What is the maximum allowable interval between semaglutide injections?

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Maksimaalne lubatud vahe semaglutidi süstete vahel

Semaglutidi süstete vaheline maksimaalne lubatud vahe on umbes 2 nädalat (14 päeva), kuid ravimi efektiivsuse säilitamiseks tuleks püüda manustada järgmine annus võimalikult kiiresti pärast unustatud annuse meenutamist. 1

Farmakokineetiline põhjendus

Semaglutidi pikk poolväärtusaeg on ligikaudu 1 nädal, mis tähendab, et ravim püsib vereringes umbes 5 nädalat pärast viimast annust 1. See pikk poolväärtusaeg tuleneb:

  • Ulatuslikust seondumisest plasmavalkudega (>99% albumiiniga)
  • Aeglasest kliirensist (umbes 0,05 L/h)
  • Stabiilsusest DPP-4 ensüümi lagunemise suhtes

Püsiseisund saavutatakse 4-5 nädala jooksul kord nädalas manustamisel 1.

Praktilised soovitused annuse vahele jätmisel

Kuigi ravim püsib vereringes kuni 5 nädalat, ei tähenda see, et ravi võib katkestada pikemaks ajaks:

  • Kui annus jäetakse vahele: Manustada võimalikult kiiresti, kui meenutamine toimub 5 päeva jooksul
  • Kui möödunud >5 päeva: Jätta vahele jäänud annus vahele ja jätkata tavapärase graafikuga
  • Maksimaalne vahe: Kuigi farmakokineetiliselt püsib ravim veres kuni 5 nädalat, ei tohiks süstete vaheline aeg ületada 2 nädalat, et säilitada terapeutiline efekt ja vältida glükeemilise kontrolli halvenemist

Oluline hoiatus

Pikemad katkestused (>2 nädalat) võivad nõuda annuse uuesti tiitrimist alates madalamast annusest, et vältida seedetrakti kõrvaltoimeid (iiveldus, oksendamine, kõhulahtisus), mis on semaglutidi kõige sagedasemad kõrvaltoimed 2, 3.

Kliinilistes uuringutes kasutati standardset kord nädalas manustamise skeemi, ja püsiseisundi saavutamine ning terapeutiline efekt sõltuvad regulaarsest manustamisest 4, 5.

References

4
Research

Once-Weekly Semaglutide in Adults with Overweight or Obesity.

The New England journal of medicine, 2021

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