Clinical Quick Reference Monthly / Winter '24-'25 / Ozempic® – A Glucagon-like Peptide-1 Agonist
THE SEMAGLUTIDE EDIT
This edition will cover fundamental aspects related to the prescription use of semaglutide, known by the brand name, Ozempic (Novo-Nordisk). Novo-Nordisk also manufactures semaglutide under the brand names Wegovy®and Rybelsus.®
Ozempic ® is also known by the generic name semaglutide. Semaglutide is an injectable medication that is offered in strengths of 0.5 mg, 1 mg, or 2 mg. This prescription drug is most commonly used with diet and exercise strategies to improve blood sugar in adult patients who have been diagnosed with T2D.
Semaglutide has additionally been found to help reduce their risk of major cardiovascular events. In T2D patients with known heart disease, this incretin mimetic medication has been shown to reduce the risk of heart attack and stroke.
What Type of Medication is Semaglutide?
Semaglutide, or Ozempic®, is a prescription drug that is similar to a hormone that occurs naturally in the human body. This hormone helps control blood sugar, digestion and insulin levels.
Semaglutide is part of a class of medications referred to as glucagon-like peptide-1 (GLP-1) agonists (incretin mimetics).
These type of drugs work by binding to GLP-1 receptors, thereby stimulating release of insulin from the pancreas.
Some of the other GLP-1 agonists include:
Liraglutide
Lixisenatide
When Was Ozempic® Approved?
Ozempic® was approved for type 2 diabetes by the U.S. Food and Drug Administration (FDA) in December 2017.
Ozempic is not recommended for weight loss, but some people use it for that purpose.
However, the FDA did approve semaglutide for weight loss, under the brand name Wegovy. That version was intended for adults with a body mass index (BMI) of 27 or higher. The U.S. Food and Drug Administration approved the Wegovy (semaglutide) injection (dose of 2.4 mg once weekly) specifically for chronic weight management in adults with obesity /or overweight and at least one weight-related condition (e.g.: high blood pressure, type 2 diabetes, or high cholesterol) in 2021.
Rybelsus is an oral form of semaglutide. This medication is not approved by the U.S. Food and Drug Administration (FDA) for chronic weight management.
Semaglutide Precautions
Healthcare professionals should be careful not to confuse Ozempic®, or semglutide, with insulin.
Semaglutide works to help the pancreas release insulin. This medication also helps to prevent the patient’s liver from making and releasing sugar. Semaglutide slows movement of food through the stomach, an effect which may aid in weight loss.
Semaglutide Side Effects
Providers should be aware that as with any other medication, benefits associated with semaglutide come with risks and the potential for side effects.
Healthcare professionals should provide patients with appropriate education regarding the benefits and risks.
In rare cases these medications have been associated with serious side effects.
Serious side effects associated with semaglutide include:
allergic reaction
diabetic retinopathy
gallstones
hypoglycemia
increased risk of thyroid cancer
kidney issues
pancreatitis (*see special note below)
Research indicates that semaglutide (Ozempic®) is effective at controlling blood glucose with a low risk of hypoglycemia. Patients that are overweight or obese generally lose some weight while using the drugs. On average the weight loss is about 6.5 pounds, or 3 kg. While most patients will only experience minimal side effects (health teach patients about the gastrointestinal effects of semaglutide: abdominal cramps, diarrhea, and nausea); it is crucial that healthcare providers discuss and review the potential for more serious effects.
Pancreatitis is the swelling of the pancreas. This can cause severe pain in the upper abdomen. Pancreatitis may be acute (sudden) or chronic (ongoing).
Symptoms of pancreatitis:
Pain: Severe pain in the upper abdomen that may spread to the back or chest. Pain may be worse after eating or drinking, or when lying down.
Nausea and vomiting: upset stomach, urge to throw up
Swelling and tenderness: upper abdomen may feel swollen or painful
Fever: fever or chills
Rapid heart rate: heart may beat faster than normal
Lower blood pressure: blood pressure may be lower than usual
Jaundice: the skin or whites of the eyes may appear yellow
Other symptoms:
diarrhea,
bloating,
indigestion,
weight loss,
clay-colored stools.
Patients should seek immediate medical asistance if they experience symptoms of pancreatitis. Pancreatitis left untreated can be fatal.
P.S.:
Mounjaro (tirzepatide) is intended for type 2 diabetes to lower blood sugar levels . It may be helpful for weight loss. Mounjaro is a medication that can help with weight loss by mimicking hormones that regulate appetite and blood sugar. It is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist that is FDA-approved for long-term use in patients with diabetes.
Medical Terminology
Incretins - group of metabolic hormones that stimulate a decrease in blood glucose levels
Insulin - a peptide hormone produced by beta cells of the pancreatic islets; regulates metabolism of carbohydrates, fats and protein by promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cell
GLP-1 - a 30- or 31-amino-acid-long peptide hormone
T2D - form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin
Anatomy & Physiology
