Semaglutide

Semaglutide is a prescription drug used to reduce weight, treat type 2 diabetes, and reduce the risk of chronic kidney disease and serious cardiovascular events in certain adult patients.

Semaglutide is a GLP-1 receptor agonist that acts like the natural GLP-1 hormone released after eating. Semaglutide reduces appetite, delays gastric emptying, increases insulin release, and decreases the amount of glucagon released.

Semaglutide is available as a weekly injection (Ozempic, Wegovy) or as a daily oral tablet (Rybelsus).

The brand names of semaglutide are Ozempic, Rybelsus, and Wegovy, all manufactured by Novo Nordisk. Each brand is approved by the FDA for different conditions. FDA approval for semaglutide was first granted on December 5, 2017, for the Ozempic brand.

What is semaglutide used for?

The FDA-approved uses of semaglutide for each brand are:

• Ozempic: Type 2 diabetes, risk of major cardiovascular events, chronic kidney disease.
• Wegovy: Weight management, risk of major cardiovascular events.
• Rybelsus: Type 2 diabetes.

Wegovy (semaglutide) for weight loss

Wegovy (semaglutide) is used for weight reduction and maintenance in patients 12 years of age and older with obesity.

• Use to reduce the risk of major cardiovascular events (e.g., heart attack, stroke, or death) in adults with type 2 diabetes and known heart disease.
• The injection is given once a week under the skin of the abdomen, thigh or upper arm using an auto-injector (pen).
• This injection should be used in addition to a reduced-calorie diet and increased physical activity.

Ozempic (semaglutide) injection

Ozempic is used to treat type 2 diabetes in adults to control blood sugar levels, along with diet and exercise.

• Use to reduce the risk of major cardiovascular events in adults with type 2 diabetes and known heart disease.
• Use to reduce the risk of decline in kidney function, kidney failure, and death from cardiovascular disease in adults with chronic kidney disease (CKD) and type 2 diabetes.
• The injection is given once a week under the skin of the abdomen, thigh or upper arm using an auto-injector (pen).

Rybelsus (semaglutide) oral tablets

Rybelsus tablets are used to treat type 2 diabetes in adults to control blood sugar levels.

• The oral tablet is taken daily.
• Semaglutide tablets should be used in addition to a calorie-restricted diet and increased physical activity.

What is the difference between Ozempic, Wegovy and Rybelsus?

How does semaglutide work?

Semaglutide works by mimicking a natural hormone in the body, GLP-1 (glucagon-like peptide-1), which is released after eating to regulate appetite and blood sugar levels. By activating GLP-1 receptors, semaglutide works by:

• Stimulates insulin production in the pancreas.
• Reduces sugar production in the liver.
• Digestion slows down, so food stays in the stomach longer.
• Reduces appetite and food intake.

These combined effects help you stay full longer, eat less, and have better control over blood sugar levels. Semaglutide therefore supports weight loss, improves blood sugar management, and helps reduce the risk of cardiovascular disease. Semaglutide’s mechanism of action to reduce the risk of kidney problems is not fully understood.

Semaglutide belongs to the class of drugs known as GLP-1 receptor agonists.

Side effects of semaglutide

Common side effects

Common side effects of semaglutide include nausea (20.3%), vomiting (9.2%), diarrhea (8.8%), abdominal pain (5.7%), and constipation (3.1%). These side effects occurred in type 2 diabetics taking Ozempic 1 mg in several placebo-controlled studies.

Gastric or gastrointestinal side effects are common but tend to be mild and resolve within a few weeks; they generally do not interfere with long-term treatment. Gastric side effects may occur more frequently at higher doses.

The risk of symptomatic hypoglycemia occurred in 3.8% of all patients. Among diabetics taking insulin, with or without metformin, 29.8% experienced symptomatic hypoglycemia, and 1.5% had severe hypoglycemia.

Tips for coping with stomach side effects

The following tips can help you manage the stomach side effects of semaglutide:

• Eat slowly.
• Choose smaller meals.
• Prefer plain, low-fat foods (such as crackers, toast, and rice).
• Avoid fried or sugary foods.
• Eating foods with water content (such as soup or jelly).
• Do not lie down immediately after eating.
• Drink clear or ice-cold liquids.
• Get some fresh air if you feel sick.

Rybelsus is not recommended for patients with severe gastroparesis.

Tips for coping with hypoglycemia

Check your blood sugar levels regularly if you are also taking other diabetes medications such as insulin or sulfonylureas (e.g., glibenclamide/glyburide, glipizide, and gliclazide) and if you are increasing the dose of semaglutide.

Your doctor may reduce the dose of insulin or sulfonylureas to reduce the risk of hypoglycemia.

Symptoms of hypoglycemia:

• Feeling hungry
• Dizziness
• Anxiety or irritability
• Sweat
• Tremble
• Tingling of the lips
• Heart palpitations
• Fatigue or weakness
• Visual disturbances such as blurred vision
• confusion

Treatment of hypoglycemia

Eating or drinking anything that raises your blood sugar quickly, such as sugary foods or drinks, including a small glass of fruit juice or a sugary soft drink (non-diet), glucose or dextrose tablets or gel, or sugary sweets.

Check your blood sugar after 10 to 15 minutes. If your blood sugar remains low, have another sugary snack or drink and check again after 10 minutes.

Once your symptoms improve, eat a healthy snack or meal that will keep your blood sugar stable for longer and prevent it from dropping again.

Severe hypoglycemia may require a glucagon injection.