SEMAGLUTIDE (Ozempic, Wegovy)

What is it?

Semaglutide Information Guide

• It is a Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist

• Previously used solely as a diabetes medication

  o Originally approved by the FDA under the brand name Ozempic in December 2017

• Now used as an aid for healthy weight loss o Approved by the FDA in June 2021

How does it work?

• It decreases your appetite by:
  o Slowing down your gastric emptying
  o Acting in areas of the brain involved in regulating appetite and caloric intake

• It helps with diabetes by:
  o Increasing release of insulin (helping sugar get into your cells to utilize energy and lower blood sugar)
  o Decreasing inappropriate release of glucagon secretion (the hormone that increases blood sugars)

Who qualifies for it?

• Overweight individuals that do not have contraindications to the medication (i.e., history of thyroid cancer)

  o If our certified Doctoral level Nurse Practitioner (DNP) decides you are not a good candidate for the medication, you will not be charged for your initial visit

• Should not take if pregnant or plan to be while using medication

What is the dosing?

• You will receive a once/week subcutaneous injection (smaller and shorter needle than used for vaccinations)

• Your dose will be slowly titrated monthly
  o Starting dose of 0.25 mg once weekly
  o Max/maintenance dose of 2.4 mg once weekly

How long will I be on it?

• This varies patient to patient based on response to the medication and how quickly weight loss goals are met

• Most patients will likely be on it approximately 6 months, though could be shorter/longer

What are possible side effects?

• Nausea, vomiting, diarrhea, abdominal pain, constipation, heartburn, burping, dizziness o Mostly during dose escalation and tend to decrease over time

How can I minimize side effects?

• Limit foods/drinks that are high in unhealthy fats or sugars
  o i.e., fried foods, processed foods, desserts, alcohol, etc.

What are the risks?

• Acute Kidney Injury (AKI)-small overall risk. Increased risk with preexisting kidney impairment or periods of severe dehydration

• Diabetic retinopathy: Primarily with preexisting diabetic retinopathy or large and rapid decline in HbA1C (measure of severity of diabetes)

• Gallbladder disease: higher risk with longer treatment (>26 weeks) or substantial and rapid weight loss

• Allergic Reaction: anaphylaxis or angioedema possible

• Medullary thyroid carcinoma: noted in animal studies. Patients with a personal or family

  history of thyroid cancer or multiple endocrine neoplasia syndrome may be at increased

  risk

• Pancreatitis: Small overall risk. Increased risk with prior history of pancreatitis, or have

  other risk factors for pancreatitis, including: high lipids, cholelithiasis, alcohol use, and obesity

How can I maintain the weight I lose after discontinuing the medication?

• This medication provides the jump start needed for healthy living

• While maintaining the weight loss is not guaranteed, we work to develop sustainable,

  individualized health plans that we hope will develop into long-term habits

Willow C.