How does this medication work? What will it do for me?
Semaglutide belongs to the class of medications called human glucagon-like peptides. It is used for chronic (long-term) management of body weight, together with reduced caloric intake and increased physical activity. It may be prescribed for adults with a body mass index (BMI) of 30 kg/m² or more, or people with a BMI of 27 kg/m² who also have another weight-related illness, such as high blood pressure, type 2 diabetes, or dyslipidemia (high cholesterol). It may also be prescribed for adolescents between 12 and 18 years old who have not experienced adequate weight loss on a reduced-calorie diet and increased physical activity. Adolescents must have a body weight greater than 60 kg (132 pounds) and an initial BMI of 30 kg/m² or more.
Semaglutide aids in weight control by affecting sensations of hunger, causing a decrease in appetite and food intake. It slows down the passage of food from the stomach into the intestine, causing the user to "feel full" for longer after a meal. It also decreases the maximum glucose level in the blood and the amount of insulin needed for the body to use the glucose.
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?
Solution for Injection Multi-Use Pen
0.25 mg
Each prefilled pen contains 1 mg of semaglutide in 1.5 mL, delivering 4 doses of 0.25 mg. Nonmedicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide, and water for injection.
0.5 mg
Each prefilled pen contains 2 mg of semaglutide in 1.5 mL, delivering 4 doses of 0.5 mg. Nonmedicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide, and water for injection.
1 mg
Each prefilled pen contains 4 mg of semaglutide in 3 mL, delivering 4 doses of 1 mg. Nonmedicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide, and water for injection.
1.7 mg
Each prefilled pen contains 6.8 mg of semaglutide in 3 mL, delivering 4 doses of 1.7 mg. Nonmedicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide, and water for injection.
2.4 mg
Each prefilled pen contains 9.6 mg of semaglutide in 3 mL, delivering 4 doses of 2.4 mg. Nonmedicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, hydrochloric acid, sodium hydroxide, and water for injection.
How should I use this medication?
The recommended starting dose of semaglutide is 0.25 mg once a week, injected subcutaneously (under the skin) on your abdomen (stomach area ), upper thigh, or upper arm, exactly as instructed by your doctor. After 4 weeks, your doctor will increase the dose to 0.5 mg once weekly, gradually increasing the dose every 4 weeks, to the recommended 2.4 mg weekly. This gradual increase of the dose should minimize side effects on the digestive system.
Semaglutide can be injected at any time of the day, without regard to meals. It should be injected on the same day each week. If it is necessary to change the day of administration, doses must be separated by at least 72 hours.
Your doctor or nurse will assist you in the preparation and injection of your first dose (or first few doses) and can teach you how to give yourself the injection at home. Do not attempt to inject this medication on your own until you completely understand how to inject a dose. If you are unsure of how to prepare or administer a dose, ask a health care professional to clarify for you. If you are having difficulty giving yourself injections, ask a family member or other caregiver for help if they are willing to become involved with your treatment and are willing to learn how to give you your injections.
Use a different injection site for each dose. Avoid injecting this medication into an area of skin that is sore, red, infected, or otherwise damaged.
Semaglutide should be clear and colourless. Do not use semaglutide if you notice particles or anything unusual in the appearance of the solution.
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 and the next dose is at least 48 hours away, take the dose as soon as possible and continue with your regular schedule. If it is less than 48 hours until for your next dose, skip the missed dose and continue with your regular dosing schedule. If you miss 2 or more consecutive doses you may need to reduce the dose temporarily to reduce side effects. 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 in the refrigerator, protect it from light and moisture, and keep it out of the reach of children. After first use, the pen may be kept at room temperature for up to 4 weeks, or in the refrigerator for up to 8 weeks.
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 a personal or family history of thyroid cancer
- have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body)
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
- changed sense of taste
- constipation
- diarrhea
- dizziness or lightheadedness when rising from a lying or sitting position
- fatigue
- gas
- hair loss
- headache
- heartburn
- hemorrhoids
- injection site reactions (e.g., itching, redness, swelling, pain)
- nausea
- stomach ache and/or bloating
- vomiting
- weakness
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:
- changes in mood
- delayed stomach emptying
- fast heartbeat
- feeling faint
- severe constipation (e.g., stomach ache, bloating, vomiting)
- signs of dehydration (e.g., decreased urine, dry skin, dry and sticky mouth, sleepiness, dizziness, headache, thirst, confusion)
- signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
- 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 a bowel obstruction (e.g., feeling of fullness or swelling in the belly, constipation, feeling gassy, unable to pass gas, severe belly pain, vomiting)
- symptoms of appendicitis (e.g., sudden pain in the middle or lower right abdomen, chills, fever, nausea, vomiting)
- 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)
- symptoms of kidney injury (e.g., swelling legs, ankles and feet, shortness of breath, confusion, fatigue, no urine production)
- vision 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)
- thoughts of suicide or self-harm
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.
Dehydration: Symptoms of nausea, vomiting, and diarrhea may be more common at the start of treatment and can result in loss of fluid from the body. If you experience symptoms of dehydration, such as thirst, decreased urine or tear production, dizziness or headaches, contact your doctor.
Gallstones: Semaglutide has been associated with an increase in gallstone formation. Gallstones often form when there is significant or fast weight loss. If you experience symptoms of gallstones, such as nausea and vomiting, pain under the right shoulder or between the shoulder blades or severe abdominal pain, contact your doctor as soon as possible.
Heart problems: This medication may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease (e.g., recent heart attack, angina, heart failure) 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.
Intestinal problems: Semaglutide may slow down the speed that material passes through the digestive system. If you have digestive system problems, 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: Decreased kidney function has been reported with the use of semaglutide. This may be more likely to occur if you have reduced kidney function when you start using this medication. 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.
Liver function: The safety and effectiveness of using this medication for people with reduced liver function have not been studied. If you have reduced liver function or liver 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 may experience low blood sugar. This may be more likely if you are also taking a sulfonylurea (e.g., glyburide, gliclazide) to control high 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.
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.
Thyroid cancer: In rare cases, people have developed thyroid cancer while using 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.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Use effective birth control while you are using this medication and for at least 2 months after your last dose of semaglutide.
Breast-feeding: It is not known if semaglutide passes into breast milk. If you are breast-feeding and 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 less than 12 years of age. Adolescents must weigh at least 60 kg or have a BMI of at least 30 kg/m2.
Seniors: Seniors may be at an increased risk of experiencing side effects of semaglutide.
What other drugs could interact with this medication?
For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.
If you are taking other 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.
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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