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GLP-1 Receptor Agonist

Semaglutide

Brand names: Ozempic (SC), Rybelsus (oral), Wegovy (obesity)

Used in: Diabetes & DKA

Semaglutide is a GLP-1 receptor agonist used in type 2 diabetes and, at higher doses, for weight management; it lowers glucose with weight loss and has cardiovascular benefit.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

• RYBELSUS and OZEMPIC tablets are not substitutable on a mg-to-mg basis. • Take RYBELSUS or OZEMPIC tablets orally once daily on an empty stomach in the morning with water (up to 4 ounces of water); do not take with other liquids besides water. ( 2.1 ) • Swallow tablets whole. Do not split, crush, chew or dissolve in any solution. ( 2.1 ) • After taking RYBELSUS or OZEMPIC tablets, wait at least 30 minutes before eating food, drinking beverages or taking other oral medications. ( 2.1 ) • See the Full Prescribing Information for instructions on switching between RYBELSUS and OZEMPIC tablets ( 2.3 ) and from OZEMPIC injections to RYBELSUS or OZEMPIC tablets. ( 2.4 ) Recommended Starting, …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-01-30. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It mimics GLP-1 — increasing glucose-dependent insulin secretion, suppressing glucagon, slowing gastric emptying and reducing appetite.

Prescribing in practice

  • Gastrointestinal effects (nausea, vomiting) are common, particularly during dose escalation — titrate slowly.
  • Delayed gastric emptying is relevant around general anaesthesia or sedation (aspiration risk) and can affect other oral drugs; rare pancreatitis.
  • Hypoglycaemia risk is low alone but higher with a sulfonylurea or insulin (reduce those); it is not a substitute for insulin in type 1 diabetes or DKA.

Monitoring

Monitor HbA1c and weight; review gastrointestinal tolerance and remain alert to features of pancreatitis.

Counselling the patient

  • Nausea is common at first and usually improves; the dose is increased gradually.
  • Tell anaesthetic or endoscopy teams you take it, as it slows stomach emptying.
  • Report severe, persistent abdominal pain.

Evidence & guidelines

GLP-1 receptor agonists are recommended in type 2 diabetes (especially with obesity or cardiovascular risk) per NICE NG28, with cardiovascular outcome benefit (e.g. SUSTAIN programme).

Reference: SUSTAIN-6; SELECT trial (NEJM 2023); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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