【缺藥訊息】 公告日期：2024/6/14。 缺藥品項：Ozempic 筆針 4 mg/3 mL。 缺藥原因：因運輸問題缺藥。 替代藥品：市場有同類替代藥。 配套措施：藥品量保留慢箋，同類替代品 (Trulicity 筆 藍 1.5 mg/0.5 mL/Pen) 已到貨。 【藥品供貨及處方說明】 因廠商缺貨，為避免影響健保用量，自即日起限制開立1支。 自 2024/4/25 起，Ozempic 針 4 mg/3 mL 保留給 T2DM 病人使用，自費病人請改以同成分不同劑型 Rybelsus 錠劑 14 mg 替代。 本案處理原則為：優先保障醫療需求及病人照護使用 (T2DM 診斷) 並符合該藥品署核適應症。因供貨非常不穩定，如恢復供貨將再公告。 醫療資源非常有限，如無醫療需求，請勿囤積轉賣、重複看診購買，請把醫療資源保留給醫療需求優先。 【藥品訊息】 Ozempic 筆針 衛教單張

糖尿病 Type 2 Diabetes mellitus
1. Diabetes mellitus, type 2, monotherapy or in combination with other diabetes treatment drugs<20230131>
2. Risk reduction of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular diseas

Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist

Distribution: Vd ~12.5 L
Protein binding: >99% to albumin
Metabolism: Proteolytic cleavage of the peptide backbone with sequential beta-oxidation of the fatty acid sidechain
Bioavailability: 89%
Half-life elimination: ~1 week
Time to peak, plasma: 1 to 3 days
Excretion: Urine (~3% as unchanged drug), feces

1. Hypersensitivity to semaglutide or any component of the formulation
2. Personal or family history of medullary thyroid carcinoma (MTC)
3. Patients with multiple endocrine neoplasia syndrome type 2 (MEN2)

Agents other than semaglutide are currently recommended to treat diabetes mellitus in pregnancy (ADA 2020).

Breastfeeding during therapy with oral semaglutide is not recommended due to the unknown risks associated with potential accumulation of SNAC in the infant.

Abdominal pain, nausea, diabetic retinopathy, hypoglycemia, cholelithiasis, constipation, diarrhea, dyspepsia, eructation, flatulence, gastroesophageal reflux disease, vomiting, antibody development

Initial 0.25 mg once weekly for 4 weeks, then increase to 0.5 mg once weekly; may increase to 1 mg once weekly after an additional 4 weeks if needed to achieve glycemic goals.

1. Mild to severe impairment: No dosage adjustment necessary.
2. Hemodialysis, intermittent (thrice weekly); Peritoneal dialysis: No supplemental dose or dosage adjustment necessary; use with caution due to limited clinical evidence.

No dosage adjustment necessary.