protection

Research in animal models suggests that GLP-1 can stimulate the growth and proliferation of pancreatic beta cells and that it may stimulate the differentiation of new beta cells form progenitors in the pancreatic duct epithelium. Research has also shown that GLP-1 inhibits beta cell apoptosis[1]. Taken in sum, these effects tip the usual balance of beta cell growth and death toward growth, suggesting that the peptide may be useful in treating diabetes and in protecting the pancreas against insult that harms beta cells.

In one particularly compelling trial, GLP-1 was shown to inhibit the death of beta cells caused by enhanced levels of inflammatory cytokines. In fact, mouse models of type 1 diabetes have revealed that GLP-1 protects islet cells from destruction and may, in fact, be a useful means of preventing onset of the type 1 diabetes[2].

GLP-1 and Appetite

Research in mouse models suggests that administration of GLP-1, and its similar cousin GLP-1, into the brains of mice can reduce the drive to eat and inhibit food intake[3]. It appears that GLP-1 may actually enhance feelings of satiety, helping individuals to feel fuller and reducing hunger indirectly. Recent clinical studies have shown in mice that twice daily administration of GLP-1 receptor agonists cause gradual, linear weight loss. Over a long period, this weight loss is associated with significant improvement in cardiovascular risk factors and a reduction in hemoglobin A1C levels, the latter of these being a proxy marker for the severity of diabetes and the quality of blood sugar control attained via treatment[4].

Potential Cardiovascular Benefits of GLP-1

It is now know that GLP-1 receptors are distributed throughout the heart and act to improve cardiac function in certain settings by boosting heart rate and reducing left ventricular end-diastolic pressure[5]. The latter may not seem like much, but increased LV end-diastolic pressure is associated with LV hypertrophy, cardiac remodeling, and eventual heart failure.

Recent evidence has even suggested that GLP-1 could play role in decreasing the overall damaged caused by a heart attack. It appears that the peptide improves cardiac muscle glucose uptake, thereby helping struggling ischemic heart muscle cells to get the nutrition they need to continue functioning and avoid programmed cell death. The increase in glucose uptake in these cells appears to independent of insulin[6].

Large infusions of GLP-1 into dogs have been shown to improve LV performance and reduce systemic vascular resistance. The latter effect can help to reduce blood pressure and ease strain on the heart as a result[7]. This, in turn, can help to reduce the long-term consequences of high blood pressure such as LV remodeling, vascular thickening, and heart failure. According to Dr. Holst, administration of GLP-1 following cardiac injury has “constantly increased myocardial performance both in experimental animal models and in patients.”

Size of damage in heart in control mice (A), mice given standard vasopressin therapy (B), and mice give GLP-1 (C).

Size of damage in heart in control mice (A), mice given standard vasopressin therapy (B), and mice give GLP-1 (C).
Source: Diabetes Journal

GLP-1 and the Brain

There is some evidence to suggest that GLP-1 can improve learning and help to protect neurons against neurodegenerative diseases such as Alzheimer’s disease. In one study, GLP-1 was shown to enhance associative and spatial learning in mice and even to improve learning deficits in mice with specific gene defects. In rats that over-express the GLP-1 receptor in certain regions of the brain, learning and memory are both significantly better than in their normal controls[8].

Additional research in mice has shown that GLP-1 can help to protect against excitotoxic neuron damage, completely protecting rat models of neurodegeneration against glutamate-induced apoptosis. The peptide can even stimulate neurite outgrowth in cultured cells. Researchers are hopeful that additional research on GLP-1 will reveal how it might be used to halt or reverse certain neurodegenerative diseases[9].

Interestingly, GLP-1 and its analogue exendin-4 have been shown in mouse models to reduce levels of amyloid-beta in the brain as well as the beta-amyloid precursor protein found in neurons. Amyloid beta is the primary component of the plaques observed in Alzheimer’s disease, plaques which, while not necessarily known to be causative, are associated with the severity of the disease. It remains to be seen if preventing amyloid beta accumulation can protect against the effects of Alzheimer’s disease, but this research is, at the very least, a tantalizing clue as to how scientists my intervene in the progression of mild cognitive impairment to full Alzheimer’s disease[10].

