Tips and Tricks for Semaglutide, Ozempic and Wegovy
Hi, I am Dr. Craig Primack, and today I’m coming to you from Scottsdale Weight Loss Center. It has been quite some time since I’ve done a medical minute. Today, I’m going to talk about one of my favorite current weight loss drugs. Now over the last six months, year, maybe year and a half, I’ve used this drug a lot.
Before I even get into details, I will tell you that there is no one weight loss drug for everybody. We’ve built up a lot of experience using weight loss drugs over the past 15 years that I’ve been doing this. And I will tell you, even though this drug is good for a lot of people, it’s not good for everybody. That being said, let’s get to it.
So this weight loss drug is called semaglutide. It is a GLP-1 style drug. What does that mean? So semaglutide comes in two forms. The first form is something called Ozempic, in this blue pen. And the other one is called Wegovy, in the white pen. It is the same drug, although it is a different delivery system.
You and I both have a hormone called GLP-1. It comes from the small intestine, the ileum, the area right past the stomach. The way I think about it is as food goes through the stomach and gets to the small intestine, the body is absorbing it. Even though that’s not exactly what it’s doing, it kind of says that “I’m full” and sends a hormonal signal to the brain that tells your body “I’m full” so you don’t go out and get more food right away, because it’s working on absorbing that food right then and there.
The half life, so the amount of time that this hormone lasts in your system, half of it is gone in two minutes. And another quarter of it would be gone in a little bit later. So in a couple minutes, let’s call it 10 minutes or less, that hormonal signal is completely gone. This is an artificial form of the drug GLP-1 called semaglutide. And the half life is a week long. It lasts in your system for a week at a time. So your body fuels fullness all the time. That is a great benefit for many of us in weight loss.
Tips and Tricks
So I’m going to show you a few tips and tricks I’ve learned throughout the last year. The first part is when should I take this drug? It is a once a week drug. When you read the package insert, it takes between one and three days to fully kick in. So I love to have my patients use this drug on a Wednesday. Why on a Wednesday? Because it takes between one and three days, so by Friday night, it’s fully kicked in. It’s fully kicked in through the rest of your… If there is social eating on the weekend, social eating. And then in the beginning at the lower doses, it may start to wear off before the end of your week. So maybe that’s one day before on a Tuesday. Tuesday’s typically not a big eating day. So first thing is Wednesday.
Now sometimes I’ll say, start the drug immediately when you get it. Let’s say that’s Friday. The following week, depending, I may have someone do it the next day before, so Thursday. The next week on Wednesday, and then we stay at Wednesday. It’s very easy to use both of these pens.
So the first one, Ozempic, you actually have to put a needle on. And what I’ll show you is it has a cap on it right now. You take the cap off, you take this little needle and there’s two pieces of plastic on the needle. You screw it on very simply. There’s this first cap you take off right there. There’s a second cap that you take off right there. And you guys can’t see it, but this is a 32 gauge tiny, tiny needle. The next you do is you look at this little window where there’s a zero. The first time you ever use the pen, you prime it by putting it to these first two little dots and you push the button and it goes back down to zero. That’s before you even give yourself a dose.
The next time you do it, you turn it all away, let’s do it that way, to 0.25, which is about 18 clicks here. These little clicks. That may come into use in the future if we decide to try to adjust your dosing at all. But you put it at 0.25. You put this tiny little needle usually in your abdomen. It can go also in your thigh or arm and you push the button down. And as you can see, it goes all the way back to zero. When it goes back to zero, you then count to 5. 1, 2, 3, 4, 5, and you are done. Find a Sharps container. Or what I tell a lot of people is take an old medicine bottle, the yellow with the safety cap that’s empty. Take this little needle off. Just like that. And throw it in your safety container. When it is full, then take it back to your pharmacy. So you do have to use, or at least touch the outside part of the needle on this one.
On Wegovy, another version of this, this is an auto injecting needle. You can see there’s a little window here. What I have found is the best place to put this one, even though it can be in your abdomen or your arm, it is in your thigh when you’re sitting in a chair. So you pull the plunger out and I’m going to show you the little window and pretend my thigh is my arm right here. And you push it down, you’re going to hear two clicks. You’re going to hear a click right away. You’re going to see this little yellow bar. It’s going to go about three quarter. Click again, and then move a little bit more. When it is done moving after the second click you are done, you never saw a needle and you have the full dose in you.
Both of these medicines are adjusted somewhat differently, so please ask your medical professional what is the best way to do that. Hopefully this has helped you a little bit learn something about semaglutide, a great drug for many of us here in weight loss. I will be back soon with another medical minute.