Introduction
Semaglutide has been making waves in the market for its efficacy in treating type 2 diabetes and obesity.
From regular people to celebrities, it has become a buzzword because of its positive impact on weight management.
Danish pharmaceutical company Novo Nordisk developed semaglutide in 2012. It then received FDA approval between 2017 and 2021 for its three different brands: Ozempic, Wegovy, and Rybelsus.
Ozempic and Rybelsus both treat type 2 diabetes but are in different formats. Wegovy, meanwhile, is used to treat obesity. Both Ozempic and Wegovy come in pre-filled disposable injection pen formats, whereas Rybelsus is in pill format.
No matter how popular a drug is, it is always best to read about its contraindications and potential side effects. This holds true especially if you have underlying conditions or co-morbidities.
Read on as we share a comprehensive guide on semaglutide’s overall safety.
Mechanism of action
Semaglutide’s efficacy lies in its chemical composition. Several studies have investigated its positive benefits on other conditions apart from type 2 diabetes and obesity.
In pharmacology, “mechanism of action” refers to the biochemical process by which a substance creates an effect in the body. Pharmacology is the study of the properties and effects of drugs and chemicals,
Semaglutide is classified as a GLP-1 receptor agonist, a type of drug that mimics the behavior of gut-based hormone GLP-1. When blood sugar levels are elevated after eating, semaglutide triggers the pancreas to release the hormone insulin. Insulin, in turn, helps decrease the amount of glucose in the blood.
Other effects of semaglutide include slowing down digestion and helping patients feel fuller for longer.
People taking the medicine experience a decrease in appetite and as a result of eating less, lose weight.
Safety and efficacy
How safe is semaglutide? Let’s look at its safety profile, which refers to a summary of its overall safety, potential risks, and side effects.
As safety and efficacy are closely intertwined topics, most research on semaglutide’s safety typically also examines its efficacy as well. The following are some examples.
Ozempic and Wegovy (subcutaneous semaglutide)
On type 2 diabetes
Another study published in the Journal of Pharmaceutical Technology examined semagltutide’s effectiveness and safety in treating type 2 diabetes. A number of the participants took semaglutide, while others took other diabetes medications.
The study’s findings showed that semaglutide reduced blood sugar levels more successfully than other diabetes drugs.
On obesity
A study in Cureus looked at the efficacy of once-weekly semaglutide (Ozempic or Wegovy) in treating people who were overweight. The researchers discovered that 40 percent of participants lost at least 15 percent of their body weight over 68 weeks. These were the people who received semaglutide once weekly. Those in the placebo group, meanwhile, lost significantly less weight.
On cardiovascular problems
Apart from type 2 diabetes, Ozempic also helps reduce the risk of developing cardiovascular problems like heart attack or stroke.
Wegovy, meanwhile, has been found to heart disease markers, from high cholesterol to high blood sugar levels, and hypertension.
In varying dosages
A 2023 study examined subcutaneous semaglutide’s efficacy and safety if with varying dosages and with and without lifestyle interventions. Subcutaneous means to be injected under the skin.
Participants without lifestyle interventions had a higher incidence of hypoglycemia than in the group with lifestyle interventions. Semaglutide injections also had notable benefits on weight loss as well as on heart health.
Rybelsus (oral semaglutide)
On blood sugar levels
A 26-week study found that oral semaglutide (Rybelsus) effectively lowered blood sugar levels in adults suffering from type 2 diabetes. Participants experienced a 1.2 to 1.4% reduction in their HbA1c levels whereas those on placebo lost 0.3%.
At higher doses
A study investigated the efficacy and safety of oral semaglutide at 7 mg and 14 mg doses. Participants on 7 mg and 14 mg oral semaglutide reduced their HbA1c levels by 1.06% and 1.10% respectively.
Similarly, another study looked at once-daily oral semaglutide’s efficacy and safety in higher doses over 68 weeks.
25 mg and 50 mg proved to be more effective in lowering blood sugar levels and reducing weight. However, researchers recorded more side effects on 25 mg and 50 mg versus those on only 25 mg of semaglutide. The adverse effects were mainly gastrointestinal disorders, most of which were mild to moderate.
Side effects
The most common adverse effects of semaglutide taken via injection include gastrointestinal issues such as diarrhea, constipation, or abdominal pain.
Semaglutide’s more serious side effects include allergic reactions, hypoglycemia, pancreatitis, kidney problems, and thyroid c-cell tumors.
Allergic reactions
Serious allergic reactions to semaglutide administered subcutaneously are rare. Consult your physician immediately should you develop any side effects. This includes itching or swelling of the face, tongue, or throat; rashes; extreme dizziness; or difficulty breathing.
Hypoglycemia (low blood sugar)
When used in conjunction with other anti-diabetic medicines, semaglutide can potentially trigger hypoglycemia. It’s a condition wherein the blood sugar is lower than normal.
Hypoglycemia can cause shaking, sweating, dizziness, difficulty concentrating, quickening of the heart rate, and feelings of extreme hunger.
