Home Drug Guide Semaglutide

Drug Guide

Generic Name

Semaglutide

Brand Names Ozempic, Rybelsus, Wegovy

Classification

Therapeutic: Antidiabetic agent, Obesity agent

Pharmacological: GLP-1 receptor agonist

FDA Approved Indications

  • Type 2 diabetes mellitus (Ozempic, Rybelsus)
  • Chronic weight management in obesity or overweight with comorbidities (Wegovy)

Mechanism of Action

Semaglutide mimics the GLP-1 hormone, enhancing glucose-dependent insulin secretion, suppressing inappropriate glucagon secretion, slowing gastric emptying, and reducing appetite, which leads to improved glycemic control and weight loss.

Dosage and Administration

Adult: Ozempic: 0.5 mg once weekly, may increase to 1 mg weekly; Rybelsus: 3 mg daily for 30 days, then increase to 7 mg daily, up to 14 mg; Wegovy: 2.5 mg weekly, titrating up to 2.4 mg weekly.

Pediatric: Not approved for pediatric use.

Geriatric: Adjustments not typically necessary but monitor for renal impairment.

Renal Impairment: Use with caution; dosage adjustments may be required.

Hepatic Impairment: No specific adjustments recommended.

Pharmacokinetics

Absorption: Moderate oral bioavailability, greater absorption with higher doses.

Distribution: Bound to plasma proteins.

Metabolism: Metabolized via proteolytic cleavage, not via CYP enzymes.

Excretion: Excreted mainly via urine and feces.

Half Life: Approximately 1 week, allowing once-weekly dosing.

Contraindications

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple endocrine neoplasia syndrome type 2

Precautions

  • History of pancreatitis, gallbladder disease, or severe gastrointestinal disease; monitor for signs of pancreatitis and renal impairment; caution in patients with diabetic retinopathy; pregnancy and lactation should be avoided or used with caution.

Adverse Reactions - Common

  • Nausea (High)
  • Vomiting (Moderate)
  • Diarrhea (Moderate)
  • Abdominal pain (Moderate)

Adverse Reactions - Serious

  • Pancreatitis (Rare)
  • Hypoglycemia (particularly when used with insulin or sulfonylureas) (Rare)
  • Thyroid C-cell tumors (observed in rodents) (Preclinical evidence, human risk unknown)

Drug-Drug Interactions

  • Insulin, sulfonylureas (increase hypoglycemia risk)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, HbA1c, weight, and renal function.

Diagnoses:

  • Risk for hypoglycemia
  • Imbalanced nutrition: less than body requirements

Implementation: Administer as prescribed, advise on dietary and lifestyle changes, monitor for adverse effects.

Evaluation: Assess glycemic control, weight changes, and side effects.

Patient/Family Teaching

  • Use weekly injections or daily tablets as directed.
  • Report severe nausea, vomiting, or signs of pancreatitis.
  • Maintain follow-up appointments for monitoring.
  • Adjust diet and exercise as per healthcare provider’s advice.

Special Considerations

Black Box Warnings:

  • Thyroid C-cell tumors (including MTC)

Genetic Factors: Risks may vary based on genetic predisposition, especially regarding thyroid tumors.

Lab Test Interference: May affect certain lab tests, such as pancreatic enzymes.

Overdose Management

Signs/Symptoms: Severe nausea, vomiting, hypoglycemia, signs of pancreatitis.

Treatment: Supportive care, activated charcoal if ingestion was recent, monitor vital signs, and provide glucose or insulin as needed.

Storage and Handling

Storage: Store in a refrigerator (2°C to 8°C). Protect from light and heat; do not freeze.

Stability: Stable until the expiration date printed on the packaging when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.