GLP-1 exhibits minimal to moderate side effects, low oral and excellent subcutaneous bioavailability in mice. Per kg dosage in mice does not scale to humans.

About The Author

The above literature was researched, edited and organized by Dr. Logan, M.D. Dr. Logan holds a doctorate degree from Case Western Reserve University School of Medicine and a B.S. in molecular biology.

Scientific Journal Author

In 1986 Professor Jens Juul Holst discovered the GLP-1 hormone in connection with his work on stomach ulcer surgery. Since the discovery, Novo Nordisk have used the research to successfully develop products to treat diabetes and obesity. The hormone GLP-1 can be used to regulate blood sugar levels and satiety. Not only has it made treatment of obesity and diabetes possible, it has also proven useful preventatively through early diagnosis for citizens who are at risk of developing diabetes and obesity. In 2015, Jens Juul Holst received the prestigious international Fernström prize for his research on GLP-1. He is one of the most cited researchers in Europe, with over 1,200 published articles and citations in over 3,500 articles annually.

Professor Jens Juul Holst is being referenced as one of the leading scientists involved in the research and development of GLP-1. In no way is this doctor/scientist endorsing or advocating the purchase, sale, or use of this product for any reason. The purpose of citing the doctor is to acknowledge, recognize, and credit the exhaustive research and development efforts conducted by the scientists studying this peptide. Professor Jens Juul Holst is listed in [11] under the referenced citations.

Referenced Citations

  • [1] “The Physiology of Glucagon-like Peptide 1 | Physiological Reviews.” [Online].
  • [2] “Combined treatment with lisofylline and exendin-4 reverses autoimmune diabetes. - PubMed - NCBI.” [Online].
  • [3] “The proglucagon-derived peptide, glucagon-like peptide-2, is a neurotransmitter involved in the regulation of food intake. - PubMed - NCBI.” [Online].
  • [4] “Interim analysis of the effects of exenatide treatment on A1C, weight and cardiovascular risk factors over 82 weeks in 314 overweight patients with... - PubMed - NCBI.” [Online].
  • [5] “Cardiac function in mice lacking the glucagon-like peptide-1 receptor. - PubMed - NCBI.” [Online].
  • [6] “Glucagon-like Peptide 1 Can Directly Protect the Heart Against Ischemia/Reperfusion Injury | Diabetes.” [Online].
  • [7] “Recombinant glucagon-like peptide-1 increases myocardial glucose uptake and improves left ventricular performance in conscious dogs with pacing-ind... - PubMed - NCBI.” [Online].
  • [8] “Glucagon-like peptide-1 receptor is involved in learning and neuroprotection. - PubMed - NCBI.” [Online].
  • [9] “Protection and reversal of excitotoxic neuronal damage by glucagon-like peptide-1 and exendin-4. - PubMed - NCBI.” [Online].
  • [10] “A new Alzheimer’s disease interventive strategy: GLP-1. - PubMed - NCBI.” [Online].
  • [11] Holst JJ. From the Incretin Concept and the Discovery of GLP-1 to Today's Diabetes Therapy. Front Endocrinol (Lausanne). 2019;10:260. Published 2019 Apr 26. doi:10.3389/fendo.2019.00260 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497767/

Semaglutide History

Semaglutide was developed in 2012, by a team of researchers at Novo Nordisk as a longer-acting alternative to liraglutide as a once-weekly diabetes therapy.It was given the brand name Ozempic. Clinical trials were started on 6 January 2016, and completed on 19 May 2017.

Researchers at the University of Leeds and Novo Nordisk reported in 2017, that it can also be used for the treatment of obesity. It reduces hunger, food craving and body fat.[34] A Phase 3 Randomized Controlled Trial found that once-weekly injection of 2.4 mg of the drug resulted in an average change of −14.9% body weight at 68 weeks compared to −2.4% for the placebo.

The US FDA New Drug Application (NDA) was filed in December 2016, and in October 2017, the FDA Advisory Committee voted 16–0 in favor. Approval was announced in December 2017. It can be administered by injection or orally.Marketing authorization in the European Union was granted in February 2018.The Japanese Ministry of Health, Labour and Welfare announced approval on 23 March 2018. Health Canada issued approval on 4 January 2018.

