Semaglutide: A Weight management drug.
Uses, Dosage, Administration ,Side effects, Related warnings and Contraindications .
Recently The FDA approved once weekly Semaglutide injection.
It is indicated for chronic weight management in adults.
Semaglutide is a GLP-1 receptor agonist .
Semaglutide oral 2/4 mg, is the first-approved drug for chronic weight management in adults.
It has been used with general obesity or overweight since 2014. It is administered for chronic weight management in adults.
The patient with a BMI of 27 kg/m² or greater are treated with this .
who have at least one weight-related comorbidity is preferred for this medication. The patients who have type 2 diabetes or hypertension treated with this .
Scientists say a new drug has been shown to be successful in reducing obesity by suppressing hunger. In a large-scale international trial, they found that many of those who took part in the test managed to lose an average of 15 kg in 15 months.
The trials were conducted on about 2,000 people who were given an injection of the drug semaglutide once a week, as well as advice on eating habits and keeping the body healthy.
They lost an average of 15 kg in a 15-month trial, and scientists say the results of the trial suggest the drug could usher in a “new era” in the treatment of obesity.
Jan, from Kent, UK, who took part in the trial, lost 28 kg, one-fifth of his body weight.
“This medication has changed my life and also changed my attitude towards food,” he says.
He said he had previously tried to control his weight by dieting, which was “very difficult”, but the experience of taking the drug was quite different, as he was less hungry after taking it.
“It was not difficult;
After the end of the trial, Jan’s hunger has increased again and he is gaining weight again.
Jan took part in trials
After landing at the airport, Jan said it was impossible for him to fly the plane before losing weight
He says: “Losing weight during the trial was not difficult at all, now we have to fight hunger all the time again.”
Semaglutide is a familiar name to many who seek treatment for type 2 diabetes. But this drug has been applied in higher doses in this weight loss trial.
Semaglutide is administered in conjunction with a proper or correct diet and exercise program to control high blood sugar in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, organ damage, and sexual dysfunction. Proper control of diabetes can also reduce the risk of heart attack or stroke. Semaglutide is same as to our body’s natural hormone (incretin). It responds to high blood sugar (eg after meals) by releasing insulin and reduces the amount of sugar produced by the liver.
How to administer Semaglutide 14 mg Medicine (tablet/injection/capsule) ?
- Please read the medication guide of the pharmacist every time you start taking semaglutide and supplementary medicines. In case of any doubt or problem, please talk to your doctor or health specialist.
- Take this medicine as directed by your doctor with a mouthful of plain water (no more than 4 ounces or 120 ml), usually once a day. Don’t administer this drug with any other beverages. Take the medicine in the hole intake. Don’t break or split or chew the tablets. Wait at least 30 minutes after taking semaglutide, and then eat or drink anything other than plain water, and any other medicines by mouth.
- For best results, you should eat 30 to 60 minutes after taking semaglutide. It is important to take this medication in the same way for each dose.
- The dosage depends on your medical condition and response to treatment.
- To reduce the risk of side effects, your doctor may ask you to start taking this medication at a lower dose and then gradually increase the dose. Follow the doctor’s instructions carefully.
- Administer this medicine on a regular basis to get the most health benefits from it. To help you remember, please take it at the same time every day.
- Do not increase the dose or use the medicine more frequently or for longer than the prescribed time. Your condition will not improve quickly, and your risk of side effects will increase.
If your condition does not improve or worsen (your blood sugar is too high or too low), please tell your doctor.
Side effects or Bad effects:
- abdominal pain,
- loss of appetite,
- diarrhea or
If you continue to take semaglutide, nausea will usually go away. In case getting or feeling of these any side effects persist or worsen, tell your doctor or pharmacist as soon as possible.
Remember, your doctor prescribes this medication because he believes that your benefits outweigh the risks of side effects. Many people who use this drug do not have serious side effects.
If you have any serious side effects, please tell your doctor immediately, including symptoms of kidney problems (such as changes in urine output), vision changes (such as decreased vision/blurred vision).
Semaglutide rarely causes very serious (possibly fatal) pancreatic disease (pancreatic inflammation). If you develop symptoms of pancreatitis, seek immediate medical attention, including severe abdominal pain/abdominal pain, persistent nausea/vomiting.
