From the Guidelines
Semaglutide is not recommended for intramuscular (IM) injection as this medication is only approved for subcutaneous (SC) or oral administration depending on the formulation. The recommended protocol for administering semaglutide via subcutaneous injection involves starting with 0.25 mg once weekly for 4 weeks as an initial dose, then increasing to 0.5 mg once weekly, and further increasing to 1.0 mg and 1.7 mg weekly every 4 weeks at each dose, until the maintenance dose of 2.4 mg is reached after 16 weeks, as outlined in the study by 1.
Key Administration Details
- The injection should be administered in the abdomen, thigh, or upper arm using a prefilled pen device.
- Patients should rotate injection sites to prevent lipohypertrophy.
- The medication should be stored in the refrigerator before first use and can be kept at room temperature for up to 28 days after opening.
Mechanism of Action and Side Effects
- Semaglutide works by mimicking the incretin hormone GLP-1, which stimulates insulin secretion, suppresses glucagon release, slows gastric emptying, and reduces appetite, as supported by the guidelines outlined in 1.
- Common side effects include nausea, vomiting, diarrhea, and abdominal pain, which typically improve over time as the body adjusts to the medication.
Dosing Adjustments
- Clinical judgment is recommended for adjusting the titration schedule as needed for an individual patient’s response, tolerance, and adverse effects, with considerations for dose adjustments or restarting the titration schedule if doses are missed, as recommended by 1.
From the Research
Protocol for Semaglutide Administration
The recommended protocol for administering semaglutide via injection is typically subcutaneous, not intramuscular. Here are the key points to consider:
- Subcutaneous Injection: Semaglutide is usually administered via subcutaneous injection, once weekly, at a dose of 2.4 mg 2, 3.
- Dose Escalation: The dose may be escalated over a period of weeks to minimize gastrointestinal side effects 3, 4.
- Administration Route: There is no evidence to support the use of intramuscular injection for semaglutide administration. Subcutaneous injection is the recommended route of administration 2, 3, 5, 4, 6.
- Comparison with Other GLP-1 RAs: Semaglutide has been compared with other GLP-1 receptor agonists, such as liraglutide, and has been shown to be effective in reducing HbA1c and body weight 3, 5, 6.
Key Considerations
Some key considerations when administering semaglutide include:
- Gastrointestinal Side Effects: Semaglutide may cause gastrointestinal side effects, such as nausea, diarrhea, and vomiting 3, 5, 4, 6.
- Dose Titration: The dose of semaglutide may need to be titrated to minimize side effects and optimize efficacy 3, 4.
- Monitoring: Patients receiving semaglutide should be monitored for changes in HbA1c, body weight, and other relevant clinical parameters 2, 3, 5, 4, 6.