wegovy - semaglutide injection 2.4mg
Average weight loss at 68 weeks: 15% (vs 2.4% in placebo)
Effective in 83.5% (more than 5% weight loss at 68 weeks)
Used as an adjunct to a reduced calorid diet and increased physical exercise
– BMI >30 kg/m2
– BMI >27 with co-morbidity (HTN, T2DM, Dyslipidaemia)
WARNING: Risk of Thyroid c-cell tumours (in rodents)
– Wegovy is contraindicated in patients with personal or family history of MTC or MEN2
– Counsel patients re symptoms of thyroid tumours (eg. mass in neck, dysphagia, dyspnoea, hoarseness_
Adverse Reactions
– commonly in around 5%, nausea/vomiting, constipation, abdominal pain, headache, flatulence, gastroenteritis
– concomittent use of Insulin has not been evaluated and dose reduction should be considered
– causes delay of gastric emptying and can impact absorption of oral medications.
– Pregnancy: may cause fetal harm, therefore discontinue if pregnancy detected. Also do not take for atleast 2 months before considering pregnancy.
Warnings:
– Further evaluate patients if serum calcitonin is raised or thyroid nodules noted on examination or imaging
– Acute pancreatits – has been noted with use of GLP-1 receptor agonists and therefore symptoms should be looked for
– Gallstones were reported in 1.6% of patients taking Wegovy (vs 0.6% of placebo patients) and therefore there was a higher rate of cholecystitis.
– Hypoglycaemia – wegovy lowers blood glucose and symptoms of hypoglycaemia should be described to patients. Those with Type 2 diabetes taking this should have BMs monitored.
– AKI – some reports of AKI and worsening renal failure with some requiring haemodialysis The majority were in patients with vomiting or diarrhoea.
– Hypersensitivity including anaphylaxis
– diabetic retinopathy – monitor in those with a history
– increased heart rate – instruct patients to report palpitations
– suicidal behaviour – same as with other weight management products