Semaglutide

SEMAGLUTIDE INFORMATION

Semaglutide is a Glucagon-like peptide-1 (GLP-1) produced by the gut. It increases insulin production, a hormone that lowers the blood sugar level while inhibiting glucagon secretion, which is a hormone that raises blood sugar, reduces appetite while delaying gastric emptying.

  • Reduces food intake by lowering appetite.
  • It slows food digestion in the stomach.
  • Decrease body fat percentage.
  • Weight loss.
  • Decreased cardiovascular outcomes in subjects with type 2 diabetes and cardiovascular disease.
  • Lower HbA1c levels.
  • Enhance the growth of β cells in the pancreas.

SEMAGLUTIDE FOR WEIGHT LOSS

Semaglutide originally came to market as a drug to treat diabetes.
Its brand-name is Ozempic when used for diabetes.
When used for obesity its brand name is Wegovy.
It belongs to a class of drugs known as glucagon-like peptide 1 mimetics (IGL-1).

These drugs were introduced to the market in 2005. From the outset it was recognized that they assisted with weight loss. More recently research studies have enabled the drugs to become FDA approved for the treatment of obesity. In comparative studies, Semaglutide appears to have been the most beneficial for weight loss within this class.

HOW DOES SEMAGLUTIDE WORK?

  • Semaglutide slows down the movement of food through the intestine enabling patients to feel full for a longer period of time.
  • It helps to lower blood sugar by making insulin work better, thus reducing the impact of insulin which is a hormone that stimulates obesity.
  • It also suppresses the part of the brain that drives food craving.

SIDE EFFECTS, CAUTIONS AND WARNINGS

  • Nausea, abdominal pain, and constipation can occur. In many cases the symptoms will fade with continued use.
  • Animal studies have indicated the possibility of increased risk of thyroid cancer. In clinical use that has not been seen in humans however it's not recommended for people with a prior history of thyroid cancer.
  • Inflammation of the pancreas, a condition known as pancreatitis can occur. This is obvious since it causes severe abdominal pain. People who had prior pressure pancreatic or liver disease should not use this drug.
  • Whenever ill with a fever, nausea, vomiting or diarrhea you should stop using the drug and call your provider for guidance. The loss of too much body fluid can make it dangerous for you to take this medication.
  • You should not use this drug if you're pregnant or planning to get pregnant within 3 months.

HOW IS IT ADMINISTERED

Once weekly by self-administered subcutaneous injections with a tiny needle is necessary to administer the drug. Prior to starting the medication, you will be trained on proper storage and administration of the medication, and disposal of used needles.

WHAT DOSE DO I GIVE MYSELF?

You will be given a titration schedule to follow.

The maximum effective dose is 96 mg per week. Many patients will experience significant benefit at a lower dose therefore pushing to the maximum level is rarely needed.

You should never adjust your dose upward without input and guidance from your practitioner. However, you may stop the drug at any time if there are concerns regarding side effects.

COST

Your insurance will be charged for an office visit so you may have a copay at each monthly visit. We do not bill your insurance for Semaglutide. You are required to pay for the medication prior to getting the medication given to you. The cost for the Semaglutide ranges from $300 - $400 a month, depending on your dose. The lower your dose, the lower the cost.

PROTOCOL

To reduce adverse side effects, it is recommended to start with the dose escalation chart below.

Injected under the skin, usually once per week on the same day, at any time of the day, with or without food. The lowest efficacious dose is recommended to reduce the risk of side effects and to reduce cost.

Week 1 - 4 Inject 0.25mg (10 units) SQ weekly

Week 5 - 8 Inject 0.5mg (20 units) weekly

Week 9 - 12 Inject 1mg (40 units) weekly

Week 13 - 16 inject 1.7mg (68 units) weekly

Week 17+ inject 2.4mg (96 units) weekly