Although semaglutide does not usually cause low blood sugar (hypoglycemia), blood sugar levels may decrease if the drug is used in combination with other diabetes medications. Discuss with your doctor or pharmacist whether you need to reduce the dose of other diabetes medicines. Low blood sugar can also be caused by drinking too much alcohol, insufficient calories in food, or unusually strenuous exercise.
Symptoms may include
- sudden sweating,
- rapid heartbeat,
- loss of appetite,
- blurred vision,
- dizziness or
- shaking hands/feet.
It is a good practice to carry glucose tablets or gels to treat hypoglycemia. If you don’t have this reliable form of glucose, use sugary sources (such as sugar, honey, candy, fruit juice, or non-weight-loss soda) to quickly raise your blood sugar. In case of forget to take the drug, please talk to your doctor or pharmacist to find out what you should do.
- Symptoms and signs of high blood sugar level or hyperglycemia are increase of thirst/ increase of urination. If you notice these symptoms, tell your doctor immediately. You need to adjust or increase the dose.
- Very severe allergic reactions to this drug are rare. But in case you feel any symptoms of a severe allergic reaction such as skin rash, itching/swelling (especially mouth/tongue/throat), severe dizziness, and difficulty breathing, please seek medical attention immediately.
This is not a complete list of possible side effects. If you notice other side effects not listed above, please contact your doctor or pharmacist.
- Before taking semaglutide, please tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which may cause allergic reactions or other problems. For more detailed information, please consult your pharmacist.
- Before using this medicine, tell your doctor or pharmacist your medical history, especially: prescription eye problems (diabetic retinopathy), pancreatitis (pancreatitis), kidney problems, stomach/intestinal eases (such as gastroparesis), Digestive problems).
- You may experience blue light due to low or high blood sugar leading to decreased vision, dizziness, or drowsiness. Do not drive, use machinery, or engage in any activity that requires caution or clear vision unless you are confident that you can perform such activities safely.
- Limit alcohol when using this medication because it may increase your risk of low blood sugar.
- When your body is under stress (for example, fever, infection, injury, or surgery), your blood sugar may be difficult to control. Consult your doctor, as this may require changes to your treatment plan, medications, or blood sugar tests.
- Before surgery, tell your doctor or dentist all the products you use (including prescription drugs, prescription drugs, and herbal products).
- During pregnancy, this medicine should be used only when clearly needed. If you plan to become pregnant, become pregnant or think you may become pregnant, please discuss the benefits and risks of using this medication directly with your doctor. The manufacturer recommends that you stop using the drug 2 months before the planned pregnancy.
- Pregnancy can lead to diabetes or worsening. Discuss plans for blood sugar control during pregnancy with your doctor. Your doctor may change your diabetes treatment (such as diet and medication, including insulin) during your pregnancy.
- It is not clear what he will do after he leaves. Consult a doctor before breastfeeding of your baby.
- Drug interactions can change the way drugs work or increase the risk of serious side effects. This document does not interact with all possible drugs. Keep a list of all the products you use (including prescription/over-the-counter drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop or change the dosage of any medicine without the approval of your doctor.
- Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops, such as timolol) can prevent the rapid/pulsing you usually feel when your blood sugar is too low (hypoglycemia) Heartbeat. These drugs will not affect other symptoms of low blood sugar, such as dizziness, loss of appetite, or sweating.
General Instructions for Administration
- Many medicines affect your blood sugar, making it difficult to control. Before starting, stopping, or changing any medications, talk to your doctor or health specialist or pharmacist to find out how medicines affect your body or blood sugar. Follow the instructions to check your blood sugar regularly and share the results with your doctor.
- If you have any symptoms of high or low blood sugar, please tell your doctor immediately. (See also the side effects section.) Your doctor may need to adjust your diabetes medication, exercise plan, or diet.
- If someone overdose and has severe symptoms, such as wheezing or difficulty breathing, call 911. Otherwise, please call the poison control center immediately. U.S. residents can call their local poison control center at 1-800-222-1222. Canadian residents can call the Provincial Poison Control Center.
- Do not share this medicine with others.
- Join the diabetes education program to learn more about how to manage diabetes through medication, diet, exercise, and regular physical exams.
