From the Guidelines
Semaglutide remains in the body for approximately 5-7 days when administered as a once-weekly injection and about 1 day for the daily oral form. The extended half-life of the injectable form is why it's dosed weekly rather than daily like many other medications. The long duration results from semaglutide's molecular structure, which includes modifications that protect it from rapid breakdown and allow it to bind to albumin (a protein in blood), slowing its elimination from the body 1. This prolonged presence enables consistent blood levels of the medication throughout the week, providing continuous effects on blood sugar control and appetite regulation. The extended duration also improves treatment adherence since patients only need to remember a weekly injection rather than daily dosing. If a dose is missed, patients should take it as soon as they remember if within 5 days of the scheduled dose; otherwise, they should skip the missed dose and resume their regular schedule. Key points to consider when prescribing semaglutide include:
- Its once-weekly dosing regimen for the injectable form
- Its daily dosing regimen for the oral form
- The importance of consistent dosing to maintain therapeutic effects
- The potential for improved treatment adherence due to the extended duration of action
- The need for patients to understand the proper procedure for handling missed doses. It's also important to note that semaglutide has been shown to have cardiovascular benefits, as demonstrated in the SUSTAIN-6 trial, where it reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes 1.
From the FDA Drug Label
With an elimination half-life of approximately 1 week, semaglutide will be present in the circulation for about 5 weeks after the last dose.
The semaglutide stays in the body for approximately 5 weeks after the last dose 2.
From the Research
Semaglutide Pharmacokinetics
- Semaglutide has a half-life of 7 days, allowing for once-weekly subcutaneous administration 3
- It reaches steady state in 4-5 weeks 3
- The pharmacokinetic parameters of semaglutide include area under the curve plasma concentrations (AUC), maximal plasma concentration (Cmax), time to Cmax, half-life (t1/2), and clearance 4
- Food and various dosing conditions can affect the oral semaglutide exposure, but there are limited drug-drug interactions and no dosing adjustments are needed in patients with upper gastrointestinal disease, renal impairment, or hepatic impairment 4
Duration of Action
- Semaglutide stays in the body for approximately 4-5 weeks to reach steady state, with a half-life of 7 days 3
- The long half-life of semaglutide allows for once-weekly dosing, making it a convenient treatment option for patients with type 2 diabetes 3, 4
Clinical Implications
- Semaglutide has been shown to reduce cardiovascular risk factors, including blood pressure and lipid profile, in patients with type 2 diabetes 5
- It has also been found to produce a 1.5-1.9% glycosylated hemoglobin A1c reduction and a 5-10% weight reduction from baseline in clinical efficacy studies 3