Frequently Asked Questions About Semaglutide

Follow instructions for either the Sublingual Suspension or the Subcutaneous Injection.

Subcutaneous Injection

Semaglutide is injected subcutaneously once a week.  A subcutaneous injection delivers medication into the fatty layer below the skin.  Before self-administering the initial dose, contact your doctor or our pharmacy if there’s anything that’s unclear or of concern.

• Gather the components: Vial of Semaglutide, a syringe, alcohol swabs and a puncture-proof sharps container for disposing of the used needle.
• Subcutaneous injections can be given in the: upper arm, top of the thigh, and the abdomen (at least two inches away from belly button). Comfortably position your body to reach and expose the injection site.
• Choose a smooth area of skin, away from burns, scars or previous injection sites and rotate the injection site each time.
• Clean the injection site with an alcohol swab and let dry.

Prepare the Medication | Draw up the syringe:

• Wash your hands, then snap the cap off of the vial and wipe the rubber stopper with a new alcohol swab.
• Take the cap off the needle and pull back on the plunger to draw air into the syringe. The air will be injected into the vial prior to drawing up the dose.  The volume of air injected into the vial should equal the volume of medication to be drawn out of the vial.
• Fully insert the needle into the rubber stopper and push the plunger so the air goes into the vial.
• Keep the needle in the stopper and turn the vial upside down. The vial will remain upside down until the full dose is drawn up and the needle is ready to be removed.
• Keep the tip of the needle in the liquid and pull back on the plunger to draw the medicine into the syringe.
• Fill the syringe to the amount prescribed.
• Check for air bubbles and gently tap the syringe to move any bubbles to the tip. Inject any air collected at the tip of the syringe back into the vial.
• The dose can only be correctly measured when there is a full column of liquid from the tip of the syringe to the end of the plunger that is free of air bubbles. The very end of the plunger should be at the measuring mark matching the prescribed dose.
• Turn the vial right-side-up and pull the needle out. You are ready to inject the medication.

Giving the injection:

• With your non-dominant hand, gently pinch and hold a fold of skin and fat at the injection site where it was cleaned with the alcohol swab.
• Hold the syringe like a pencil with your dominant hand and position the needle so that it will go straight into the skin (90-degree angle).
• Insert the needle as far as it will go with one smooth decisive movement.
• Once the needle is in, you can release the pinch of skin and use your non-dominant hand to steady the syringe.
• Pull back on the plunger gently, if blood appears in the syringe, do not inject. Pull out the syringe and insert it in a slightly different place. If no blood, proceed with the injection.
• Inject the medication by slowly pushing the plunger all the way down. When the dose has been completely injected, remove the needle.
• Place the alcohol wipe over the injection site and apply pressure for 30 seconds.
• Discard the needle in the sharps container without recapping it and wash your hands.
• Do not reuse needles.

Sublingual Suspension

This medication is designed to be taken under the tongue (sublingually).  The absorption takes place through the tissues under your tongue and the floor of your mouth.  To ensure max absorption, keep the solution under the tongue and avoid swallowing until a full minute has passed.  Swallowing the medication too soon decreases its effectiveness.

Use the oral syringes supplied to measure the prescribed dose in milliliters.

• fully insert the tip of the oral syringe into the stopper
• invert the vial and draw up the dose
• place the tip of the syringe beneath your tongue and gently push the plunger
• hold the medication in place for 1 to 2 minutes before swallowing

To prevent washing away the medication or altering its absorption, you should AVOID:

• eating or drinking for 30 to 45 minutes
• immediately brushing your teeth
• smoking for 2 hours before or after a dose

Subcutaneous Injection

Store the medication in the refrigerator (60°-77°F) and keep away from light.  Leave it in the original vial until ready to inject.  It is not recommended to draw up doses ahead of time.

Sublingual Suspension

Store the medication at room temperature 60°-77°F (15°-25°C) and keep away from light.  Leave it in its original vial and gently shake before drawing up the dose.

Subcutaneous Injection

The injectable form is dosed once a week.  If the next scheduled dose is 2 or more days away, take the missed dose as soon as you remember it.  It the next scheduled dose is less than 48 hours away, skip the dose and continue with your regular schedule.  Do not take 2 doses within 48 hours of each other.

Sublingual Suspension

The sublingual form is typically dosed once a day.  We recommend trying to take it at the same time every day.  If you forget a dose, but remember it the same day, then it is OK to take it as soon as you remember.  If the missed dose isn’t recognized until the next day, skip that dose and resume therapy at your next scheduled time.  Do not take two doses of Semaglutide at the same time.

There are no specific foods to avoid, but as part of a healthier diet, you should cut down on foods high in fat, sugar and calories.

Foods that are fried, fatty, spicy or high in sugar are more likely to cause upset stomach or nausea.  Because of the delay in gastric emptying, larger meals may not be well tolerated.  Try eating smaller meals and eating more slowly.  For most people, stomach upset or diarrhea is temporary and usually resolves within a few weeks after starting treatment.

There is no known test or biological marker that accurately predicts an individual’s response to therapy.

Disappointing results are often due to:

• Not following a strict enough diet and exercise regimen. Lifestyle changes are necessary for optimal results.
• Not giving it enough time. Most people start losing weight within the first 4 weeks, but some people take longer.
• The dose is not high enough. To reduce the risk of side effects, therapy is usually started at a low dose, then gradually increased. Dose changes are not recommended in intervals of less than 4 weeks.  It typically takes about 4 months of therapy to reach the final maintenance dose.
• Skipping or forgetting doses. Choose a specific time of day to take the medication and adhere to the schedule. If you are intentionally skipping doses because of side effects, notify your doctor of the issue. Most side effects become less bothersome over time.
• Other existing health conditions may be hindering weight loss.

It is not uncommon for patients to report temporary changes in their taste during therapy.

Typical descriptions include:

• Food tasting too salty
• Salads, chips, coffee, or dark chocolate tasting exceptionally bitter
• A metallic taste in the mouth whenever they eat
• Food tasting distorted or weird
• An unpleasant sulfur smell or taste
• Changes in taste preferences
• Their mouth feeling dry

Nausea is one of the most common side effects and is most prevalent when starting treatment or increasing the dose. Most patients tolerate the degree of nausea fairly well and it typically improves over time.

If nausea is particularly bothersome:

• Eat smaller meals and avoid fatty food, fried food, and foods high in sugar.
• Limit spicy or acidic foods.
• Eat more slowly.

Compounds are pharmacist-prepared, custom medications designed to meet the unique needs of patients.  Healthcare professionals often choose to prescribe compounded medications when mass-produced, commercially manufactured products don’t fit a patient’s individual needs.

Our pharmacy is regulated by State Boards of Pharmacy and strictly adheres to USP standards (United States Pharmacopeia).  All the ingredients used in our compounds only come from FDA register facilities.