Semaglutide is a novel diabetes medicine. It has been recently marketed in Pakistan by Novo Nordisk Pharmaceuticals for the treatment of patients with diabetes mellitus type 2.
It has superior glycemic efficacy compared to most other antidiabetic medicines and GLP-1 analogs. It is associated with significant weight loss.
Semaglutide Formulations and Brand Names:
Ozempic is a once-weekly formulation of Semaglutide. It is administered as a subcutaneous injection once a week.
In Pakistan, Ozempic is the only formulation of Semaglutide that is available in the market. It is a once-weekly formulation of Semaglutide. Other formulations of Semaglutide are Rybelsus and Wegovy.
Rybelsus is available as oral tablets in other countries. It is given in a dose of 3 mg, 7 mg, or 14 mg once daily.
The usual maximum dose is 14 mg once daily. It is initially given in a dose of 3 mg that is increased at weekly intervals to the maximum dose of 14 mg once daily.
Wegovy has only been approved for the treatment of obesity especially diabetes patients who are obese ( diabesity).
Like Ozempic, it is also administered once a week as a subcutaneous injection.
Other GLP-1 analogs being used in Pakistan:
Currently used GLP 1 analogs in Pakistan are Liraglutide and dulaglutide. Of all the GLP 1 analogs, Ozempic is considered to be the most effective in terms of blood glucose control and especially for the treatment of obese diabetic patients.
In the Sustain Trials, Semaglutide superiority was demonstrated over placebo and most other antidiabetic medications including metformin, Sitagliptin (Januvia), Empagliflozin (Jardiance), Insulin Glargine (Lantus), Exenatide (Byetta), Dulaglutide (Trulicity), and Liraglutide (Victoza).
Ozempic Price in Pakistan:
Semaglutide Injection (Ozempic) costs 19500 PKR a month in Pakistan. One single pen injection has a total of four doses. Each dose is given as a once-weekly subcutaneous injection.
Ozempic can be bought directly from the Novo helpline at a monthly discounted rate of PKR of 16000 a month.
Ozempic Price in the US:
Ozempic and other brands are too costly. They are usually prescribed to diabetic individuals with insurance covering the cost. Each 0.5 and 0.25 mg injection costs USD 617.95 per ml. Each tablet of Oral Rybelsus costs USD 30.90.
Side effects and Contraindications to Ozempic Use:
Like all GLP 1 analogs, it is associated with gastrointestinal side effects. Most patients develop nausea, vomiting, and bloating after meals.
Most of these side effects can be prevented by initiating the smallest dose i.e. 0.25 mg once a week. The dose can then be increased to 0.5 mg once a week after a month.
Other simple maneuvers to reduce the GI side effects include taking a balanced healthy diet and antacids.
Semaglutide has also been associated with an increased incidence of pancreatitis. Individuals with a history of pancreatitis should ideally avoid Semaglutide (Ozempic, Rybelsus, and Wegovy).
Semaglutide, like all other GLP-1 analogs, is contraindicated in patients who have been diagnosed with MEN 2 syndrome. It should also be avoided in patients with a family history of MEN 2 syndrome.
In acutely ill patients, Ozempic and other brands of Semaglutide should not be used as it can lead to dehydration and acute renal failure.
It is also important to reduce the dose of concomitant glucose-lowering drugs, especially insulin and insulin secretagogues. The risk of hypoglycemia increases when Semaglutide (Ozempic) treatment is initiated in patients on other anti-diabetic medications.
Patients should discontinue taking other GLP-1 analogs and DPP-IV inhibitors such as Sitagliptin, Vildagliptin, and Linagliptin when started on Semaglutide treatment.