What is microdosing semaglutide (Glucagon-like peptide-1 (GLP-1) receptor agonist)?

From the Guidelines

Microdosing semaglutide is not a recommended or FDA-approved approach, as it lacks robust clinical evidence and may carry risks such as unpredictable results, improper dosing, and potential medication contamination. When considering the use of semaglutide, it is essential to prioritize the most recent and highest quality studies, such as the STEP trials 1, which demonstrated the efficacy of semaglutide in weight loss and improving weight-related comorbidities. The standard dosing of semaglutide, which starts at 0.25mg weekly and gradually increases, has been shown to be effective in reducing weight and improving weight-related comorbidities, as well as decreasing the risk of cardiovascular disease events 1. Some key points to consider when evaluating the use of semaglutide include:

• The biological mechanism of semaglutide, which mimics the GLP-1 hormone to slow gastric emptying, increase satiety, and improve insulin sensitivity 1
• The potential benefits of semaglutide, including significant weight loss and improvement in weight-related comorbidities, as well as a decreased risk of cardiovascular disease events 1
• The potential risks and limitations of microdosing semaglutide, including unpredictable results, improper dosing, and potential medication contamination when splitting doses
• The importance of long-term use of semaglutide, as demonstrated by the STEP trials, which showed significant weight regain after cessation of treatment 1. Overall, while microdosing semaglutide may be considered by some, the lack of robust clinical evidence and potential risks associated with this approach make it a less desirable option compared to standard dosing regimens.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Microdosing Semaglutide

• Microdosing semaglutide refers to the practice of taking very small doses of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, which is typically used to treat type 2 diabetes and obesity 2, 3, 4, 5, 6.
• Semaglutide is a medication that mimics the action of the hormone GLP-1, which helps to regulate blood sugar levels and appetite 3, 6.
• The typical dose of semaglutide for weight management is 2.4 mg once weekly, but microdosing involves taking much smaller doses, often in the range of 0.1-0.5 mg per week 5.

Efficacy and Safety

• Studies have shown that semaglutide is effective in reducing body weight and improving glycemic control in patients with type 2 diabetes and obesity 2, 3, 5, 6.
• The safety profile of semaglutide is generally similar to that of other GLP-1 receptor agonists, with common adverse events including gastrointestinal symptoms such as nausea and vomiting 3, 4, 5, 6.
• Microdosing semaglutide may have a more favorable safety profile compared to higher doses, as it may reduce the risk of adverse events such as gastrointestinal symptoms and hypoglycemia 4, 6.

Clinical Trials

• The STEP program, a series of clinical trials, investigated the efficacy and safety of semaglutide for weight management in adults with overweight or obesity 5.
• The PIONEER program, another series of clinical trials, compared the efficacy and safety of oral semaglutide with other oral antihyperglycemic agents and placebo in patients with type 2 diabetes 6.
• These trials demonstrated that semaglutide is effective in reducing body weight and improving glycemic control, with a safety profile consistent with other GLP-1 receptor agonists 2, 3, 5, 6.