Semaglutide (Wegovy, Ozempic) is a prescription medication that can help you manage type 2 diabetes and lose weight. Understanding the potential side effects of these medications will help you understand what to expect during your treatment. Semaglutide has gastrointestinal side effects and requires careful monitoring for severe reactions like hypoglycemia and potential organ damage. Dosage and administration vary by form and condition, emphasizing gradual increases and lifestyle adjustments to manage side effects effectively.
What is Semaglutide?
Semaglutide is a drug compound that mimics the biochemical behavior of human’s peptide-hormone glucagon-like peptide-1 (GLP-1). Semaglutide shares a large amount of structural identity to our native GLP-1, for these reasons, semaglutide is categorized as a GLP-1 receptor agonist. GLP-1 receptor agonists can bind to the GLP-1 receptor and stimulate the molecular and cellular responses that GLP-1 is biologically responsible for.
GLP-1 is a hormone secreted by the small intestines and interacts in pathways regulating glycemic and hunger-responses through a myriad of mechanisms. However, the hormone’s short half-life decreases its bioavailability and thus limits its clinical implications. Semaglutide’s developmental purpose is to both activate GLP-1 receptors and induce the responses for longer than our natural hormone, due to having a longer half-life.
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As a GLP-1 receptor agonist, semaglutide’s mechanism of action is the combination of processes mediated through GLP-1 receptor activation. Semaglutide’s activation of GLP-1 receptors results in blood sugar regulation through supporting multiple glycemic responses. Increased pancreatic beta-cell production, glucose-dependent insulin secretion, and glucagon inhibition all contribute to lowered blood sugar. Research has also identified GLP-1 receptor stimulation in connection to increased neural satiation-pathways; this paired with delayed gastric emptying results in reduced hunger and food-intake.
Semaglutide brand names
Semaglutide is the drug compound’s generic name, however, there has been an increase in visibility of the multiple effects that semaglutide can have and a growing popularity as a result. Semaglutide is more commonly referred to by one of its different brand names which includes Ozempic, Rybelzus, and the more recently FDA-approved title Wegovy.
Precautions/Interactions
While the use of semaglutide may feel ever-growing, not everyone can take the medication. Those pregnant and breastfeeding are advised not to use the medication as studies in those groups are not robust enough to ensure safety and efficacy. Moreover, only Wegovy has been clinically approved for patients as young as 12 years of age; provided they are diagnosed with a BMI within the 95th percentile or greater.
If you take or are prescribed other types of medications, the interactions may make semaglutide an ineffective and potentially dangerous treatment option. Compounds such as furosemide, thiazide diuretics, and ritodrine can reduce the efficacy of semaglutide. Semaglutide should not be taken while on any other GLP-1 receptor agonists or tirzepatide. Additionally, due to the delayed gastric emptying caused by semaglutide, precautions should be taken to monitor the absorption of oral medications in concurrent use with semaglutide.
Finally, the antidiabetic effects of the medication place patients at a high risk of hypoglycemia when paired with other blood-glucose lowering agents, beta-blockers, androgens, insulin, or insulin secretagogues. Drugs with antidiabetic therapeutic properties should be monitored closely, and it is recommended to lower their dosage to reduce the possibility of hypoglycemia.
Allergic Reactions
Research has noted severe allergic reactions in response to hypersensitivity of GLP-1 receptor agonists including both anaphylaxis and angioedema. Due to their similar structure and shared biochemical behavior, different GLP-1 receptor agonists can also share immunological activity. Prior to starting semaglutide, sincere caution should be taken if you have experienced any hypersensitivity effects to other GLP-1 receptor agonists.
Proper Use
Semaglutide has been approved for clinical use by the US Food and Drug Administration under its different brand names. Brand-name semaglutide has guidelines specific to each manufacturer as set by the FDA which are to be fully evaluated by healthcare providers when prescribing the medication for both approved and off-label use. The combination of semaglutide’s physiological effects can have benefits that can work adjunctly with physical activity and proper nutrition to treat multiple diseases.
FDA approval for semaglutide is primarily focused on treating type 2 diabetes mellitus in adults. Additionally, it is approved to treat adult patients diagnosed as obese or overweight who have at least one weight-related chronic illness (such as type-2 diabetes, hypertension, high cholesterol, etc). It is important to follow all preparation, storage, and administration guidelines explicitly to avoid complications from misuse.
Dosage
Semaglutide is available in multiple dose strengths, with the amount paid highly dependent on your reason for starting the medication and the administration method type. Thus, the dosage will ultimately be set through the prescription written by your healthcare provider. For example, the injectable forms of semaglutide come as pre-filled pens that can range from single-dose injections of 0.25 mg all the way to multi-dose injections of 8 mg. Alternatively, the pill form is only available in oral strengths of 3 mg, 7 mg, and 14 mg. Despite the differing dosages available, the general recommendation is to start at a lower initial dose of the medication and gradually increase the prescription to a higher amount.
Storage
It is recommended by the manufacturer of both Wegovy and Ozempic that their prefilled injectable pens are refrigerated and stored at roughly 36-46°F (2-8°C) to avoid the compound losing its effectiveness. In contrast, Rybelsus, the oral form of the compound, should be stored at room temperature or about 59°F to 86°F (15°C to 30°C).
