Semaglutide, a selective long-acting GLP-1 receptor agonist, has gained popularity for its role in obesity management by reducing appetite and ad libitum intake (1). Recently, the U.S. FDA approved Semaglutide 2.5mg, known as Wegovy, for chronic weight loss management in individuals with weight loss-related conditions like hyperlipidemia, hypertension, or type 2 diabetes (1).
In early 2022, a concerning shortage of the injectable version, Ozempic, was announced by the FDA, starting a wave of scarcity that began in the Hollywood industry (1). This shortage emerged as Semaglutide garnered attention on TikTok as a purported "celebrity weight loss drug." Numerous Hollywood stars showcased significant weight loss results, with some admitting to using the drug, while others denied any drug usage (1).
The soaring demand for Semaglutide and pharmaceutical companies' stocking practices led to a sharp shortage, resulting in turmoil in the healthcare industry (1). Patients who relied on this drug faced challenges as they grappled with its limited availability. Some were forced to reduce their dosage, which affected their treatment plans (1).
To address the shortage, healthcare practitioners started prescribing alternative GLP-1 antagonists like Dulaglutide (Trulicity), Tirzepatide (Mounjaro), Liraglutide (Victoza, Saxenda), Exenatide (Byetta), Semaglutide (Rybelsus), and Lixisenatide (Adlyxin) (1).
The shortage of Semaglutide was not limited to the USA; countries like Canada, the United Kingdom, China, and India also faced similar crises (1). India restricted the export of 13 active pharmaceutical ingredients to safeguard its domestic drug supply.
Despite their widespread use, Semaglutide and similar drugs pose significant risks. Its usage is contraindicated during pregnancy, with the need for discontinuation at least two months before planning pregnancy. Semaglutide also carries potential risks of embryofoetal mortality, structural abnormalities, and growth retardation (2). Patients must be informed about potential adverse events, especially for those with a history of suicidal attempts, as Semaglutide may lead to depression, behavioral changes, or suicidal thoughts. The drug is also linked to acute pancreatitis, pancreatic cancer, cholelithiasis, gall bladder-related disorders, and gastrointestinal adverse reactions (2).
While Semaglutide and similar drugs are regulated by the FDA, stricter protocols must be implemented to ensure their safe usage.
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References:
(1) Lexicomp. Semaglutide: drug information. In: Post TW, ed. UpToDate. Waltham (MA): UpToDate; 2018: www.uptodate.com. Accessed 2018 Dec 12.
(2) Yabe D, Nakamura J, Kaneto H, et al. Safety and efficacy of oral semaglutide versus dulaglutide in Japanese patients with type 2 diabetes (PIONEER 10): an open-label, randomised, active-controlled, phase 3a trial. Lancet Diabetes Endocrinol. 2020;8(5):392–406. doi: 10.1016/S2213-8587(20)30074-7.
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