Ozempic (Semaglutide)

Ozempic is a GLP-1 receptor agonist used in the management of metabolic disorders:

• Type 2 diabetes mellitus: improves glycemic control and reduces HbA1c levels.
• Cardiovascular risk reduction: lowers risk of major adverse cardiovascular events in adults with established cardiovascular disease.
• Weight management adjunct: assists with weight loss when used alongside diet and exercise in appropriate patients.

• Semaglutide binds to the glucagon‑like peptide‑1 (GLP‑1) receptor, enhancing glucose‑dependent insulin secretion, suppressing inappropriate glucagon release, and slowing gastric emptying. These actions collectively improve post‑prandial glucose excursions and promote satiety, supporting glycaemic control and weight reduction.

Semaglutide may cause a range of adverse reactions, most of which are mild to moderate in intensity.

Common Side Effects

• Nausea: mild to moderate nausea is frequently reported.
• Vomiting: occasional episodes may occur.
• Diarrhea: loose stools are commonly observed.
• Constipation: some patients experience reduced bowel movements.
• Abdominal pain: discomfort in the stomach area may be reported.
• Decreased appetite: reduced desire to eat is a frequent effect.

Serious or Rare Side Effects

• Pancreatitis: inflammation of the pancreas can occur.
• Severe hypoglycaemia: especially when combined with insulin or sulfonylureas.
• Acute kidney injury: renal function may deteriorate in susceptible individuals.
• Thyroid C‑cell tumours: potential risk observed in rodent studies.
• Allergic reactions: including anaphylaxis and severe skin reactions.
• Gallbladder disease: increased incidence of gallstones or cholecystitis.

When prescribing Ozempic, clinicians should consider several safety aspects:

• Renal function: assess baseline kidney function and monitor periodically.
• Gastrointestinal history: evaluate risk of nausea, vomiting, or pancreatitis.
• Thyroid disease: avoid in patients with a personal or family history of medullary thyroid carcinoma.
• Pregnancy and lactation: use only if the potential benefit justifies the risk.
• Concomitant insulin or sulfonylureas: adjust doses to reduce hypoglycaemia risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Semaglutide has a limited profile of drug‑drug interactions, but clinicians should remain vigilant:

Major Interactions (Avoid)

• Rapid‑acting insulin: may cause severe hypoglycaemia when combined.
• Sulfonylureas: increase risk of low blood sugar.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: potential reduction in absorption due to delayed gastric emptying.
• Warfarin: monitor INR closely as glycaemic changes may affect anticoagulation.
• Digoxin: altered renal clearance may require dose adjustment.
• Beta‑beta  

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