How does this medication work? What will it do for me?
Semaglutide belongs to a group of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It is used alone or with other medications to improve blood glucose (sugar) levels for people with type 2 diabetes.
Diabetes medications such as semaglutide are used when diet, exercise, weight reduction, and medications such as metformin, glyburide, or insulin have not been found to lower blood sugar well enough on their own. It works by helping your body make more insulin and control blood glucose levels.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white-to-light-yellow, oval-shaped tablet, debossed with "3" on one side and "novo" on the other side, contains 3 mg of semaglutide. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).
Each white-to-light-yellow, oval-shaped tablet, debossed with "7" on one side and "novo" on the other side, contains 7 mg of semaglutide. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).
Each white-to-light-yellow, oval-shaped tablet, debossed with "14" on one side and "novo" on the other side, contains 14 mg of semaglutide. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).
How should I use this medication?
The recommended starting dose of semaglutide is 3 mg taken by mouth once daily. After 30 days, your dose will be increased to 7 mg once daily. If, after another 30 days, your blood sugar is still not controlled, your doctor may increase your dose to the maximum of 14 mg once daily.
Semaglutide should be taken on an empty stomach, at least 30 minutes before the first meal or beverage of the day. After taking semaglutide, wait 30 minutes before taking any other medications. Do not crush or chew the tablet. Swallow it whole with half a glass (120 mL) of water.
It is important to take this medication on an empty stomach and with only enough water to swallow the tablet. Taking this medication with food or too much water prevents it from working well.
Do not take more than 1 tablet at a time to make a higher dose. For example, do not take 2 tablets of 7 mg semaglutide instead of one 14 mg tablet.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you:
- are allergic to semaglutide or any ingredients of the medication
- are pregnant
- are breast-feeding
- have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body)
- have a personal or family history of thyroid cancer
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- burping or gas
- change in sense of taste
- decreased appetite
- stomach pain
- upset stomach
- weight loss
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- fast heartbeat
- signs of low blood glucose (e.g., anxiety, blurred vision, confusion, difficulty concentrating, difficulty speaking, dizziness, drowsiness, fast heartbeat, feeling jittery, headache, hunger, irritability, nausea, nervousness, numbness or tingling of the lips or tongue, sweating, tiredness, trembling, weakness)
- symptoms of gallstones (e.g., intermittent, severe, dull pain in the upper right part of the abdomen; nausea; vomiting; intolerance of fatty or greasy foods)
- changes caused by diabetic retinopathy (e.g., blurred or changing vision, floaters, changes in colour vision)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- severe hypoglycemia (e.g., disorientation, loss of consciousness, seizures)
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
- symptoms of a serious allergic reaction (e.g., swelling of the face or throat, difficulty breathing, wheezing, or itchy skin rash)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking medication to manage your blood glucose levels.
Dizziness/reduced alertness: Semaglutide may cause episodes of low blood glucose which can cause dizziness or reduced alertness. Avoid driving, operating machinery, or performing other potentially hazardous tasks when you are experiencing low blood glucose levels.
Heart problems: This medication may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease or an abnormal heart rhythm (e.g., heart block or fast heart rate), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: Semaglutide may cause decreased kidney function. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Low blood glucose (hypoglycemia): People who use semaglutide and are also taking a sulfonylurea (e.g., glyburide, gliclazide) or insulin to control high blood sugar are more at risk of experiencing hypoglycemia (low blood sugar). If you experience symptoms of hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling of the tongue or lips, contact your doctor. Your doctor may need to adjust the dose of your medication(s).
Pancreatitis (inflammation of the pancreas): Semaglutide can cause pancreatitis. If you experience symptoms of pancreatitis such as severe and persistent abdominal pain that may move to the back with or without vomiting, contact your doctor immediately. If you have previously had pancreatitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Risk of thyroid cancer: In rare cases, people have developed thyroid cancer while using medications similar to semaglutide. People with a personal or family history of thyroid cancer or people who have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body) should not use this medication. If you develop difficulty swallowing or breathing, hoarseness or notice a mass developing in your neck, contact your doctor as soon as possible.
Vision: Diabetic retinopathy is a complication of diabetes that results from uncontrolled blood glucose levels. When blood glucose levels are brought under control quickly, symptoms of retinopathy may become worse for a short period of time. If you experience vision changes with the use of semaglutide, talk to your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Women who plan on becoming pregnant should talk to their doctor and are advised to stop taking semaglutide for at least 2 months before becoming pregnant. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if semaglutide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
There may be an interaction between semaglutide and any of the following:
- acetylsalicylic acid (ASA)
- antipsychotics (e.g., clozapine, olanzapine, quetiapine, risperidone)
- corticosteroids (e.g., beclomethasone, cortisone, dexamethasone, hydrocortisone, prednisone)
- diabetes medications (e.g., chlorpropamide, dapagliflozin, glyburide, insulin, linagliptin, metformin, rosiglitazone)
- diuretics (e.g., furosemide, hydrochlorothiazide, indapamide)
- estrogens (e.g., estradiol, ethinyl estradiol, conjugated estrogen)
- hepatitis C antivirals (e.g., daclatasvir, glecaprevir and pibrentasvir, ledipasvir, velpatasvir)
- HIV protease inhibitors (e.g., lopinavir, ritonavir, saquinavir, tipranavir)
- monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
- progestins (e.g., cyproterone, levonorgestrel, medroxyprogesterone, norethindrone, progesterone)
- quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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