MetabolicTier 1 β Strong clinical evidence (RCTs)
Semaglutide
Ozempic Β· Wegovy Β· Rybelsus
Long-acting GLP-1 receptor agonist with FDA approval for T2 diabetes and obesity. The most clinically validated weight-loss peptide with 15β20% body weight reduction in trials.
π SC injection / Oralπ§ Refrigerate at 2β8Β°C; after first use keep at room temperature up to 28 days (pen)
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Mechanism of Action
GLP-1 receptor agonist that suppresses appetite via hypothalamic centres, slows gastric emptying, and enhances glucose-dependent insulin secretion while suppressing glucagon.
Clinical Applications
- βType 2 diabetes management (FDA approved)
- βObesity treatment β BMI β₯30 or β₯27 with comorbidities (FDA approved)
- βCardiovascular risk reduction in T2 diabetes
- βNASH/NAFLD (emerging evidence)
- βPolycystic ovary syndrome weight management
Dosing Protocol
Recommended Dosing
SC injection (Ozempic/Wegovy). Start 0.25 mg/week Γ 4 weeks, then titrate by 0.25 mg every 4 weeks to target dose (0.5β2.4 mg/week depending on indication). Oral form (Rybelsus): 3β14 mg/day taken fasting.Safety & Contraindications
Possible Side Effects
- β Nausea (most common, usually transient)
- β Vomiting and diarrhoea
- β Constipation
- β Risk of pancreatitis (rare)
- β Thyroid C-cell hyperplasia risk (do not use with thyroid cancer history)
- β Gastroparesis with long-term use
- β Injection site reactions
Contraindications
- βPersonal or family history of medullary thyroid cancer
- βMultiple endocrine neoplasia syndrome type 2 (MEN2)
- βPancreatitis history
- βPregnancy
- βSevere gastrointestinal disease
Combinations & Synergies
π BPC-157may mitigate GI side effects and gastroparesis risk
π 5-Amino-1MQcomplementary metabolic action via NNMT inhibition
π Tirzepatidedo not combine β same receptor class