Semaglutide was approved for medical use in Australia in August 2019 for "the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise; and as monotherapy when metformin is not tolerated or contraindicated."

In November 2021, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Wegovy, intended for the treatment of people with obesity or who are overweight in the presence of other related conditions.[40] The applicant for this medicinal product is Novo Nordisk A/S.Wegovy was approved for medical use in the European Union in January 2022.

An injectable version (Ozempic) was approved for medical use in the United States in December 2017, and in the European Union, Canada, and Japan in 2018. A version which is taken by mouth (Rybelsus) was approved for medical use in the United States in September 2019, and in the European Union in April 2020. It is the first glucagon-like peptide receptor protein treatment approved for use in the United States that does not need to be injected. It was developed by Novo Nordisk. Side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation.

In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection sold under the brand name Wegovy for long-term weight management in adults.

Semaglutide Brands

Trade Brands: Ozempic, Rybelsus, Wegovy, others

Semaglutide, sold under the brand name Ozempic among others, is an antidiabetic medication used for the treatment of type 2 diabetes and long-term weight management.

Legal status

  • AU: S4 (Prescription only) [1][3][2][4]
  • CA: Rx-only; Schedule D [5][6]
  • UK: POM (Prescription only) [7][8]
  • US: ℞-only [9][10][11]
  • EU: Rx-only [12][13][14]
  • In general: ℞ (Prescription only)

    • References

    1. ^ a b c "AusPAR: Semaglutide". Therapeutic Goods Administration (TGA). 2 December 2020. Retrieved 23 February 2022.
    2. ^ a b "Rybelsus". Therapeutic Goods Administration (TGA). 22 February 2022. Retrieved 23 February 2022.
    3. ^ a b "Summary for ARTG Entry:315107 Ozempic 1 mg semaglutide (rys) 1.34 mg/mL solution for injection pre-filled pen". Therapeutic Goods Administration (TGA). Retrieved 6 June 2021.
    4. ^ "Summary for ARTG Entry:346198 Rybelsus semaglutide 3 mg tablet blister pack". Therapeutic Goods Administration (TGA). Retrieved 23 February 2022.
    5. ^ https://pdf.hres.ca/dpd_pm/00058023.PDF[bare URL PDF]
    6. ^ https://pdf.hres.ca/dpd_pm/00055582.PDF[bare URL PDF]
    7. ^ "Ozempic 0.25 mg solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 9 April 2021. Retrieved 6 June 2021.
    8. ^ "Rybelsus - Summary of Product Characteristics (SmPC)". (emc). 25 November 2020. Retrieved 6 June 2021.
    9. ^ a b c d e "Ozempic- semaglutide injection, solution". DailyMed. Retrieved 5 June 2021.
    10. ^ a b c "Rybelsus- oral semaglutide tablet". DailyMed. Retrieved 5 June 2021.
    11. ^ a b c "Wegovy- semaglutide injection, solution". DailyMed. 4 June 2021. Retrieved 11 March 2022.
    12. ^ a b c "Ozempic EPAR". European Medicines Agency (EMA). Retrieved 26 September 2020.
    13. ^ a b "Rybelsus EPAR". European Medicines Agency (EMA). 29 January 2020. Retrieved 26 September 2020.
    14. ^ a b c "Wegovy EPAR". European Medicines Agency (EMA). 11 November 2021. Retrieved 11 March 2022.

    Semaglutide Using

    Drug information provided by: IBM Micromedex

    Brand Name

    1. Ozempic

    Descriptions


    Semaglutide injection is used to treat type 2 diabetes. It is used together with diet and exercise to help control your blood sugar. This medicine is also used to lower the risk of heart attack, stroke, or death in patients with type 2 diabetes and heart or blood vessel disease. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist.

    This medicine is also used together with diet and exercise to help lose weight and keep the weight off in patients with obesity caused by certain conditions.

    This medicine is available only with your doctor's prescription.

