Overview:

Ozempic (Semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes and chronic weight management. It works by increasing insulin secretion, reducing glucagon release, and slowing gastric emptying. This leads to improved blood sugar control and appetite reduction.

Uses of Ozempic:

• Improves glycemic control in adults with type 2 diabetes mellitus.
• Reduces the risk of major cardiovascular events in diabetic patients with heart disease.
• Used off-label for chronic weight management in obese or overweight adults.

Dosage and Administration:

Starting dose: 0.25 mg once weekly (for 4 weeks, not for glycemic control but for tolerance).

Maintenance dose: 0.5 mg once weekly, which may be increased to 1 mg or 2 mg once weekly as needed and tolerated.

Ozempic is administered via subcutaneous injection in the abdomen, thigh, or upper arm. It can be taken with or without food, but the injection site should be rotated weekly.

Side Effects:

• Nausea, vomiting, diarrhea, or constipation
• Abdominal pain or indigestion
• Rare but serious: pancreatitis, gallbladder disease, and possible risk of thyroid tumors (seen in animal studies)

Drug Interactions:

• Increased risk of hypoglycemia when used with insulin or sulfonylureas.
• May delay the absorption of oral medications due to delayed gastric emptying.

Warnings & Precautions:

• Not recommended in patients with a personal or family history of medullary thyroid carcinoma.
• Should be avoided in patients with severe gastrointestinal disease or pancreatitis.
• Use with caution in patients with kidney disease.

References:

1. Marso SP et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. New England Journal of Medicine, 2016.

2. Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 2021.

3. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care, 2023.