Rybelsus contains the active salt semaglutide. This FDA-approved medicine is used to scale down blood sugar levels. It is used for the treatment of adults (aged 18 years and older) with type-2 diabetes when diet and exercise are not sufficient:
- On its own – when individuals cannot consider metformin (another diabetes medication) or
- With other medications for diabetes – when the other medications are not sufficient to control the blood sugar levels. These may be medications you take orally or inject such as insulin.
It is crucial that patients continue with their diet and exercise plan as agreed with their health specialist.
Dosage: The initial Semaglutide tablets dosage is 3 mg once daily for 30 days. After 30 days, the dosage can be increased to a maintenance dosage of 7 mg once daily. After at least 30 days with a dosage of 7 mg once daily, the dosage can be increased to a maintenance dosage of 14 mg once daily to further improve glycaemic management. The maximum proposed single daily dose is 14 mg. Taking two tablets of of 7 mg to reach the effect of semaglutide 14 mg dose has not been evaluated and is therefore not recommended. If any dose is missed, the missed dose needs to be skipped and the very next dose should be taken the following day.
Treatment Reactions: The most commonly reported side effects with Semaglutide oral tablets are:
- Abdominal pain
- Decreased appetite
Warnings and Precautions:
- Semaglutide uses are restricted in those with type 1 diabetes mellitus or in those with diabetic ketoacidosis. Diabetic ketoacidosis may establish in insulin-dependent patients who had prompt discontinuation or dose reduction of insulin when treatment with a GLP-1 receptor agonist is initiated.
- The use of GLP-1 receptor agonists may be responsible for causing gastrointestinal side effects that can be responsible for causing dehydration, which in rare cases can result in deterioration of renal function. Those who have been treated with semaglutide therapy must be advised of the probable risk of dehydration in relation to gastrointestinal adverse reactions and consider precautions in order to avoid fluid depletion.
- Acute pancreatitis may appear with the use of GLP-1 receptor agonists. Patients must be aware of the characteristic signs and symptoms of acute pancreatitis. In case pancreatitis occurs, Semaglutide tablets 3 mg must be discontinued; in the case confirmed, this treatment should not be re-initiated. Caution must be exercised in those with a known history of pancreatitis.
- Those treated with semaglutide tablets in conjunction with insulin or sulfonylurea may have a higher probability of hypoglycaemia. The probability of hypoglycaemia can be scaled down by decreasing the dose of insulin or sulfonylurea when starting therapy with semaglutide.
- In those with diabetic retinopathy treated with s.c. semaglutide and insulin, a higher probability of occurring diabetic retinopathy complications have been noted, a probability that is difficult to be excluded for oral semaglutide. Caution must be imposed when using semaglutide in all those with diabetic retinopathy. All these patients must be monitored precisely and treated as per needed.
- Females of childbearing age should use contraception when treated with Semaglutide tablets 14 mg. Do not use this medicinal product during pregnancy. If a patient wants to become pregnant, or pregnancy occurs, treatment with this medicine should be discontinued.
- Semaglutide has little, or no, or negligible impact on the potential to drive or use machines. If Semaglutide is used along with insulin or sulfonylurea, patients should consider precautions in order to avoid hypoglycemia while driving and using machines.