Generic
Semaglutide
36 brands available in the market
At a glance
Semaglutide is a GLP-1 receptor agonist used for the treatment of type 2 diabetes mellitus. It improves glycemic control by increasing glucose-dependent insulin secretion, suppressing glucagon secretion, and slowing gastric emptying.
Description
Semaglutide is a GLP-1 analogue with 94% sequence homology to human GLP-1. It acts as a GLP-1 receptor agonist, selectively binding to and activating the GLP-1 receptor. It reduces blood glucose in a glucose-dependent manner by stimulating insulin secretion and lowering glucagon secretion when blood glucose is high. It also delays gastric emptying.
Indications
- Type 2 diabetes mellitus (as an adjunct to diet and exercise)
- Reduction of major adverse cardiovascular events in type 2 diabetes with established cardiovascular disease
- Chronic weight management in obesity (BMI ≥30) or overweight (BMI ≥27 with weight-related comorbidity)
Therapeutic class
GLP-1 Receptor Agonists
Pharmacological class
Incretin Mimetic
Pharmacology
Semaglutide activates GLP-1 receptors, enhancing glucose-dependent insulin secretion, suppressing inappropriately elevated glucagon secretion, and slowing gastric emptying. It also reduces appetite, leading to decreased body weight and fat mass.
Mechanism of action
Activates GLP-1 receptors to increase insulin secretion, decrease glucagon, and slow gastric emptying.
Dosage
Diabetes (Injection):
- Starting: 0.25 mg once weekly for 4 weeks
- Maintenance: 0.5 mg once weekly after 4 weeks
- Additional control: 1 mg once weekly if needed
Diabetes (Tablet):
- Starting: 3 mg/day for 30 days
- Maintenance: 7 mg/day
- Additional control: 14 mg/day
Obesity (Injection):
- Starting: 0.25 mg once weekly for 4 weeks
- Titration: 0.5→1.0→1.7→2.4 mg (each for 4 weeks)
- Maintenance: 2.4 mg once weekly
Administration
- Subcutaneous injection (abdomen, thigh, or upper arm)
- Once weekly, on the same day each week, any time of day
- With or without meals
- Tablet: At least 30 minutes before the first food/beverage of the day with 4 oz plain water
Missed dose
- Injection: Take within 5 days of missed dose; if more than 5 days, skip
- Tablet: Take as soon as possible; if almost time for next dose, skip
Side effects
Common Side Effects (>10%):
- Nausea (15.8-20.3%)
- Hypoglycemia with adjunctive therapy (16.7-29.8%)
1-10%:
- Vomiting (5-9.2%), Diarrhea (8.5-8.8%)
- Abdominal pain (5.7-7.3%), Constipation (3.1-5%)
- Dyspepsia, flatulence, GERD
Rare:
- Anaphylaxis, pancreatitis
Precautions & warnings
- Risk of thyroid C-cell tumors (MTC); contraindicated in personal/family history of MTC or MEN 2
- Do not use in type 1 diabetes or diabetic ketoacidosis
- Monitor for signs of pancreatitis
- Caution in history of diabetic retinopathy
- Monitor renal function with severe GI reactions
- Do not use during pregnancy; discontinue 2 months before planned pregnancy
Contraindications
- Personal or family history of Medullary Thyroid Carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known hypersensitivity to semaglutide or any component
- Pregnancy and lactation
Drug interactions
- Insulin secretagogues (sulfonylureas) or insulin: Increased hypoglycemia risk; consider dose reduction
- Oral medications: Gastric emptying delay may affect absorption
Food interactions
Caution is advised when consuming alcohol with Semaglutide (hypoglycemia risk); consult your doctor.
Use in pregnancy
Use in Pregnancy: Limited data in pregnant women; animal studies show potential fetal risk; discontinue 2 months before planned pregnancy; use only if clearly needed; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: No data on presence in human milk; breastfeeding is not recommended due to potential serious reactions; consult your doctor.
Pediatric use
Safety and efficacy not established in children <18 years
Geriatric use
No dose adjustment required based on age
Renal / hepatic impairment
Renal Impairment: No dose adjustment for mild-severe impairment; not recommended in ESRD; consult your doctor.
Hepatic Impairment: No dose adjustment needed; caution required; consult your doctor.
Overdose effects
Overdose up to 4 mg in a single dose reported; most common adverse reaction was nausea; no specific antidote; provide supportive treatment.
Storage conditions
Injection: Store at 2-8°C in a refrigerator; do not freeze; protect from light. Tablet: Store below 30°C in a cool and dry place; protect from light; keep out of reach of children.
Chemical structure
Semaglutide