Understanding Semaglutide: Dosage Guidelines and Usage
What is Semaglutide?
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps regulate blood sugar levels and appetite. It's marketed under two main brand names:
- Ozempic for managing type 2 diabetes
- Wegovy for chronic weight management
Dosage Guidelines
For Type 2 Diabetes (Ozempic)
- Initial Dose: 0.25 mg once weekly for 4 weeks (adjustment period)
- Maintenance Dose: Increase to 0.5 mg once weekly
- Maximum Dose: Can increase to 1 mg once weekly after at least 4 weeks at 0.5 mg if needed
For Weight Management (Wegovy)
- Initial Dose: 0.25 mg once weekly (weeks 1-4)
- Titration Schedule:
- Weeks 5-8: 0.5 mg weekly
- Weeks 9-12: 1.0 mg weekly
- Weeks 13-16: 1.7 mg weekly
- Maintenance Dose: 2.4 mg weekly after week 16
Administration Guidelines
- Inject subcutaneously in the abdomen, thigh, or upper arm
- Use the same day each week
- Can be taken with or without food
- Maintain at least 2 days between doses if schedule adjustment is needed
Important: Never share injection pens between patients, even if the needle is changed.
Missed Doses
- Take within 5 days of missed dose
- Skip if more than 5 days have passed
- Resume regular schedule on next planned day
Special Populations
| Patient Group | Dosing Consideration |
|---|---|
| Elderly (≥65) | No dose adjustment required |
| Renal impairment | Monitor closely; no adjustment needed |
| Hepatic impairment | Limited data; use with caution |
Monitoring Requirements
Regular monitoring should include:
- Blood glucose levels
- HbA1c
- Body weight
- Kidney function
- Potential side effects
Important Considerations
Side Effects
Common side effects include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Abdominal pain
Contraindications
Semaglutide is contraindicated in patients with:
- Personal or family history of medullary thyroid carcinoma
- Multiple endocrine neoplasia syndrome type 2
- History of severe hypersensitivity to semaglutide
- History of pancreatitis
Drug Interactions
- Insulin and insulin secretagogues
- Oral medications requiring rapid absorption
- Other GLP-1 receptor agonists
Long-term Management
- For type 2 diabetes: Ongoing as prescribed
- For weight management: Evaluate continuation based on response at 6 months
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