What Is Semaglutide?

Written by: Clara Hanson-Smith

Reviewed by: Sunny Dhain MPharmRS PgDip IndP

Date reviewed: 27/12/2023

Semaglutide is a synthetic analogue of the human glucagon-like peptide-1 (GLP-1). It functions as a GLP-1 receptor agonist, exhibiting pharmacological properties similar to the endogenous hormone. Semaglutide has been developed for the management of type 2 diabetes mellitus (T2DM) and chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity.

Clinical evidence and guidelines:

Numerous clinical trials have demonstrated its efficacy in lowering blood sugar levels and aiding in weight loss.

Guidelines from organisations provide recommendations on its use in diabetes management and weight management.

For detailed clinical information, consulting sources such as the National Institute for Health and Care Excellence (NICE), the Medicines and Healthcare Products Regulatory Agency (MHRA), or the specific product websites for Ozempic and Wegovy would be beneficial. Remember, this medication should only be used under the guidance of a healthcare professional.

General precautions for Semaglutide (Wegovy, Ozempic, Rybelsus):

1. Pancreatitis: There is a potential risk of acute pancreatitis. Patients should be informed about the symptoms and the need to seek medical advice promptly if symptoms develop.
2. Diabetic Retinopathy: Patients with a history of diabetic retinopathy should be monitored regularly as GLP-1 receptor agonists have been associated with the risk of worsening diabetic retinopathy.
3. Gastrointestinal Adverse Effects: Common side effects include nausea, vomiting, diarrhea, and constipation. Gradual dose escalation may reduce gastrointestinal symptoms.
4. Hypoglycemia Risk: When used in combination with insulin or insulin secretagogues (like sulfonylureas), there is an increased risk of hypoglycemia. Dose adjustments of the concomitant medications may be necessary.
5. Renal Impairment: Caution is advised in patients with renal impairment, including those with end-stage renal disease.
6. Hepatic Impairment: Patients with hepatic impairment should be closely monitored, although no dose adjustment is typically required.
7. Pregnancy and Breastfeeding: Not recommended during pregnancy and breastfeeding due to insufficient data on safety and efficacy.

How semaglutide works

Semaglutide, a GLP-1 receptor agonist, works by increasing insulin release, reducing glucagon secretion, and slowing gastric emptying, which enhances blood glucose control in type 2 diabetes. Additionally, it suppresses appetite, aiding in weight management for obesity. Its cardiovascular benefits are noted, though the precise mechanisms remain under investigation.

How should I take semaglutide?

Semaglutide is administered as either a subcutaneous injection or an oral tablet, depending on the formulation. The method of administration and dosage vary based on the specific brand (Ozempic, Wegovy, or Rybelsus) and the individual’s treatment plan.

What if I miss a dose?

If you miss a dose of semaglutide, the approach to managing the missed dose can vary slightly depending on the specific medication (Ozempic, Wegovy, or Rybelsus) and the dosage schedule. Always follow the specific instructions your healthcare provider provides or in the patient information leaflet that comes with your medication. The advice on handling missed doses can vary based on individual health circumstances and the specific semaglutide product you are using. However, here are some general guidelines:

For Injectable Semaglutide (Ozempic, Wegovy):

• If less than 5 days: Take the missed dose as soon as you remember.
• If more than 5 days late: Skip the missed dose and take your next dose on the regularly scheduled day.
• Do not double dose: Avoid taking two doses at the same time to make up for a missed dose.

For oral Semaglutide (Rybelsus):

• If you remember the same day: Take the missed dose on the same day as soon as you remember. Then return to your regular dosing schedule the next day.
• If you remember the next day: Skip the missed dose and take the next dose at your regular scheduled time.
• Do not double dose: Avoid taking two doses at the same time to make up for a missed dose.

General advice:

• Regular Schedule: It’s essential to try to take semaglutide at the same time each day (or week for injectables) to maintain steady blood levels of the medication.
• Consult Healthcare Provider: If you frequently miss doses or are unsure about what to do after a missed dose, consult your healthcare provider for personalized advice.
• Monitoring: Continue monitoring your blood glucose levels regularly, as missing doses can affect your blood sugar control.

Always follow the specific instructions provided by your healthcare provider or in the patient information leaflet that comes with your medication. The advice on handling missed doses can vary based on individual health circumstances and the specific semaglutide product you are using.

What happens if I overdose?

In case of an overdose of semaglutide, it is important to seek immediate medical attention. The UK emergency services can be contacted at 999 for urgent situations or 111 for non-urgent medical advice. Symptoms of an overdose may include severe nausea, vomiting, or hypoglycemia. Immediate medical intervention is crucial.