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of semaglutide injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of semaglutide injection in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Chloroquine
    • Hydroxychloroquine

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Depression, history of or
    • Diabetic retinopathy, history of or
    • Digestion problems or
    • Kidney disease or
    • Type 2 diabetes (for patients using Wegovy™)—Use with caution. May make these conditions worse.
    • Diabetic ketoacidosis (ketones in the blood) or
    • Type 1 diabetes—Should not be used in patients with these conditions. Insulin is needed to control these conditions.
    • Multiple endocrine neoplasia syndrome type 2 (MEN 2) or
    • Thyroid cancer, history of—Should not be used in patients with these conditions.
    • Pancreatitis (inflammation of the pancreas), history of—It is not known if this medicine will be safe in patients with this condition.

    Proper Use

    When you start using this medicine, it is very important that you check your blood sugar often, especially before and after meals and at bedtime. This will help lower the chance of having very low blood sugar.

    Carefully follow the special meal plan your doctor gave you. This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

    This medicine comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

    If you will be using semaglutide at home, your doctor will teach you how the injections will be given. Be sure you understand exactly how the medicine is to be injected.

    This medicine is given as a shot under the skin of your stomach, thighs, or upper arm. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.

    If you use this medicine with insulin, do not mix them into the same syringe. It is acceptable to inject these in the same body area, but the shots should not be right next to each other.

    Check the liquid in the pen. it should be clear and colorless. Do not use it if it is cloudy, discolored, or has particles in it.

    Use a new needle each time you inject your medicine.

    Never share medicine pens with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of infection.

    Use this medicine on the same day each week, at any time of the day, with or without meals.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For type 2 diabetes and lowering the risk of heart attack or stroke:
      • For injection dosage form (Ozempic® solution):
        • Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose as needed. However, the dose is usually not more than 2 mg once a week.
        • Children—Use and dose must be determined by your doctor.
    • For weight management:
      • For injection dosage form (Wegovy™ solution):
        • Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose every 4 weeks. However the dose is usually not more than 2.4 mg once a week.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    If you miss a dose of Ozempic®, use it as soon as possible within 5 days after your missed dose. If you miss a dose for more than 5 days, skip the missed dose and go back to your regular dosing schedule.

    If you miss a dose of Wegovy™, and the next scheduled dose is more than 2 days away, use it as soon as possible. If you miss a dose, and the next scheduled dose is less than 2 days away, skip the missed dose and go back to your regular dosing schedule. If you miss a dose of this medicine for more than 2 weeks, use it on the next scheduled dose. Ask your doctor about how to restart your treatment.

    Storage

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    Store in the refrigerator. Do not freeze.

    Store your new, unused medicine pen in its original carton in the refrigerator. Do not freeze. You may store the opened Ozempic® pen in the refrigerator or at room temperature for 56 days or the opened Wegovy™ pen in the refrigerator or at room temperature for 28 days. Throw away the pen after you use it for 56 days for Ozempic® or 28 days for Wegovy™, even if it still has medicine in it.

    Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

    Precautions

    It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

    Tell your doctor if you are pregnant or planning to become pregnant. Do not use this medicine for at least 2 months before you plan to become pregnant.

    It is very important to carefully follow any instructions from your health care team about:

    • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
    • Other medicines—Do not take other medicines during the time you are using semaglutide unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
    • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, diabetic patients may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur during pregnancy in patients with diabetes.
    • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

    In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

    This medicine may increase the risk of having thyroid tumors. Tell your doctor right away if you have a lump or swelling in your neck or throat, trouble swallowing or breathing, or if your voice gets hoarse.

    Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

    Check with your doctor right away if you have gaseous stomach pain, indigestion, recurrent fever, severe nausea or vomiting, stomach fullness, or yellow eyes or skin. These may be symptoms of gallbladder problems (eg, cholelithiasis, cholecystitis).

    This medicine may cause diabetic retinopathy. Check with your doctor if you have blurred vision or any other changes in vision.

    This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use semaglutide with other medicines, including insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.

    • Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
    • If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms including seizures or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family should also know how to use it.

    This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

    This medicine may cause acute kidney injury. Check with your doctor right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

    This medicine may increase your heart rate while you are at rest. Check with your doctor right away if you have fast or pounding heart beat.

    Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

    • Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, or unusual thirst.
    • If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

    This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, including feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Less common

    1. Belching
    2. bloated, full feeling
    3. excess air or gas in the stomach or intestines
    4. gaseous stomach pain
    5. heartburn
    6. passing gas
    7. recurrent fever
    8. stomach discomfort, fullness, or pain
    9. yellow eyes or skin

    Rare

    1. Burning feeling in the chest or stomach
    2. indigestion
    3. stomach upset
    4. tenderness in the stomach area

    Incidence not known

    1. Anxiety
    2. blurred vision
    3. chest tightness
    4. chills
    5. cold sweats
    6. confusion
    7. cool, pale skin
    8. cough
    9. darkened urine
    10. difficulty swallowing
    11. discouragement
    12. dizziness
    13. fast heartbeat
    14. feeling sad or empty
    15. headache
    16. hives, itching
    17. increased heart rate
    18. increased hunger
    19. irritability
    20. lack of appetite
    21. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    22. loss of consciousness
    23. loss of interest or pleasure
    24. nausea
    25. nightmares
    26. pains in stomach, side, or abdomen, possibly radiating to the back
    27. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    28. redness of the skin
    29. seizures
    30. shakiness
    31. skin rash
    32. slurred speech
    33. tiredness
    34. trouble breathing
    35. trouble concentrating
    36. trouble sleeping
    37. unusual tiredness or weakness
    38. vomiting

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    1. Diarrhea

    Less common

    1. Constipation
    2. hair loss

    Rare

    1. Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
    2. change in taste
    3. loss of taste

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    FAQ

    A FAQ is a list of frequently asked questions (FAQs) and answers on a particular topic.

