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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.