Oral Semaglutide is indicated for the treatment of adults with insufficiently controlled type 2 diabetes to improve glucose control. It contains the active ingredient Semaglutide which has been approved for the treatment of obesity. Oral Semaglutide belongs to the same family of GLP-1 Receptor agonist medications that are used for diabetes and weight loss treatment.
How does Oral Semaglutide work?
Oral semaglutide is a GLP-1 (Glucagon Like Peptide-1) Receptor agonist. GLP-1 is a hormone that regulates appetite, blood sugar and cardiovascular health- present in the brain, heart and gut. Oral Semaglutide reduces blood sugar levels by increasing insulin secretion, and reduces body weight and body fat mass by suppressing appetite, reducing craving for fatty foods. This allows the individual to sustain a caloric deficit that is necessary for weight loss.
Oral Semaglutide reduces blood sugar levels and suppresses appetite for weight loss
How effective is Oral Semaglutide?
Oral semaglutide is safe and effective for the treatment of diabetes and weight loss, as proven by 8 multi-center, global randomised controlled clinical trials that looked at blood sugar levels (using Hba1c) and weight loss.
In the PIONEER 4 trial, 711 patients with diabetes were randomised to oral semaglutide 14mg, liraglutide 1.mg and placebo. After 52 weeks of treatment, the patients in the oral semaglutide 14mg treatment group achieved a 1.2% reduction in Hba1c and 4.3kg weight loss. The results were more significant in the Oral Semaglutide group compared to the Liraglutide group.
In another double blind trial (PIONEER 6) which focused on cardiovascular outcomes, 3,183 patients with diabetes and obesity (mean BMI 32.3) were treated for 16 months. By end of treatment, 35% of patients had loss >5% of body weight, and 15% of patients had lost 10% of body weight in the Semaglutide group.
Is Oral Semaglutide safe?
Safety of Oral Semaglutide has been well studied in healthy subjects and patients with type 2 diabetes. Following oral administration, peak bloodstream concentration occurred 1 hour later. Steady state exposure is reached after 4-5 weeks of daily oral administration. Absorption of Oral Semaglutide decreases if taken with food or large volumes of water.
How to take Oral semaglutide?
Oral Semaglutide is a tablet taken once daily in the morning with small sips of water. After taking the medication, it is recommended not to eat, drink or consume other medication for 30 minutes.
Oral Semaglutide comes in 3mg, 7mg and 14mg dosages. Most patients start at 3mg dose for a month, before increasing to 7mg dose. Where required, 14mg dose may be prescribed.
If a dose is missed, the medication should be skipped for a day and the next dose taken the following day. Do not double dose by taking the medication at night and again on the morning the next day.
Side effects and risks of Oral Semaglutide
Oral Semaglutide is not recommended for patients who are pregnant, breastfeeding or below 18 years of age. Women of child bearing potential should avoid pregnancy and use contraception. No dosage adjustment is required for patients with kidney or liver disease.
Common but minor side effects include: nausea, bloating, vomiting, diarrhea or constipation. These effects are usually transient and improve in 3-4 weeks.
Rare but significant side effects include risk of acute pancreatitis, gallstone formation- hence this medications should be avoided in patients with a history of these conditions
Oral semaglutide vs Injectable Semaglutide
Both types of semaglutide contain the same medication- semaglutide, and are manufactured by the same pharmaceutical company- Novo Nordisk (Denmark). Recently, they been the subject of significant media attention, with celebrities such as Elon Musk and Oprah Winfrey sharing on social media their weight loss transformation after using these medications. As a result, there is a global shortage, with patients now resorting to off label usage of oral semaglutide for weight management
Disclaimer: Oral Semaglutide is licenced in Singapore for the treatment of diabetes. Use of Oral Semaglutide in non diabetic patients is considered off label.
Switching from Injectable to Oral Semaglutide
Due to global shortage, it is a common scenario where patients who managed to obtain a prescription (locally or overseas) suddenly find themselves out of supply and need to switch to a close alternative. Oral Semaglutide 14mg is approximately equivalent to injection semaglutide 0.5mg once weekly
Where to get Oral Semaglutide in Singapore?
Oral Semaglutide is a prescription only medication and is available in medical clinics or hospitals. A doctor’s consultation and prescription is required. Oral Semaglutide is not available for online purchase without prescription or over the counter.
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