Pancreatitis
One of the less common but serious potential side effects is acute pancreatitis. It’s a condition characterized by the inflammation of the pancreas over a short period.
Kidney problems
A 2021 study reported there had been cases of acute kidney injury in chronic kidney disease (CKD) patients taking semaglutide. Researchers speculated that the weight loss caused by semaglutide may have contributed to the patient’s decline in kidney function.
Thyroid c-cell tumors
In a study involving lab rats, researchers discovered that these developed thyroid tumors or medullary thyroid carcinoma after receiving semaglutide. Despite these results, it is still unknown whether semaglutide may also potentially cause the same in humans.
Semaglutide safety vs. other GLP-1 agonists
While semaglutide and its fellow GLP-1 Ras exenatide and liraglutide generally have comparable safety profiles, there are also key differences.
The three medications share gastrointestinal issues like vomiting, nausea, diarrhea, and abdominal pain and a low risk of causing hypoglycemia. On the other hand, semaglutide was found to be more effective in promoting weight loss. Studies also suggest that it has a positive impact on cardiovascular health.
Who should avoid semaglutide injections?
If you are considering taking semaglutide, it’s important to understand whether or not you are eligible for it. In light of semaglutide’s common side effects, people with the following conditions or medical histories should avoid semaglutide altogether.
1. Pregnant or planning to get pregnant
Taking semaglutide injections while pregnant may result in the baby’s birth defects, growth problems, or death.
2. Breastfeeding
Semaglutide as medication has a way of seeping into breast milk and thus being passed onto a baby.
3. Drinking alcohol
Drinking regularly while diabetic can mess up your blood glucose levels, causing either hyperglycemia or hypoglycemia.
4. Taking other medication
Some drugs with insulin may clash or have a negative side effect when taken alongside Ozempic. These include antibiotics, antifungals, corticosteroids, beta-blockers, calcium channel blockers, sulfonylureas, non-steroidal anti-inflammatory drugs, or monoamine oxidase inhibitors (MAOIs).
5. Undergoing a procedure requiring an empty stomach
Some American and Candian anesthesiologists have observed patients would inhale food and water in their lungs while sedated. This was even when they were instructed to stop eating six to eight hours before the surgery or procedure.
6. History of medullary thyroid cancer (MTC)
When one has MTC, it triggers the production of calcitonin. There are no direct negative side effects of having too much calcitonin in the blood. However, MTC can metastasize and affect tissues, particularly lymph nodes. Lymph nodes are responsible for filtering unhealthy cells such as cancer cells.
7. History of gallbladder disease
There was a higher incidence of acute cholecystitis (inflammation of the gallbladder) among those taking GLP-1 receptor agonists like semaglutide.
8. History of pancreatitis
Although rare, patients who take semaglutide run the risk of getting pancreatitis, or the inflammation of the pancreas.
9. History of diabetic retinopathy
More patients with type 2 diabetes and heart problems taking Ozempic experienced diabetic retinopathy than those on placebo. Diabetic retinopathy refers to blindness due to diabetes.
10. Acute kidney injury; history of chronic renal failure
Some reports note that the condition of patients with chronic renal failure worsened while taking Ozempic. Others developed acute kidney injury.
Misconceptions about semaglutide’s safety
While semaglutide brands Ozempic and Wegovy have become popular, false information about them has still been making the rounds online.
Speaking to Business Insider, Dr. Christopher McGowan, a board-certified physician in internal medicine, lamented fake news items on social media. These typically exaggerated the possible side effects of semaglutide.
“Semaglutide is a legitimately effective medication,” he told Insider. “It provides health-altering weight loss. It has an overall excellent safety profile and is generally well tolerated.”
With patients attesting to semaglutide’s efficacy, people might jump to the wrong conclusion that anyone can take semaglutide. This could not be further from the truth as semaglutide has its share of risks and contraindications. Other myths claim that semaglutide is addictive and that people don’t need to change their lifestyles to enjoy its benefits.
There is no truth to these myths as semaglutide is not formulated with any addictive substances. Also, while semaglutide can successfully promote weight loss, it should not be treated as a silver bullet.
The health benefits of proper diet, exercise, and semaglutide far outweigh taking semaglutide on its own without any lifestyle changes.
To prevent yourself from falling prey to misconceptions, seek the advice of your healthcare provider.
Conclusion
Safety is of paramount importance in the medical field. Pharmaceutical companies need to ensure that the risk of side effects is minimal in their products.
When compared to its fellow GLP-1 receptor agonists exenatide and liraglutide, semaglutide generally shared a comparable safety profile.
Although semaglutide has its share of mild to severe side effects, these are generally rare.
Studies can attest to the general safety and efficacy of semaglutide on patients with type 2 diabetes and obesity. It’s also proven safe and effective for a host of other health conditions.
Amid the proliferation of false content online about semaglutide, consumers must remain vigilant and seek their healthcare provider’s guidance.
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