- Understand the symptoms of hyperglycemia and hypoglycemia and how to treat hypoglycemia. Follow the instructions to check your blood sugar regularly.
- While taking this medicine, you should undergo laboratory and/or medical tests (such as kidney function, fasting blood glucose, hemoglobin A1c). Keep all medical and laboratory appointments. Please contact your doctor for more details.
Miss dose of Semaglutide:
If you miss a dose, skip the missed dose. Take the next dose regularly. Don’t double the dose to catch.
Store it in the original container at room temperature. Keep away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
Unless instructed, do not flush the medicine into the toilet or pour it into the drain. When this product expires or is no longer needed, please cancel the product correctly. Please contact your pharmacist or local waste disposal company.
The central nervous system, pain, metabolic syndrome, cardiovascular, tissue fibrosis, and UTI and Semaglutide
Semaglutide is a long-acting GLP-1 agonist from Novo Nordisk and is currently undergoing phase 3 clinical trials as a weekly T2DM treatment (Figure 2). The structure of semaglutide is different from that of liraglutide in two ways. Pos2 is replaced by Gly Aib (U), which causes the enzymatic degradation of DPP-4. Provide important war protection. In addition, the modified fatty acid chain and two PEG2 spacers have been proven to be effective for long periods in vitro and in vivo.
Due to these two changes, the half-life of semaglutide in humans is 160 hours, and the HbA1c dose-dependent method is reduced by 0.2 mg or more, which is a reduction of 1.7%. More importantly, semaglutide is currently being studied in a clinical trial of once-daily oral treatment.
Type 2 diabetes and semaglutide
The second semaglutide is a new GLP-1 agonist, administered once a week. It is 94% similar to human GLP-1, has two amino acid substitutions (Lau et al., 2015), and has a half-life of 1 week. The SUSTAIN trial compared semaglutide with various other drug treatments and the result was positive; SUSTAIN 1 (2017) showed that HbA1c was improved at 30 weeks compared with placebo, and approximately 75% of semaglutide patients had HbA1c The level is below 7.0%.
This achievement without severe hypoglycemia or weight gain brings additional benefits. DPP-4 inhibitors (Ahren et al., 2017) and other GLP-1 agonists (Pratley et al., 2018) (SUSTAIN 2, SUSTAIN 7) support follow-up trials to improve outcomes for HbA1c and weight loss. More certifications. ,
International Review of Cellular and Molecular Biology of semaglutide & Other GLP-1R agonists
Other emerging GLP-1R agonists are dulaglutide and semaglutide. In the later clinical development of Eli Lilly, dulaglutide contains two DPP-4 resistant GLP-1 molecules, which are combined with a modified IgG4 Fc fragment, resulting in a half-life of 90 hours (Barrington et al., 2011; Glasner et al.) 2010; Grunberger et al., 2012). Developed by Novo Nordisk, semaglutide is a compound with a structure similar to liraglutide, but with a larger linker molecule consisting of an increased length of fatty acid derivatives.
At the same time, alanine is converted to aminoisobutyric acid at position 8. These changes increase the binding efficiency and stability of albumin, resulting in a half-life of approximately 160 hours (Kapitza et al., 2012); Knock et al., 2012). A phase 3 head-to-head clinical trial program called SUSTAIN has begun to compare the efficacy of semaglutide and exenatide (Knock et al., 2012).
Understanding the chemical and synthetic biology methods of cell function and semaglutide
Semaglutide is the latest GLP-1R agonist and was approved by the FDA at the end of 2017 as a weekly injection for the treatment of T2DM. This peptide is chemically similar to liraglutide, which has two structural changes (Lau, Bloch, et al., 2015). The first is to replace Gly with the non-protein amino acid 2-aminoisobutyric acid (AIB) at position 2. The second is to link octadecane dioxide to the side chain of Lys-26 through a short polyethylene glycol (PEG) spacer and a β-glutamic acid linker.
Amino acid substitution makes the peptide more resistant to DPP-4 than liraglutide. The presence of part of the 18-carbon fatty acid leads to a higher binding relationship with serum albumin, which means that the half-life is about 7 days. . Humans (Van Wittelstuizen, Pedersen and Jensen, 2016).