Administration
All available forms of semaglutide are optimized for self-administration. The specific method of administration will be dependent on whether the medication is oral (Rybelsus) or an injection (Wegovy and Ozempic). Oral administration of semaglutide includes taking the prescribed pill everyday with half a cup of water (4 oz) at least thirty minutes before having any food or additional beverages. The injectable form of semaglutide should be administered to a clean and dry, 1-2 inch pinch of skin at a 90-degree angle. Additionally, the injection site is meant to be under the skin on either the abdomen, thigh or upper arm.
Gastrointestinal Side Effects of Semaglutide
Due to the molecular and cellular mechanisms of semaglutide, side effects related to gastrointestinal health are a common experience amongst patients. Semaglutide’s stimulation of the satiation response can reduce hunger and food intake. While reduced appetite is often a desired effect for individuals seeking to treat weight related disorders the changes in appetite can also be accompanied by indigestion and changes in your sense of taste.
Additionally, nausea, vomiting, bloating, and abdominal pain are all gastrointestinal side effects frequently reported as reasons for stopping the medication. Although the mechanisms aren’t fully clear, research suggests that delayed gastric emptying, interactions with satiety and other neural pathways play a role in the adverse gastrointestinal effects of semaglutide. Moreover, higher doses are more closely associated with these side effects.
Common Side Effects
As with any medication semaglutide carries common side effects that may be undesirable, but are not life threatening. In addition to a reduction in appetite and gastrointestinal effects, individuals may experience fatigue, headaches, and tenderness at injection sites (if using the injectable pen as the administration method). Another common and expected effect of semaglutide is lowered blood glucose levels; which is often of particular interest for individuals seeking the antidiabetic properties of the medication.
Serious Side Effects
Research has identified more severe cases from using semaglutide that can manifest and potentially be deadly. Serious side effects include diabetic retinopathy, which is damage to the retina and can present as blurred vision. Moreover, lowered blood sugar can evolve into hypoglycemia if prolonged and unmonitored.
Research has also shown GLP-1 receptor stimulation to be associated with other severe complications including pancreatic inflammation, gallbladder disorders and increased risk of thyroid tumors. The development of more severe side effects from semaglutide is consistently being studied. Thus, monitoring symptoms, maintaining acclimation periods for increasing dosage and considerations for predisposition to any health risks is important.
Long Term Side Effects
Depending on your reasons for starting semaglutide, long term side effects may or may not feel manageable. It is also important to recognize that semaglutide is considered by many clinicians as a life-long treatment. The persistent and expected effects of semaglutide include the usual purposes of treatment such as lowered blood sugar, slowed gastric emptying, increased satiety, reduced hunger, and more.
Most effects last for the same duration as the use of the medication. Unless you are experiencing unwanted side effects, serious complications or you have another reason you want to stop treatment most side effects are not a cause for concern.
Dealing with Semaglutide Side Effects
Regardless of how long you plan on taking semaglutide, or your reason for being prescribed the medication, it is important to monitor all side effects. Observing and recording any side effects is critical to monitoring your progress, which is vital to taking any medication. Not only will this help you track any adverse effects, but it will also support your doctor in following how you’re experiencing your treatment.
Additionally, if you’re on other medications that may increase side effects resulting from GLP-1 receptor activation – it may be beneficial to reduce the dosage of one of your treatments. Any changes to your healthcare plan should be thoroughly discussed and approved by your healthcare provider first. Even more, harmful side effects are linked to higher dosages and immediate dose escalations. Therefore, it is recommended that healthcare providers gradually increase dosage after a low initial dosing period for all forms of semaglutide. Moreover, if a lower dosage provides the results you want, you and your healthcare provider may choose to maintain your dosage at that point.
Semaglutide is prescribed to supplement physical activity and proper nutrition, as the therapeutic effects of semaglutide are augmented through clean eating and being increasingly active. Furthermore, maintaining the effects requires adopting healthy lifestyle habits as well. Making sustainable lifestyle shifts to support the processes mediated by the drug will contribute to you seeing the effects you want and help mitigate adverse side effects.
Conclusion
At all stages of considering, starting, and using semaglutide, you should be in regular communication with a trusted healthcare provider. Your initial period of taking semaglutide will require you to track and discuss your progress strictly as it is generally prescribed as a gradual increase. If you’re having adverse effects it is important to reach out to your doctor and explain what you’re experiencing in detail. Regardless of severity, any side effects that are impacting your quality of life should be communicated to your physician.
Additionally, if you do experience serious side effects, they could be signs of the development of severe conditions like chronic pancreatic, renal, and gallbladder disorders. Manifestations of this can look like blurred vision, depression, pancreatitis, gallstones, and sudden back pain. Serious side effects should be communicated as soon as possible, and if you cannot contact your general practitioner, be sure to report the side effects immediately. Most of these serious conditions can evolve into more severe complications; however, they can also be treated if caught early.
Lastly, if you are thinking of getting or becoming pregnant, or have other circumstances that may require you to stop semaglutide, you should speak with your doctor. If there are any reasons you’re contemplating stopping, reducing, or changing your medication, it’s critical that you have an in-depth conversation with a healthcare provider beforehand.
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