From the Guidelines
Semaglutide should not be administered intramuscularly (IM) as it is specifically designed and approved for subcutaneous (SC) injection only. When semaglutide is incorrectly injected IM instead of SC, several potential issues may occur. The medication could be absorbed more rapidly from muscle tissue than intended, potentially altering its pharmacokinetic profile and leading to faster onset but possibly shorter duration of action. This altered absorption rate might increase the risk of side effects such as nausea, vomiting, or hypoglycemia due to higher peak concentrations, as noted in the context of insulin injection techniques 1. Additionally, IM injection may cause more pain, tissue damage, or inflammation at the injection site compared to the proper SC route. The efficacy of the medication might also be compromised as semaglutide's clinical trials and dosing recommendations were based on SC administration. Some key points to consider when administering semaglutide include:
- Injecting into subcutaneous tissue of the abdomen, thigh, or upper arm using the appropriate injection device
- Following the specific instructions provided with the medication to avoid incorrect administration
- Being aware of the potential for lipohypertrophy, an accumulation of subcutaneous fat in response to repeated injections, which can contribute to erratic drug absorption and increased glycemic variability, as discussed in the context of insulin injection 1. If an IM injection occurs accidentally, it is crucial to monitor for increased side effects and contact a healthcare provider. Proper injection technique is essential to optimize the safety and efficacy of semaglutide, and healthcare providers should educate patients on the correct method of administration to minimize risks and ensure the best possible outcomes.
From the Research
Administration of Semaglutide
- Semaglutide is typically administered subcutaneously (SC) for the treatment of type 2 diabetes 2, 3, 4.
- There is no direct evidence in the provided studies regarding the effects of administering semaglutide intramuscularly (IM) instead of subcutaneously (SC).
Pharmacokinetics and Pharmacodynamics
- The studies provided focus on the efficacy and safety of oral and subcutaneous semaglutide, with no mention of intramuscular administration 2, 3, 5, 4.
- The pharmacokinetics and pharmacodynamics of semaglutide may be affected by the route of administration, but this is not explored in the provided studies.
Safety Considerations
- The safety profile of subcutaneous semaglutide has been extensively studied, with common adverse events including gastrointestinal disturbances, injection-site reactions, and increased risk of biliary disease 3, 4.
- There is no evidence in the provided studies to suggest that intramuscular administration of semaglutide would have a different safety profile than subcutaneous administration.
Efficacy
- The efficacy of semaglutide in improving glycemic control and promoting weight loss has been demonstrated in numerous studies, but these studies have used subcutaneous or oral administration 2, 5, 4.
- It is unclear whether intramuscular administration of semaglutide would have a similar efficacy profile to subcutaneous administration.
Case Reports
- A case report of acute pancreatitis in a patient taking subcutaneous semaglutide highlights the potential for rare adverse events with GLP-1 RA use, but does not provide information on intramuscular administration 6.