    Taking 2.4 Mg/0.75 Ml Subcutaneous Pen Injector as example, inject this medication under the skin in the thigh, abdomen, or upper arm as directed by your doctor, usually once weekly. It may be used with or without food. The dosage is based on your medical condition and response to treatment. Your doctor will start you on a low dose first to decrease your risk of stomach/abdominal side effects, and gradually increase your dose. Follow your doctor's instructions carefully.
    Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. Do not inject in an area that is tender, bruised, red, hard, or has scars or stretch marks.
    Use this medication regularly to get the most benefit from it. To help you remember, use it on the same day and time each week. It may help to mark your calendar with a reminder. Carefully follow the meal plan and exercise program your doctor has recommended. Learn how to store and discard medical supplies safely.
    Semaglutide is used with a doctor-approved exercise, behavior change, and reduced-calorie diet program to help you lose weight. It is used by certain overweight people, such as those who are obese or have weight-related medical problems.
    Semaglutide has an average rating of 6.1 out of 10 from a total of 886 ratings on Drugs.com. 47% of reviewers reported a positive experience, while 33% reported a negative experience.
    Once-weekly semaglutide was superior to sitagliptin in improving glycaemic control and reducing body weight in patients with T2D inadequately controlled on metformin. The safety and tolerability profiles were consistent with those of semaglutide and other GLP-1 RAs.
    Patients can lose significant weight on semaglutide because it suppresses appetite. Semaglutide can be taken orally or by injection, according to Novo Nordisk, and it works by increasing the production of insulin, a hormone produced by the pancreas that helps regulate blood sugar.
    You should not use semaglutide if you are allergic to it, or if you have: multiple endocrine neoplasia type 2 (tumors in your glands); a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or. diabetic ketoacidosis (call your doctor for treatment).
    No, hair loss wasn't reported as a side effect by people taking Ozempic in clinical studies. But hair loss and hair thinning may occur in people who have diabetes and consistently high blood sugar levels. If you have questions about hair loss, talk with your doctor or pharmacist.
    The study demonstrates that long-term use of oral semaglutide with flexible dose adjustment results in durable improvements in glycemic control and further reductions in body weight and is generally well tolerated.
    “It looks like semaglutide 2.4 mg is effective and safe across a wide spectrum of patients with obesity who might be prescribed this drug, whether you are older or younger, higher BMI or lower, and regardless of race/ethnicity,” Garvey said.
    You can check it here: https://www.ncbi.nlm.nih.gov/books/NBK543967/
    medwireNews: People with obesity continue to lose weight if they remain on semaglutide 2.4 mg after an initial 20 weeks of treatment, but gradually regain it if they switch to placebo, show the STEP 4 findings. The trial participants lost an average 10.6% of their starting bodyweight during the 20-week run-in period. https://diabetes.medicinematters.com/semaglutide/obesity/step-4-long-term-treatment-needed-for-full-semaglutide-benefit/18993192
    You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control.
    The study demonstrates that long-term use of oral semaglutide with flexible dose adjustment results in durable improvements in glycemic control and further reductions in body weight and is generally well tolerated.
    Continuation of semaglutide after 20 weeks of initial therapy leads to significant continued weight loss, according to a new study, but stopping the therapy causes patients to regain much of the weight they initially lost.
    Swelling/redness/itching at the injection site, tiredness, nausea, vomiting, diarrhea, or constipation may occur. Nausea usually lessens as you continue to use semaglutide. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Other adverse reactions with a frequency of >0.4% were associated with OZEMPIC include fatigue, dysgeusia and dizziness.
    if you're not eating much, you absolutely need a good full spectrum micro nutrient sup, also water intake is huge (try to add some electrolytes). you're in a fasted state... probably and if you're not used to that energy is going to be WAY down. If you're going to a straight fast get some info from other prolonged fasting sub reddits. If you're not meaning to be fasted. Force yourself to eat a few hundred calories atleast, easily digestible foods and good protiens. Remember most weight loss should be like ~ 1 to 2 lbs a week. More than that you'll gain it right back when you stop taking sema. especially if you don't learn good habits like exercise and healthy eating.
    If you will be using semaglutide at home, your doctor will teach you how the injections will be given. Be sure you understand exactly how the medicine is to be injected. This medicine is given as a shot under the skin of your stomach, thighs, or upper arm. Use a different body area each time you give yourself a shot.
    Wegovy? (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI ≥30) or overweight (excess weight) (BMI ≥27) who also have weight-related medical problems to help them lose weight and keep the weight off.
    No, you don't have to avoid any specific foods during your Ozempic treatment. Also, the drug can be taken with or without food. However, Ozempic is used to improve blood sugar levels in adults with type 2 diabetes, and it's used along with diet and exercise.
    Semaglutide is not the trade name but the actual name of the medication. Semaglutide is current licensed for the management of the 2 diabetes under the trade name Ozempic. Semaglutide for type 2 diabetes is available as an injection and tablet.
    Semaglutide is only available on prescription. It can't be bought in pharmacies or supermarkets, and can only be prescribed to suitable patients by a licensed medical professional. There are also some online semaglutide shops, better to consult before purchasing.
    yes. It stops you feeling hungry and makes you feel full. It also improves your body's ability to regulate blood sugar levels. Semaglutide reduces feelings of hunger which means you eat less food. This helps to reduce your body weight, when combined with a healthy diet and exercise.
    Like other GLP-1 RAs, a common side-effect of semaglutide is the slowing down of stomach emptying. In addition, mild to moderate stomach upset and nausea may occur. These symptoms usually go away within a few weeks from starting semaglutide. To reduce the indigestion symptoms, eat smaller food portions throughout the day.
