Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist
“ALERT: US Boxed Warning
Risk of thyroid C-cell tumors:
In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.
Semaglutide is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with semaglutide.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
Semaglutide, Ozempic/Rybelsus is a long-acting analog of human glucagon-like peptide-1 (GLP-1) (an incretin hormone). Semaglutide works in multiple ways to lower blood glucose and hemoglobin A1C. It stimulates the beta cells of the pancreas to release insulin when blood glucose levels are high, it slows down gastric emptying, the rate at which glucose enters the blood after meals, and also helps lower hepatic glucose output by suppressing pancreatic glucagon secretion.
Indications For Use
Officially indicated for the treatment of Diabetes mellitus type 2.
Before starting Semaglutide, Ozempic/Rybelsus make sure your physician is aware of any allergies, medications you currently take, if you have a history of bariatric surgery, diabetic retinopathy, gallbladder disease, kidney disease, a history of pancreatitis, are pregnant, or breastfeeding.
Oral: Start at 3 mg once daily ≥30 minutes before the first food, beverage, or other medications of the day for 30 days, then increase to 7 mg once daily. May increase to 14 mg once daily after 30 days on the 7 mg dose if blood sugar still uncontrolled. The lower initial dose of 3mg is intended to reduce gastric side effects but is not enough to have any effect on blood sugar. A missed dosage should be skipped, and the regimen should continue at the next scheduled dose.
Subcutaneous: Inject 0.25 mg once weekly for 4 weeks, then increase to 0.5 mg once weekly for 4 weeks, then increase to 1 mg once weekly if needed to reach target blood sugar. The lower initial dose of 0.25 mg weekly is intended to reduce gastric side effects but is not enough to have any effect on blood sugar. If changing the day of administration is necessary, allow at least 48 hours between 2 doses. If a dosage is missed, then it should be administered as soon as possible if there is at least 48 hours before the next planned dosage otherwise it should be skipped. Continue with the originally scheduled dosing schedule moving forward in either scenario.
Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include increased levels of amylase (digests starch), gastrointestinal effects (diarrhea/gas/boating), increased serum lipase (digests fats), nausea, and abdominal pain.