Semaglo 1

Indications

Semaglutide is used, together with diet and exercise, to improve blood sugar control in adults with type 2 diabetes, and to lower the risk of heart attack and stroke in people with type 2 diabetes and heart disease. Higher-dose forms are used for long-term weight management in adults with obesity, or who are overweight with a weight-related health problem.

How It Works

It copies a natural gut hormone called GLP-1. It helps the pancreas release insulin when blood sugar is high, lowers the release of glucagon (a hormone that raises sugar), slows emptying of the stomach and reduces appetite.

Dosage and Administration

Weekly injection: injected under the skin of the stomach, thigh or upper arm once a week, on the same day each week. It usually starts at 0.25 mg once a week for 4 weeks and is then increased step by step, as prescribed. Tablets: taken once a day, usually starting at 3 mg and increased as prescribed; swallow on an empty stomach with a small sip of water (no more than 120 ml) and wait at least 30 minutes before eating, drinking or taking other medicines. A doctor, nurse or pharmacist should show you how to use the pen before the first dose. Never share pens or needles.

Interactions

• With Insulin or sulfonylureas such as Gliclazide and Glimepiride, the risk of low blood sugar rises; their doses may need lowering.
• Because it slows stomach emptying, it may change how other tablets are absorbed.
• People taking Warfarin need closer INR checks when starting it.
• The tablet form can raise Levothyroxine levels.

Contraindications

Allergy to semaglutide; a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN 2); pregnancy. It is not used for type 1 diabetes or diabetic ketoacidosis.

Side Effects

Common, especially when starting or increasing the dose: nausea, vomiting, diarrhoea, constipation, stomach pain, bloating, reduced appetite and tiredness. Low blood sugar can happen when used with Insulin or sulfonylureas.

Get urgent medical help for severe stomach pain that does not go away, with or without vomiting, sometimes spreading to the back (possible pancreatitis); pain in the upper right belly with fever or yellow skin (possible gallbladder problem); a lump or swelling in the neck, trouble swallowing or a hoarse voice; severe vomiting or diarrhoea with signs of dehydration; sudden changes in vision; or signs of a serious allergic reaction.

Pregnancy and Lactation

Do not use during pregnancy. Women who could become pregnant should use contraception, and should stop semaglutide at least 2 months before a planned pregnancy, as advised by the doctor. It is not recommended while breastfeeding.

Precautions and Warnings

• Tell the doctor about any history of pancreatitis, gallstones, diabetic eye disease, or kidney problems.
• Drink enough fluids to avoid dehydration if you have vomiting or diarrhoea.
• Learn the signs of low blood sugar (shaking, sweating, hunger, confusion) if you also take Insulin or sulfonylureas.
• Tell the doctor before surgery or a procedure needing anaesthesia, as food may stay longer in the stomach.
• It is not a replacement for Insulin.

Overdose

Overdose can cause severe nausea, vomiting and, with other diabetes medicines, low blood sugar. Because it lasts a long time in the body, seek medical help for monitoring.

Therapeutic Class

GLP-1 receptor agonist (antidiabetic and weight-management medicine).

Storage

Unused pens: keep in a fridge at 2 to 8°C; do not freeze, and do not use if frozen. After first use, store as stated on the pack (usually below 30°C or in the fridge for a limited number of weeks), with the cap on to protect from light. Tablets: store below 30°C in the original blister to protect from moisture. Keep out of the reach of children.