What happens to semaglutide (glucagon-like peptide-1 receptor agonist) at room temperature?

Stability of Semaglutide at Room Temperature

Semaglutide should be refrigerated at 2-8°C (36-46°F) for optimal stability and efficacy, as exposure to room temperature can lead to degradation of the medication, potentially reducing its effectiveness and increasing risk of treatment failure. 1

Storage Requirements and Degradation Process

When semaglutide is exposed to room temperature:

• Chemical stability decreases: As a peptide-based GLP-1 receptor agonist, semaglutide is susceptible to molecular degradation when not properly refrigerated 1
• Potency reduction: The active pharmaceutical ingredient may lose potency, potentially affecting glycemic control and weight management outcomes
• Structural changes: The modified peptide structure that gives semaglutide its extended half-life (approximately 7 days) can be compromised 2

Specific Storage Guidelines

1. Primary storage: Keep semaglutide refrigerated at 2-8°C (36-46°F)
2. Room temperature exposure limits:
   • Unopened pens: Can be stored at temperatures up to 30°C (86°F) for up to 8 weeks
   • After first use: Should be stored at room temperature for no more than 56 days
   • Avoid exposure to direct heat or sunlight

Clinical Implications of Improper Storage

Improperly stored semaglutide may result in:

• Reduced efficacy: Diminished glycemic control and weight loss effects
• Treatment failure: Patients may not achieve the expected 10-15% total body weight loss or 1.5-1.9% HbA1c reduction 1, 2
• Increased risk of adverse events: Unpredictable drug concentration may alter side effect profile

Monitoring for Degradation

Unfortunately, there are no visible indicators of semaglutide degradation. Patients should:

• Track exposure time: Note when medication was removed from refrigeration
• Observe solution: While not definitive, check that solution remains clear and colorless
• Monitor clinical response: Unexplained reduction in efficacy may suggest degradation

Patient Education Points

• Temperature tracking: Advise patients to track time out of refrigeration
• Travel considerations: Use cooler bags with ice packs when traveling
• Disposal: Properly discard medication that has exceeded temperature exposure limits
• Never freeze: Freezing can damage the peptide structure and delivery device

Special Considerations

• Gastrointestinal side effects: Proper storage helps maintain consistent drug delivery, which may help manage common side effects like nausea and vomiting 1
• Cardiovascular benefits: Maintaining proper storage ensures patients receive the full cardiovascular protective effects demonstrated in clinical trials 1, 3

Proper storage of semaglutide is essential for maintaining its molecular integrity and therapeutic efficacy. Patients should be educated about these storage requirements to ensure optimal treatment outcomes and minimize risks associated with medication degradation.