Adverse Reactions, Contraindications & Warnings: Semaglutide
Semaglutide sodium belongs to a class of drugs known as GLP-1 Agonists. Ozempic, Wegovy and Rybelsus are examples of Semaglutide GLP-1 agonists.
Adverse Reactions
The most common adverse reactions, reported in ≥5% of patients treated with Semaglutide are nausea, vomiting, diarrhea, abdominal pain, and constipation. It is very important that you hydrate with water or electrolyte enhanced water daily. Following the prescribed dosing and increasing dosage every 4 weeks may reduce these adverse side effects.
Contraindications
- Semaglutide is contraindicated in patients with a personal or family history of MTC (medullary thyroid cancer) or in patients with MEN 2 (multiple endocrine neoplasia Type 2), and in patients with a hypersensitivity reaction to semaglutide sodium. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with semaglutide.
- History of diabetic retinopathy. In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
- Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting).
Warnings and Precautions
- Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
- Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic® promptly, and if pancreatitis is confirmed, do not restart.
- Hypoglycemia: Patients receiving Semaglutide in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform your physician or primary care provider that you are taking Semaglutide for weight loss should they prescribe any medications for diabetes.
- Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration.It is very important that you stay hydrated while on this medication, especially if you have any gastrointestinal side effects or voluminous diarrhea.
- Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Semaglutide. If hypersensitivity reactions occur, discontinue use of Semaglutide.
- Acute Gallbladder Disease: Acute events of gallbladder disease such as cholelithiasis (gallstones) or cholecystitis (gallbladder inflammation) have been reported in GLP-1 receptor agonist trials and postmarketing. In placebo-controlled trials, cholelithiasis was reported in 1.5% and 0.4% of patients treated with Semaglutide 0.5 mg and 1 mg, respectively, and not reported in placebo-treated patients. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.