In a 12-week phase 2 study, semaglutide reduced HbA1c levels and body weight and was more effective than liraglutide (1.2 or 1.8 mg) at higher doses (0.8 and 1.6 mg). The daily oral formulation of semaglutide has also been developed using sodium N-[8-(2-hydroxy benzoyl)amino]caprylate (SNAC), and the third phase of clinical trials is currently underway.
Diabetes and semaglutide
GLP1 receptor agonist (GLP1-RA)
GLP1 is a naturally occurring incretin with a strong insulin-stimulating effect. When the glucose level is lower than 4 mmol, its effect will be impaired. GLP1-RA agonists such as Laglutide and Semaglutide are new anti-diabetic drugs. Both LEADER and SUSTAIN tests showed that MACE (death due to cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) was lower in the GLP1-RA group; however, MACE did not have HF. GLP1-RA independently up-regulates myocardial glucose, increases insulin secretion, and enhances the survival of heart cells, thereby improving overall heart function.
A small study found that liraglutide improved diastolic function and decreased E’and E/E after 6 months of treatment.
The latest development of Parkinson’s disease and semaglutide
The possibility of the latest GLP-1R agonist semaglutide as a treatment for potential mutations in PD has also aroused people’s interest. The neuroprotective properties of semaglutide have also been shown in PD rat models. Compared with the effect of liraglutide, semaglutide MPTP administered every other day can reduce damage, reduce inflammation and restore behavior by inhibiting tyrosine hydroxylase-positive neurons (Zhang et al., 2018). Interestingly, there is now an oral active formulation called semaglutide subcutaneously in patients with T2DM (Davis et al., 2017). The beneficial effects equivalent to ide have been shown.
Novo Nordisk is establishing a trial with 270 patients in Scandinavia. This is the most ambitious trial to date and will involve a two-year trial, using dual In the blind method, patients were randomly assigned to take semaglutide or placebo once a week for 2 years. After the next 2 year open labeling period, all participants will self-administer ACT IV medications. Patients will be compared with DATscan imaging based on MDS UPDRS 3, their cognitive performance and non-motor functions, and their dyskinesias.
Development of hypoglycemic drugs for type 2 diabetes and semaglutide
Compared with placebo, the GLP-1 agonist lexicanate, which has a relatively low effect, has shown non-inferiority in the FDA-authorized CVOT, called ELIXA (Evaluation of Lecinatide in Acute Coronary Syndrome) (Table 33.2) And 33.3). The initial composite endpoints of cardiac death, myocardial infarction, stroke, or unstable angina (4-point MACE [major adverse cardiovascular event]) were 13.4% and 13.2% of lesinatide patients (HR 1.02; HR 1.02; P ). . <.001 means non-inferiority; p = .81 means excellence).
77 Similarly, in EXSCEL (Exenatide Study for Reducing Cardiovascular Events), once a week Exenatide was less safe than placebo (non-inferiority P <.001), but it was not as effective as a placebo. Not better than placebo (Excellent P = .06). Therefore, these studies confirm the cardiovascular safety defined by the FDA for these drugs.
In contrast, the CVO of liraglutide and semaglutide not only showed no inferiority to placebo but also showed superiority based on statistical examination of classification, that is, its efficacy in reducing the original overall cardiovascular endpoint. The Ledger (Role and Role of Liraglutide in Diabetes: Assessment of Cardiovascular Outcomes) study examined the vascular effects of 9,000 patients with subcutaneous injections of liraglutide once a day.
As with all diabetic CVOTs, the study population consisted of patients with type 2 diabetes who were selected as high-risk for cardiovascular events. The HR of the initial comprehensive result (3 point MACE) was 0.87 (95% CI 0.78–0.97; non-inferiority P <.001; superiority P = .001). Liraglutide (HR 0.78; 95% CI 0.66 to 0.93; P = .007) significantly reduced cardiovascular mortality.
The test (Sustain-6) that evaluates cardiovascular and other long-term outcomes (including semaglutide) in patients with type 2 diabetes is getting shorter and shorter than LiDAR. The preliminary overall result (3 point MACE) was in 6.6% of the semaglutide group and 8.9% of the placebo group (HR 0.74; 95% CI 0.58 to 0.95; non-inferiority P <.001; P = .02 ). For excellence, even though the test of excellence is not a definite endpoint). Like laglutide, semaglutide provides evidence of recovery and cardioprotection.
