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Semaglutide

Ozempic, Rybelsus, WegovyGLP-1 receptor agonistSubcutaneous injection and oral tablet

Mechanism

Activates GLP-1 receptors, increasing glucose dependent insulin secretion, reducing glucagon secretion, slowing gastric emptying, and influencing appetite.

Uses

  • Type 2 diabetes mellitus with product specific benefits
  • Chronic weight management with indicated products
  • Cardiovascular risk reduction with indicated products

Common effects

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Abdominal pain

Serious risks

  • Boxed warning for thyroid C-cell tumors
  • Pancreatitis
  • Gallbladder disease
  • Kidney injury related to volume depletion
  • Diabetic retinopathy complications in susceptible patients

Monitoring

  • Glucose and A1C when used for diabetes
  • Gastrointestinal tolerance and hydration
  • Weight when relevant
  • Vision changes and symptoms of pancreatitis or gallbladder disease

Counseling

  • Brand indications and administration instructions are not interchangeable
  • Follow the product specific titration plan
  • Report severe persistent abdominal pain
  • Discuss pregnancy plans well before treatment
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