💊 Product Name
Rybelsus®
Generic Name: Semaglutide (oral)
Class: GLP-1 receptor agonist Manufacturer: Novo Nordisk
🎯 Indication
Rybelsus is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
❗ Not indicated for use in type 1 diabetes or for the treatment of diabetic ketoacidosis.
⚙️ Mechanism of Action
Semaglutide is an analog of human glucagon-like peptide-1 (GLP-1). It:
- Stimulates insulin secretion in a glucose-dependent manner
- Suppresses inappropriate glucagon secretion
- Slows gastric emptying
- Reduces appetite, which may contribute to weight loss
This combination of effects improves postprandial and fasting glucose levels.
📏 Dosage & Administration
Available Strengths:
- 3 mg
- 7 mg
- 14 mg tablets
Titration Schedule:
| Duration | Dose | Notes |
|---|---|---|
| Weeks 1–4 | 3 mg once daily | For treatment initiation |
| Week 5 onward | 7 mg once daily | Standard therapeutic dose |
| Optional (if needed) | 14 mg once daily | For additional glycemic control after ≥30 days on 7 mg |
Administration Instructions:
- Take once daily, empty stomach, with no more than 120 mL (4 oz) of water.
- Wait at least 30 minutes before consuming food, beverages, or other oral medications.
- Do not split, crush, or chew the tablets.
⚠️ Warnings & Precautions
Black Box Warning: Thyroid C-cell Tumors
Contraindicated in patients with:
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Other Considerations:
- Pancreatitis: Discontinue if symptoms appear
- Hypoglycemia: Monitor closely when used with insulin or sulfonylureas
- Renal Impairment: Monitor kidney function in case of dehydration due to GI events
- Gallbladder Disease: Monitor for symptoms of cholelithiasis
💢 Adverse Reactions
Common (≥5%):
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Decreased appetite
Serious:
- Pancreatitis
- Acute kidney injury (secondary to dehydration)
- Hypoglycemia (when used with insulin)
- Hypersensitivity reactions (e.g., anaphylaxis, angioedema)
👶 Use in Specific Populations
- Pregnancy: Discontinue at least 2 months prior to a planned pregnancy.
- Lactation: Breastfeeding is not recommended during treatment.
- Pediatrics: Not established in patients under 18 years of age.
- Elderly: No dosage adjustment required based on age alone.