However, in SUSTAIN-6, it has been reported that individuals taking semaglutide have a significantly higher incidence of vitreous bleeding, blindness, or eye diseases that require introvert Feale drugs or photocoagulation. These adverse eye effects are attributed to the continuous rapid decrease in HbA1c. However, it is worth noting that the CVOT of diabetes drugs is not intended to affect blood sugar control in the medical group. However, the difference in active treatment has become apparent, even allowing the addition of hypoglycemic drugs to maintain blood glucose balance in control subjects.
These CVOT results have been interpreted as showing the beneficial effects of laglutide and semaglutide in the progression of atherosclerosis. Monitoring the improvement of traditional cardiovascular risk factors does not reduce risk. The mediating mechanism of cardioprotection (and nasal protection) remains to be described.
Prevent obesity and heart disease with semaglutide
Many drugs have been tested on obese subjects, but few drugs are currently available. Although drug therapy may reduce the risk of diabetes and reduce the weight of cardiovascular risk factors, recent non-invasive trials with semaglutide diabetes drugs alone have been shown to reduce morbidity and mortality, rather than weight loss. One of the reasons that weaken the confidence to use any of them is the lack of long-term data on performance.
A recent meta-analysis found that it is difficult to determine the effect of treatment for more than one year, because since 2012, four of the five drugs involved have been approved by the FDA.
Sibutramine was withdrawn from the market in 2010 and became one of the first drugs that showed promise. Patients with cardiovascular disease reported an increase in cardiovascular events and the initially promising cannabinoid receptor blocker ricombant, whose main effect is to suppress appetite and increase the incidence of suicide and depression. The rate was revoked within 2 years after approval.
77 The reluctance of such drugs that do not represent doctors to conceive is not only due to fear of causing such harm but also because a large part of the people who are selected for initial treatment are aware of the consequences of ineffectiveness.
At least in some jurisdictions, unwillingness to pay for treatment can affect patients’ willingness to take medication, and the fact that they often gain weight after treatment is stopped is also detrimental to taking medication.
Diabetic nephropathy and semaglutide
Glucagon-like peptide-1 receptor agonist
Glucagon-like peptide-1 (GLP-1) receptors are l located in glomerular endothelial and mesangial cells, macrophages, and proximal tubular cells. Renal nicotinamide inhibitors are one of the recommended methods because they have antioxidant, anti-inflammatory, and anti-fibrotic effects on the kidneys of diabetic patients. Inhibits the expression of AGE-induced adenine dinucleotide phosphatase (NADPH) and oxidizes monocyte chemoattractant protein-1, inhibits the production of pro-inflammatory cytokines, inhibits the effect of angiotensin II, and inhibits glomeruli Nephritis. β).
In addition to their incretion mimics, GLP-1 receptor agonists also reduce the risk of proteinuria and kidney disease. The role and role of liraglutide in diabetes: Cardiovascular Outcome Assessment (LEADER) Trials and tests that assess cardiovascularly and other long-term outcomes in patients with type 2 diabetes (Sustain-6), compared with patients taking placebo, early Overall cardiovascular endpoint. Preliminary analysis of the LiDAR test showed that liraglutide can reduce proteinuria in patients with normal renal function or early CKD. 139 This finding has recently been confirmed.
Susceptibility to reports of secondary renal outcomes, new persistent massive albuminuria, continuous doubling of serum creatinine levels, end-stage renal disease or a combination of deaths caused by kidney disease. After a 4-year mid-term follow-up, the incidence of renal outcomes in the liraglutide group was lower than that in the placebo group (268 out of 4668 patients vs. 4672; 337; HR, 0.78; 95% CI, 0.67 to 0.92 ; P = 0.003). This result was initially caused by the emergence of persistent large albuminuria, which was 22% lower than the placebo group.
In SUSTAIN-6, new or progressive nephropathy, defined as persistent massive albuminuria, 62 patients (3.8%) required continuous doubling of serum creatinine, eGFR <45 mL/min/1.73 m2, or continuous RRT. There were 100 people (6.1%) in the placebo group and the placebo group (HR, 0.64; 95% CI, 0.46 to 0.88; P = 0.005). This result was due to a new or sustained decrease in massive albuminuria (HR, 0.54; 95% CI, 0.37 to 0.77; P = 0.001). A randomized, open-label, parallel-group study was recently completed to compare the effects of weekly dulaglutide and insulin glargine on blood glucose control in patients with type 2 diabetes and moderate to severe chronic kidney disease (AWARD-7). In 2017, the results will be announced soon.
