Brand Names: US

• Ozempic, Rybelsus, and Wegovy

Mechanism of Action

• Semaglutide is a selective glucagon-like peptide-1 (GLP-1) receptor agonist that increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, slows gastric emptying; also acts in the areas of the brain involved in regulation of appetite and caloric intake.

Dosing Recommendations for Weight management

• Note: For use as an adjunct to diet and exercise in patients with a BMI ≥30 kg/m 2 , or in patients with a BMI ≥27 kg/m 2  and ≥1 weight-associated
  comorbidity (eg, hypertension, dyslipidemia).
• SUBQ: Initiate and adjust dose using the following schedule: In patients who do not tolerate a dosage increase, consider delaying the increase for an
  additional 4 weeks:
• Week 1 through week 4 : 0.25 mg once weekly.
• Week 5 through week 8: 0.5 mg once weekly.
• Week 9 through week 12: 1 mg once weekly.
• Week 13 through week 16: 1.7 mg once weekly.
• Week 17 and thereafter (maintenance dosage): 2.4 mg once weekly; if not
  tolerated, may temporarily decrease dosage to 1.7 mg once weekly for up to
  4 additional weeks, then increase to 2.4 mg once weekly.
• Note: The manufacturer recommends discontinuing therapy in patients who
  cannot tolerate the 2.4 mg/week dosage; however, some patients may achieve goal weight loss on a submaximal dose and may continue on the maximum tolerated dose (even if <2.4 mg/week) (Ref). Consider discontinuation if at least 5% of baseline body weight loss has not been achieved within 3 months.
• Missed dose: Missed dose should be administered as soon as possible within
  5 days; resume usual schedule thereafter. If >5 days have elapsed, skip the
  missed dose and resume administration at the next scheduled weekly dose.
  If 2 or more consecutive doses are missed, resume dosing as scheduled;
  alternatively, may reinitiate dosage adjustment schedule.

Storage recommendations

Keep refrigerated in the dark amber zip lock bag for the B12 photosensitivity. Do not store in your purse and any container that may risk plunging the medication out. The medication will lose potency if kept in a higher temperature than 86 degrees.

Recommendations for side effects

If nausea and or vomiting occur, keep hydrated with electrolytes (ex, zero sugar
Gatorade). You can take Pepto-Bismol, anti-nausea medication, and antacids.
Symptoms seem to be less if the Semaglutide is taken at night before bed.

Diet recommendations

6 small meals throughout the day. A low carb diet is recommended (avoid a no carb diet)