Why Does Semaglutide (Ozempic) Require Refrigeration? Comprehensive Guide

Introduction to Semaglutide

Semaglutide is an injectable medication used to treat type 2 diabetes and obesity. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Semaglutide works by mimicking the effects of GLP-1, a hormone that helps regulate blood sugar levels. It stimulates the release of insulin when blood sugar is high and decreases glucagon secretion when blood sugar is low.

Semaglutide was originally approved by the FDA in 2017 under the brand name Ozempic for the treatment of type 2 diabetes. In 2021, a higher dose of semaglutide was approved under the brand name Wegovy specifically for chronic weight management. Both Ozempic and Wegovy contain the same active ingredient, semaglutide.

Since its approval, semaglutide has gained widespread popularity for its efficacy in lowering A1c levels and promoting weight loss. In fact, it's not uncommon for people to use Ozempic "off-label" at the lower diabetes dose for weight management purposes. This growing trend has been fueled in part by celebrity endorsements and social media.

How Semaglutide Works for Weight Loss

The weight loss effects of semaglutide are related to its mechanisms as a GLP-1 receptor agonist. Semaglutide works in a few key ways:

• Slows gastric emptying: Semaglutide decreases the rate at which food empties from your stomach into the small intestine. This leads to increased feelings of fullness and reduces appetite.
• Increases satiety: Semaglutide activates areas of the brain involved in feelings of fullness. This promotes satiety (feeling full) after eating smaller portions.
• Suppresses appetite: By impacting appetite signals in the brain, semaglutide reduces food cravings and the desire to eat between meals.
• Lowers blood sugar: The effects on insulin and glucagon help control blood sugar levels. Lower blood sugars are associated with decreased calorie intake and some weight loss.

Through these mechanisms, semaglutide helps people eat less, feel full faster, and reduce cravings. In clinical trials, participants on semaglutide lost significantly more weight compared to placebo groups.

Clinical Trial Evidence

The weight loss effects of semaglutide have been demonstrated in several large clinical trials:

• In a 56-week study of 2,254 overweight or obese adults, those who took Wegovy (2.4mg semaglutide weekly) lost an average of 17% of their body weight compared to 2.4% for placebo.
• An extension study found that 90% of participants who continued Wegovy for a total of 68 weeks lost ≥10% of their body weight.
• People taking Ozempic (0.5 or 1mg semaglutide weekly) for diabetes lost 6-9% more body weight than those on placebo over 56-64 weeks.

Based on this research, semaglutide has become one of the most effective medications for weight loss when combined with lifestyle modification. However, it's important to note that weight loss can vary significantly from person to person.

Who is a Candidate for Semaglutide?

Semaglutide is generally recommended for certain overweight or obese individuals who have struggled to lose weight through diet and exercise alone. Ideal candidates include:

• Adults with a BMI ≥30 (or ≥27 with at least one weight-related condition such as diabetes or hypertension)
• Individuals who have tried but not succeeded with other weight loss programs
• Patients with type 2 diabetes needing help improving blood sugar control

Semaglutide should not be used in people with certain medical conditions or who are taking medications that may interfere with semaglutide. Candidacy should be evaluated by a healthcare provider.

Consulting a Healthcare Provider

A doctor or other clinician needs to prescribe semaglutide. They will review your medical history and determine if semaglutide is appropriate for you based on factors like:

• BMI and amount of weight to lose
• Blood sugar levels if diabetic
• Other health conditions
• Use of other medications
• Commitment and readiness for weight loss

If prescribed, your provider will explain how to properly administer the injections, what dose to start at, potential side effects, and schedule follow up to monitor progress. Semaglutide is not a quick fix and requires commitment to lifestyle changes.

Potential Side Effects of Semaglutide

As with most medications, semaglutide may cause certain side effects. The most common include:

• Nausea - Occurs in up to 40% of people, especially when first starting. Often improves over time.
• Diarrhea - Can occur in up to 20% of users.
• Vomiting - In around 10-15% of people.
• Constipation - Less common side effect.
• Stomach pain
• Decreased appetite - Considered an expected effect of the medication.
• Gas and bloating

Rare but serious side effects may include problems with the thyroid, pancreas, gallbladder, or increased heart rate. Semaglutide also has risks if used during pregnancy. Patients should follow up regularly with the prescribing provider.

Managing Side Effects

There are some strategies that can help minimize side effects when taking semaglutide:

• Starting with a low dose and slowly increasing over 4-16 weeks
• Injecting at different sites around abdomen to decrease injection site reactions
• Drinking plenty of fluids
• Eating smaller, more frequent meals
• Avoiding triggers like greasy, fried foods
• Staying active and exercising regularly
• Taking anti-nausea medication if needed in the beginning

Being prepared for potential gastrointestinal side effects and taking steps to manage them reduces the burden and increases the chance of staying compliant with semaglutide treatment.

Storage and Administration of Semaglutide

Now that we've covered the background, uses, and side effects of semaglutide, let's discuss the reasons why it requires refrigeration and proper administration techniques.

Why Semaglutide Needs Refrigeration

Semaglutide should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C) until first use. There are two main reasons it requires refrigeration:

1. Preserve potency - Semaglutide contains proteins that can become unstable at higher temperatures. Refrigeration helps maintain the strength and effectiveness of the medication.
2. Prevent contamination - Refrigeration protects against growth of bacteria that could contaminate the sterile semaglutide solution.

Once opened, semaglutide can be kept at room temperature no higher than 86°F (30°C) for up to 6 weeks. However, refrigeration is still preferred even after first use.

Following Proper Administration Techniques

Semaglutide is administered once weekly by subcutaneous injection just under the skin. Follow these steps for proper administration:

1. Take the semaglutide pen out of the refrigerator at least 30 minutes before injecting to allow it to reach room temperature.
2. Prepare the injection site by wiping with an alcohol pad to disinfect.
3. Attach a new disposable needle and perform the safety test.
4. Pinch 1-2 inches of skin and insert the needle at a 45 degree angle.
5. Press and hold down the injection button for 5-10 seconds then release.
6. Remove the needle and dispose of it properly.

It's critical to follow the instructions for use provided with your prescription. Always inject your prescribed dose once weekly on the same day. Rotate injection sites each week to prevent skin reactions.

Avoiding Administration Errors

To get the desired results from semaglutide and prevent potential hazards, be diligent in avoiding these administration errors:

• Injecting the wrong dose - Stick to the prescribed dose and timing.
• Reusing needles - Needles must be discarded after a single use.
• Sharing pens between people - Never share for infection control reasons.
• Not priming pen before injecting - Prime to ensure removal of air bubbles.
• Forgetting to refrigerate - Store pens in the refrigerator until first use.
• Freezing semaglutide - Do not freeze as this can damage proteins.

Careful adherence to refrigeration, injection technique, dosing schedule, and disposal guidelines allows semaglutide to work effectively and safely.

The Takeaway

Semaglutide (brand names Ozempic and Wegovy) has become a popular medication for chronic weight management due to its ability to substantially reduce body weight. However, it does carry side effects and risks if used inappropriately.

Semaglutide must be prescribed by a healthcare provider who will determine if it is suitable based on the patient's profile and need for weight loss. Once prescribed, proper refrigerated storage and administration techniques are critical. Patients also require close monitoring and follow up to keep side effects in check and avoid complications.

When used correctly under medical supervision, semaglutide can be a valuable tool for certain patients struggling with overweight or obesity through conventional lifestyle measures alone. But it is not a quick fix and requires commitment to making lasting improvements to dietary and activity habits.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.