    The researchers found that people who lost the most weight while taking semaglutide tended to then regain the most after stopping it, although they still retained a larger reduction from baseline than participants who had lost less weight during the treatment period.
    For safety, semaglutide did not increase the risk of any adverse events, hypoglycemia and pancreatitis, but induced a higher risk of gastrointestinal disorders when compared with other therapies (RR: 1.98, 95%CI: 1.49 to 2.62, P < 0.001).
    All semaglutide doses were generally well tolerated, with no new safety concerns. The most common adverse events were dose-related gastrointestinal symptoms, primarily nausea, as seen previously with GLP-1 receptor agonists.
    Semaglutide controls appetite by inhibiting the drive to eat and increasing feelings of fullness. All of this may be particularly effective at reducing body weight, especially in a society which promotes unhealthy lifestyles and overeating – and where unhealthy high-calorie foods are everywhere.
    Semaglutide injections help patients lose 15% to 18% of body weight. Last year, the U.S. Food and Drug Administration (FDA) approved Wegovy (semaglutide) for chronic weight management in adults with obesity or who are overweight and have at least one weight-related condition (such as diabetes or hypertension).
    Most patients will start semaglutide treatment at the lower 0.25 mg dose injected once a week for 4 weeks. The 0.25 mg dose is not used as your final maintenance dose to lower your blood sugar.
    Rybelsus contains the active ingredient semaglutide. Metformin contains the active ingredient metformin. It's a generic drug, and it's also the active ingredient in the brand-name drug Glumetza.
    Ozempic is the brand name for a molecule used in the treatment of type 2 diabetes that is administered as a once weekly injection. The generic name is Semaglutide. It is not insulin.
    Other GLP-1 agonist medications similar to Ozempic include Trulicity, Victoza, Bydureon, and Adlyxin. How much does Ozempic cost? The lowest GoodRx price for the most common version of Ozempic is about $810. There are also some online semaglutide shops, you can send inquiry here for cheap semaglutide sources.
    There are some online semaglutide shops, you can make an inquiry here.
    Not suggest to do so while you make them for research, you can make an inquiry here.
    Semaglutide is an injectable glucagon-like peptide-1 (GLP-1) agonist that's administered once weekly. It was originally approved in 2017 — at a much lower dose — to help control blood sugar in type 2 diabetes under the brand name Ozempic.
    And now the bad news: the current cost of the drug For most people, the biggest downside to using semaglutide for weight loss will probably be the cost. Medicare doesn't currently cover obesity medication, and most private health insurance plans don't either.
    Ozempic (semaglutide) is used to improve blood sugar control in adults with type 2 diabetes. There are currently no generic alternatives for Ozempic. Ozempic is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices could help offset the cost.
    Maximum savings of $150 for a 1-month supply, $300 for a 2-month supply, and $450 for a 3-month supply. Month is defined as 28 days. Offer is good for up to 24 months. Eligibility and restrictions apply.
    One study found that Ozempic may be slightly better than Victoza at lowering blood sugar. This same study found that Ozempic may be more likely to cause side effects than Victoza, though. And people using Ozempic were more likely to stop treatment due to side effects than people using Victoza.
    Despite the promising research, there's one major caveat to the medication: in order to keep the weight off, patients need to continue taking it. One recent study showed that patients on semaglutide lost 10% of their body weight in 20 weeks, but regained nearly all of it after the treatment.
    Results : Among 2109 adverse events associated with Ozempic since 2018, there were 140 adverse ocular events of note, with 23 cases of diabetic retinopathy, 4 cases of macular complications, and 47 cases of blurred vision.
    People not only lost a significant amount of weight with semaglutide [Ozempic, Novo Nordisk] from a clinical perspective, but we saw the continuance of weight loss, and those that continued did not experience regain.
    Interactions between your drugs No interactions were found between semaglutide and Vitamin D3. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
    It was approved by the Food and Drug Administration (FDA) for the treatment of overweight and obesity in June 2021 (with similar medications being developed as well). Semaglutide doesn't work for everyone, but when it's successful, it can help someone shed 15% of their body weight.
    Ozempic isn't currently approved for weight loss in people without diabetes. But across most of the phase 3 trials studying it for this purpose, study results showed a 15% to 18% weight loss in adults who were overweight or obese. Treatment duration in all four phase 3 trials was 68 weeks.
    You should not use semaglutide if you are allergic to it, or if you have: multiple endocrine neoplasia type 2 (tumors in your glands); a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or. diabetic ketoacidosis (call your doctor for treatment).
    No, hair loss wasn't reported as a side effect by people taking Ozempic in clinical studies. But hair loss and hair thinning may occur in people who have diabetes and consistently high blood sugar levels. If you have questions about hair loss, talk with your doctor or pharmacist.
    Semaglutide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: nausea. vomiting. diarrhea. abdominal pain. constipation. heartburn. burping.
    When compared with the placebo, semaglutide, dapagliflozin, ipragliflozin, and canagliflozin showed a significant weight loss. Conclusion: Although semaglutide, dapaglifrozin, and canagliflozin have a large weight loss effect, it is important to pay attention to muscle loss because a decrease in FFM was observed.
    In the specific population studied for Wegovy, on average people lost 35 pounds after 68 weeks (about 16 months). Whereas in the specific population studied for Ozempic, people lost about 9 pounds with the 0.5 mg dose, and people lost about 12 pounds with the 1 mg dose
    'A Game Changer': Drug Brings Weight Loss in Patients With Obesity. In a clinical trial, participants taking semaglutide lost 15 percent of their body weight, on average.

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