What is Semaglutide Oral?
Semaglutide Oral is the same GLP-1 compound as injectable semaglutide (see lexicon entry), just as a tablet. Clinically it is approved as the first oral GLP-1 agent. The advantage: no injection. The catch: absorption through the stomach is sensitive and bioavailability is low.
How it works
Like injectable semaglutide, the oral form activates the GLP-1 receptor: more satiety, dampened appetite, slower gastric emptying. To survive stomach acid it is formulated with an absorption enhancer. Still only a small part reaches the blood, hence the higher mg numbers than the injection.
The mechanism in detail is in the semaglutide entry.
How to take it
Intake here is decisive for the effect:
- In the morning fasted, with at most half a glass of water.
- Then wait at least 30 minutes before eating, drinking or taking other tablets.
- More water or food markedly worsens absorption.
Dosing
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What the research shows
The PIONEER 1 study (Aroda, 2019) showed that oral semaglutide as monotherapy in type 2 diabetes lowered long-term blood sugar and weight compared with placebo. Oral semaglutide is approved as the first GLP-1 tablet, so the data is solid, the sensitive absorption is the sticking point in everyday use.
Side effects
- Mainly gastrointestinal: nausea, fullness, constipation or diarrhea, especially when dosing up.
- A slow ease-in keeps this small.
- More details in the semaglutide entry.
Storage
Store dry, cool and protected from light, out of reach of children. Keep the original container closed and mind the expiry date.