From the Guidelines
Semaglutide should be initiated at a dose of 0.25 mg once weekly by subcutaneous injection for 4 weeks, then increased to 0.5 mg once weekly, and further increased to 1 mg weekly if additional glycemic control is needed for type 2 diabetes, or to 2.4 mg weekly for weight management, as supported by the most recent evidence 1. The medication works by mimicking the incretin hormone GLP-1, which increases insulin secretion, decreases glucagon secretion, slows gastric emptying, and increases satiety. Some key points to consider when prescribing semaglutide include:
- Gradual dose titration to minimize gastrointestinal side effects, as recommended in the 2022 clinical practice guideline on pharmacological interventions for adults with obesity 1
- Contraindications, such as a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, as noted in the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes 1
- Potential complications, such as pancreatitis, hypoglycemia (especially if used with insulin or sulfonylureas), and diabetic retinopathy complications, as reported in the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes 1
- The importance of long-term use, as suggested by the results of the STEP trials, which showed significant weight regain after cessation of semaglutide treatment 1
- The benefits of semaglutide in reducing the risk of cardiovascular events, as demonstrated in the SELECT study, which showed a lower composite incidence of death due to cardiovascular events, nonfatal myocardial infarction, or nonfatal stroke at 39.8 months 1
From the FDA Drug Label
The dose of WEGOVY is 2.4 mg administered once weekly via subcutaneous injection in the abdomen, thigh, or upper arm WEGOVY should be administered once weekly, on the same day each week, at any time of day, with or without food
The recommended usage and dosage of Semaglutide for patients with type 2 diabetes or requiring weight loss is 2.4 mg administered once weekly via subcutaneous injection in the abdomen, thigh, or upper arm.
- Key administration considerations:
- Administer once weekly, on the same day each week
- Can be administered at any time of day
- Can be administered with or without food 2
From the Research
Recommended Usage and Dosage of Semaglutide
- Semaglutide is a GLP-1 receptor agonist used for the treatment of type 2 diabetes and weight loss 3, 4.
- The recommended dosage of semaglutide is 0.5 mg or 1.0 mg once weekly, administered via subcutaneous injection 4.
- A higher dose of 2.0 mg once weekly has been shown to be effective in reducing HbA1c and body weight in patients with type 2 diabetes 5.
- Semaglutide can be used in combination with other glucose-lowering agents, including metformin and sulfonylurea 3, 5.
Efficacy and Safety of Semaglutide
- Semaglutide has been shown to be effective in reducing HbA1c, body weight, and cardiovascular risk in patients with type 2 diabetes 3, 4, 5.
- The most common adverse events associated with semaglutide are gastrointestinal disorders, such as nausea and diarrhea 4, 5.
- Semaglutide has also been shown to be effective in reducing body weight and improving glycemic metrics in patients with type 1 diabetes who are overweight or obese 6.
- In patients without diabetes, semaglutide has been shown to be effective in achieving sustained weight loss, with a substantial decrease in relative and absolute body weight 7.
Special Considerations
- Semaglutide should be used with caution in patients with a history of pancreatitis or thyroid cancer 3, 4.
- Patients with renal impairment should be monitored closely while taking semaglutide, as it may increase the risk of acute kidney injury 3.
- Semaglutide is not recommended for use in patients with type 1 diabetes who are not overweight or obese, as its efficacy and safety in this population have not been established 6.