Semaglutide, also known as semaglutide, with transliterations varying by country, is the same substance.
Semaglutide has emerged as a blockbuster drug in recent years for weight loss and glucose control. Among them, oral semaglutide is the next-generation version following the injectable form. This article will clarify the differences between oral and injectable semaglutide, their weight loss efficiency, and how to take them.
Oral semaglutide was approved for market in 2019. It was approved by the FDA for treating obesity in 2021 and for treating adolescent obesity in January 2023. It is one of the few drugs in the world officially approved by the FDA for obesity treatment.
| Differences Between Oral and Injectable Forms
In terms of efficacy, when stored and taken correctly, there's no significant difference in the effectiveness of oral and injectable semaglutide. However, the administration methods and frequencies differ, and patients can choose the most suitable option based on their conditions.
Oral semaglutide is taken once daily. It offers better accessibility and does not require cold chain storage and transportation. Injectable semaglutide, on the other hand, requires a weekly subcutaneous injection, which can be administered in the abdomen, thigh, or upper arm, and requires full cold chain handling.
Research has shown that when used in combination with basal insulin, oral semaglutide is as effective as injectable semaglutide in treating type 2 diabetes, and in some cases, even more effective. It demonstrates good tolerance and yields similar results.
A review published in the "Diabetes Treatment" journal showed that oral semaglutide significantly lowers HbA1c levels compared to other GLP1-RA drugs. In this regard, there's no statistically significant difference between oral and injectable semaglutide. In terms of weight loss, oral semaglutide (excluding 1 mg injectable semaglutide) shows higher efficacy than other injectable treatments, but without statistically significant differences.
| Weight Loss Efficiency
In a randomized, double-blind, placebo-controlled STEP1 trial published in the New England Journal of Medicine, 1,961 obese or overweight non-diabetic adults were enrolled. Participants were randomly assigned in a 2:1 ratio to receive either semaglutide or a placebo, along with lifestyle interventions for 68 weeks.
After 68 weeks, the results showed that the average weight change in the semaglutide group was -14.9%, while the placebo group was -2.4%. Regarding reaching weight loss thresholds, 86.4%, 69.1%, and 50.5% of participants in the semaglutide group lost more than 5%, 10%, and 15% of their body weight, respectively. In contrast, these proportions were 31.5%, 12.0%, and 4.9% in the placebo group.
| Administration Method
Take on an empty stomach, preferably upon waking before the first meal of the day.
Swallow the tablet with about half a cup of water (less than 120mL). Do not cut, crush, or chew the tablet.
If you need to drink water, eat, or take other medications after taking the tablet, wait at least 30 minutes.
If you miss a dose, skip the missed dose and take the next dose the next day.
| Dosage
Start with a dose of 3mg oral semaglutide once daily for 30 days.
After taking the 3mg dose for 30 days, increase the dose to 7mg once daily.
If additional glucose lowering or weight control is needed, after taking the 7mg dose for at least 30 days, the dose can be increased to 14mg once daily.
| Main Side Effects
Occasionally, digestive system symptoms such as stomach discomfort, bloating, nausea, constipation, and diarrhea may occur.
If severe abdominal pain accompanied by vomiting occurs persistently, stop using immediately and seek medical attention promptly.
| Mechanism of Semaglutide for Weight Loss
Semaglutide is an analog of GLP-1, sharing 94% homology with the human GLP-1 sequence. As a GLP-1 receptor agonist, it binds to the GLP-1 receptor, initiating a series of glucose-lowering events, including stimulating insulin secretion and reducing glucagon secretion. Additionally, semaglutide can repair damaged endothelium and enhance endothelial function, benefiting the cardiovascular system.
Regarding weight loss, semaglutide can act on the digestive tract, delaying gastric emptying and increasing satiety. Moreover, it can suppress appetite by acting on the brain.