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Semaglutide

Generic Name: semaglutide (oral/injection) (SEM a GLOO tide)
Brand Name: Ozempic (0.25 mg or 0.5 mg dose), Ozempic (1 mg dose), Rybelsus

Medically reviewed by Drugs.com on Nov 27, 2019 – Written by Cerner Multum

What is semaglutide?

Semaglutide is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Semaglutide is usually given after other diabetes medicines have been tried without success. Semaglutide is not for treating type 1 diabetes.

Semaglutide may also be used for purposes not listed in this medication guide.

Important Information

You should not use semaglutide if you have multiple endocrine neoplasia type 2 (tumors in your glands), a personal or family history of medullary thyroid cancer, insulin-dependent diabetes, or diabetic ketoacidosis.

Call your doctor at once if you have signs of a thyroid tumor, such as swelling or a lump in your neck, trouble swallowing, a hoarse voice, or shortness of breath.

Before taking this medicine

You should not use semaglutide if you are allergic to it, or if you have:

  • multiple endocrine neoplasia type 2 (tumors in your glands);

  • a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or

  • diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

  • a stomach or intestinal disorder;

  • pancreatitis;

  • kidney disease; or

  • eye problems caused by diabetes (retinopathy).

In animal studies, semaglutide caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.

Semaglutide may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Semaglutide can have long-lasting effects on your body. Avoid getting pregnant for at least 2 months after you stop using semaglutide.

You should not breastfeed while using semaglutide.

Semaglutide is not approved for use by anyone younger than 18 years old.

How should I use semaglutide?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Rybelsus (oral) is taken by mouth. Take Rybelsus on an empty stomach when you first wake up, at least 30 minutes before you eat or drink anything. Take this medicine with no more than 4 ounces of water. Swallow the tablet whole and do not crush, chew, or break it.

Rybelsus works best if you eat 30 to 60 minutes after taking it.

Ozempic (injection) is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with Ozempic. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy or has particles in it. Call your pharmacist for new medicine.

Ozempic is usually given once per week at any time of the day, with or without a meal. If you want to change your weekly injection day, wait at least 2 days after your most recent injection before giving another one.

Your healthcare provider will show you where on your body to inject Ozempic. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking semaglutide. This can lead to kidney failure.

Semaglutide is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store Rybelsus tablets in their original package at room temperature, away from moisture and heat.

Storing unopened Ozempic injection pens: Store in the refrigerator. Do not freeze semaglutide, and throw away the medication if it has become frozen. Do not use an unopened injection pen if the expiration date on the label has passed.

Storing after your first use: You may keep an "in-use" injection pen in the refrigerator or at room temperature. Protect the pen from heat and sunlight. Remove the needle before storing an injection pen, and keep the cap on the pen when not in use. Throw the injection pen away 56 days after the first use.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

What happens if I miss a dose?

For Rybelsus: Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

For Ozempic: Use the medicine as soon as you can, but skip the missed dose if you are more than 5 days late for the dose. Do not use two doses within 5 days of each other.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using semaglutide?

Never share an injection pen with another person, even if the needle has been changed. Sharing this device can allow infections or disease to pass from one person to another.

Semaglutide side effects

Get emergency medical help if you have signs of an allergic reaction: hives, itching; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • vision changes;

  • signs of a thyroid tumor--swelling or a lump in your neck, trouble swallowing, a hoarse voice, feeling short of breath;

  • symptoms of pancreatitis--severe pain in your upper stomach spreading to your back, nausea with or without vomiting, fast heart rate;

  • low blood sugar--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or

  • kidney problems--little or no urination; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath.

Common side effects may include:

  • nausea (especially when you start using semaglutide);

  • vomiting, stomach pain, loss of appetite;

  • diarrhea; or

  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Semaglutide dosing information

Usual Adult Dose for Diabetes Type 2:

Oral Tablets:
Initial dose: 3 mg orally once a day for 30 days; then 7 mg orally once a day
-Titration: If additional glycemic control is needed after at least 30 days at 7 mg/day, may increase to 14 mg orally once a day
Maintenance dose: 7 to 14 mg/day
Maximum dose: 14 mg/day (taking two 7 mg tablets to achieve a 14 mg dose is not recommended)

Subcutaneous Administration:
Initial dose: 0.25 mg subcutaneously once a week for 4 weeks, then 0.5 mg subcutaneously once a week
-If additional glycemic control is needed after at least 4 weeks at 0.5 mg/week, may increase dose to 1 mg subcutaneously once a week
Maintenance dose: 0.5 to 1 mg subcutaneously once a week
Maximum dose: 1 mg/week

Switching between Subcutaneous Administration and Oral Tablets:
-Patients receiving 14 mg orally once a day can be transitioned to 0.5 mg subcutaneously once a week; subcutaneous administration should start after their last oral dose
-Patients receiving 0.5 mg subcutaneously once a week can be transitioned to 7 or 14 mg orally once a day; oral therapy should start up to 7 days after their last subcutaneous injection
-No equivalent oral dose is recommended to replace a subcutaneous dose of 1 mg weekly

Comments:
-Doses of 0.25 mg subcutaneously once a week and 3 mg orally once a day are intended for treatment initiation and are not effective doses for glycemic control.
-This drug is not recommended as a first-line therapy due to the uncertain relevance of rodent C-cell tumor findings to humans.
-This drug has not been studied in patients with a history of pancreatitis; other antidiabetic therapies should be considered in these patients.

Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

What other drugs will affect semaglutide?

Semaglutide can slow your digestion, and it may take longer for your body to absorb any medicines you take by mouth.

Tell your doctor about all your other medicines, especially:

  • insulin; or

  • oral diabetes medicine.

This list is not complete. Other drugs may affect semaglutide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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