What patient education is necessary when initiating Wegovy (semaglutide) therapy?

Patient Education for Starting Wegovy (Semaglutide)

When initiating Wegovy (semaglutide) therapy, patients should receive comprehensive education about proper injection technique, potential side effects, and monitoring requirements to ensure optimal outcomes and reduce complications.

Injection Technique and Administration

• Instruct patients to follow the same recommendations used for insulin injections regarding needle length, site selection, and rotation schemes 1
• Teach patients to rotate injection sites systematically to prevent lipodystrophy (tissue swelling/nodules), which can affect medication absorption 1
• Although the risk of lipohypertrophy is considerably less with GLP-1 receptor agonists compared to insulin, palpable injection site subcutaneous nodules have been reported with semaglutide 1
• Demonstrate proper injection technique, including checking for air bubbles and proper disposal of needles in certified waste receptacles 1
• Advise patients to never share their Wegovy pen with another person, even if the needle is changed, due to risk of blood-borne pathogen transmission 2

Common Side Effects and Management

• Inform patients that transient nausea and vomiting are relatively common side effects that typically improve over time 1
• Advise that nausea can be minimized by:
  • Starting with the lowest dose
  • Up-titrating gradually (following prescribed schedule)
  • Eating smaller portions 1
• Explain that gastrointestinal symptoms are usually self-limited with longer-acting GLP-1 receptor agonists like semaglutide 1
• Warn patients about potential constipation, diarrhea, and abdominal pain as common side effects 2

Serious Side Effects Requiring Medical Attention

• Instruct patients to discontinue Wegovy and contact their healthcare provider immediately if they experience:
  • Severe abdominal pain that may radiate to the back (with or without vomiting) as this could indicate pancreatitis 2
  • Symptoms of thyroid tumors (lump in the neck, hoarseness, difficulty swallowing, or shortness of breath) 2
  • Changes in vision 2
  • Signs of hypersensitivity reactions 2
• Advise patients about the risk of dehydration due to gastrointestinal side effects and the importance of adequate fluid intake to prevent kidney problems 2

Hypoglycemia Risk and Management

• Explain that while Wegovy alone is unlikely to cause hypoglycemia, the risk increases when used with insulin or insulin secretagogues like sulfonylureas 2
• Teach patients to recognize signs and symptoms of hypoglycemia, including:
  • Dizziness, light-headedness, blurred vision
  • Anxiety, irritability, mood changes
  • Sweating, shakiness, weakness
  • Confusion, drowsiness, slurred speech
  • Hunger, headache, fast heartbeat 2
• Instruct patients on appropriate management of hypoglycemic episodes if they are also taking medications that increase hypoglycemia risk 2

Expected Benefits and Outcomes

• Discuss realistic expectations regarding weight loss (approximately 15% of initial weight at 68 weeks) 3
• Explain cardiovascular benefits, including reduced risk of major adverse cardiovascular events in patients with overweight or obesity 4
• Inform patients about improvements in cardiometabolic risk factors and physical functioning that may occur with treatment 3

Missed Doses

• Instruct patients that if a dose is missed, it should be administered as soon as possible within 5 days after the missed dose 2
• If more than 5 days have passed, the missed dose should be skipped and the next dose administered on the regularly scheduled day 2
• Emphasize the importance of resuming the regular once-weekly dosing schedule 2

Pregnancy and Contraception

• Advise women of childbearing potential about the potential risk to a fetus 2
• Instruct women to inform their healthcare provider if they are pregnant or intend to become pregnant 2
• Emphasize the need for effective contraception during treatment 1

Follow-up and Monitoring

• Explain the importance of regular follow-up appointments to monitor response to therapy and adjust treatment as needed
• Encourage patients to maintain a log of any side effects experienced for discussion at follow-up visits 1
• Emphasize the importance of continuing lifestyle modifications (diet and physical activity) alongside medication therapy 1

By providing thorough education on these aspects of Wegovy therapy, healthcare providers can help patients achieve optimal outcomes while minimizing adverse effects and complications.