Semaglutide Approved for Weight Loss

Semaglutide targets brain areas that control appetite by mimicking a hormone called glucagon-like peptide-1 (GLP-1). A gradual increase of 2.4 mg once weekly must be made over 16 to 20 weeks to reduce gastrointestinal side effects.

Semaglutide should not be combined with other products containing semaglutide, other GLP-1 receptor agonists, or other products intended to cause weight loss, including prescription medications, over-the-counter products, and herbal supplements. There have been no studies of semaglutide in patients with pancreatitis.

Four 68-week trials have been conducted to evaluate semaglutide’s efficacy and safety. Semaglutide was studied in three randomized, double-blind, placebo-controlled trials (including 16 weeks of dose increases). One was a double-blind, placebo-controlled, randomized withdrawal trial in which patients continued to receive the drug or switched to a placebo. More than 2,600 patients received semaglutide for up to 68 weeks in these four studies, and more than 1,500 patients received a placebo.

Participants without diabetes constituted the largest placebo-controlled trial. The average age of the patients at the start of the study was 46 years, and 74% of them were female. The average weight of the participants was 231 pounds (105 kg), and the average body mass index was 38kg/m2. Compared to individuals who received a placebo, individuals who received semaglutide lost an average of 12.4% of their initial body weight. In another trial, participants with diabetes type 2 were recruited. The average age was 55 years, and 51% of the participants were female. Those studied had an average weight of 220 pounds (100 kg) and an average body mass index of 36kg/m2. According to the results of this study, individuals who took semaglutide lost 6.2% of their starting body weight.

Among the most common side effects of semaglutide are nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).

Semaglutide comes with a boxed warning informing healthcare professionals about the potential risk of thyroid C-cell tumors. The drug cannot be prescribed to patients with a personal or family history of medullary thyroid carcinoma, as well as patients with Multiple Endocrine Neoplasia Syndrome type 2 (MEN 2). 

Patients with severe allergies to semaglutide or any other component of semaglutide should not use this medication. If a severe allergic reaction is suspected, patients should stop using semaglutide immediately and seek medical help. There are also warnings for inflammation of the pancreas (pancreatitis), gallbladder problems (including gallstones), low blood sugar, acute kidney injury, diabetic retinopathy (damage to the retina in the eye), and increased heart rate.

Any patient who experiences pancreatitis or gallstones should speak with their healthcare provider.

The Woodlands Compounding Pharmacy is working on a compounded version of semaglutide.