Microbiome and semaglutide
In order to discuss the impact of diet, especially KD, we can extend the workflow and concepts of other diseases described in this chapter, such as the impact of diabetes on diabetes and the impact of diabetes drugs on the gut microbiota. In fact, some diabetes medications are known to cause weight loss, such as metformin, dapagliflozin, calgitol, semaglutide, and dulaglutide. Among them, the drugs in the SGLT2 group can cause ketosis, which is believed to help the use of such drugs to reduce weight.
The study highlights the role of metformin, glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase 4 inhibitors, sodium/glucose transporter inhibitors, and other less studied drugs in the gut microbiota. Antidiabetic drugs mainly affect the formation of the gut microbiota, which increases the SCFA-producing bacteria that cause weight loss and inflammation, reduces the Firmicutes/Bacteroidetes ratio, and improves the overall effectiveness of carbohydrate fermentation. However, the changes in the composition of the gut microbiota and its impact on pharmacological efficacy are still poorly understood.
Using a modified version of our pipeline to study the intersection of diabetes and the gut microbiome, some connections may be clarified and/or canceled in the future.
These drugs work by controlling the process of hunger in the body. After a full meal, the body secretes a hormone called GLP1, which makes the body feel exactly that hormone. As a result, I always feel full.
Some volunteers in the trial were taken the drug and some were given taken injectables of non-drug fluids. The volunteers are adviced about alternate their diet and lifestyle.
New England Journal of Medicine published the results of the trial .We, notice that people taking semaglutide lost an average of 15 kg. And those who were not taken medicine lost an average of 2.8 kg.
Thirty-two percent of those given the drug were able to lose one-fifth of their weight. But there was no change in the weight of less than 2 percent of those who were given counterfeit drugs.
Dosage and Administration.
This dose is used in very general treatment. Remember, every patient and their problem is different.
So the dose may vary depending on the type of disease. The type of treatment, the patient’s age, and the history of the treatment are also different .
The following side effects have been reported in the study when it was used.
- Nausea or vomiting
- Abdominal pain
Is Semaglutide safe for pregnant women?
- There have been no studies on the health of pregnant women to date. Thus, its effect on pregnant women is not known.
Is Semaglutide safe while breastfeeding?
- It has few side effects in mothers who are breastfeeding. If any side effects occur, stop taking the medicine and contact your doctor. If the doctor instructs, then restart the medicine.
What is the effect on the kidneys?
· Semaglutide is very harmful to any kidney.
What is the effect on the liver?
· There is no risk of liver damage if you take this drug.
What is the effect on the heart?
· There is no risk of Heart damage if you take this drug .
Did this become a habit or an addiction?
· No, there is no chance of getting addicted to Semaglutide.
Is it safe to drive or operate heavy machinery while carrying it?
· This Drug will not make you sleepy. so you can drive or operate heavy machinery.
Is it safe?
· Yes, but only take this on the advice of a doctor.
Does it help cure mental illness?
· No, This is not effective in curing mental illness.
Reactions of this drug with food and alcohol.
Reaction with food.
· What is the effect of Semaglutide with food cannot be said. There has been no scientific study on this subject.
Reactions of Alcohol and This drug.
· Taking Semaglutide with alcohol can cause serious problems in your body.
Severe reactions with other drugs.
Semaglutide should not be taken in combination with the following drugs. It may cause serious side effects in the patient.
· Cantar 16 Tablet
· Candelong 8 Tablet
· Ande Candelong 4 Tablet
· Ande Candelong 16 Tablet
· Io Angiopril 25 Tablet
· Aceten 12.5 Mg Tablet
· Aceten 25 Mg Tablet
· Repace H Tablet
· Covance 50 Tablet
· Amlozaar Tablet
· Repace AF Tablet
If you have any of the following diseases, you should not take Semaglutide. If your doctor advises you to do so.
· Diabetic retinopathy
· Inflammation of the pancreas