5.2 Weeks 1-3: Initial consultation and early monitoring
5.2 Weeks 1-3: Initial consultation and early monitoring
| Choosing an INJECTABLE GLP-1 for weight management | |||
| Medication | Semaglutide | Liraglutide | Tirzepatide |
|---|---|---|---|
| Brand name | Wegovy | Biolide, Saxenda, Nevolat | Mounjaro |
| Frequency of Administration | Weekly | Daily | Weekly |
| Route of Administration | Subcutaneous | Subcutaneous | Subcutaneous |
| Dose at initiation | 0.25mg once weekly | 0.6mg once daily | 2.5mg once weekly |
| Dose titration | Increase to 0.5mg once weekly for 4 weeks and then increase to the higher doses of 1mg, 1.7mg, and 2.4mg with a minimum of 4 weeks between each dose escalation | Increase by 0.6mg every 7 days to a maximum maintenance dose of 3mg once daily | Increase by 2.5mg every 4 weeks. Refer to the guideline for the Management of Tirzapatide for maximum maintenance doses |
| Missed doses | Administer as soon as possible and within 5 days after the missed dose. If more than 5 days have passed, the missed dose should be skipped and the next dose should be administered on the regularly scheduled day. If more doses are missed, reducing the starting dose for re-initiation should be considered. | If a dose is missed within 12 hours from when it is usually taken, the patient should take the dose as soon as possible. If there is less than 12 hours to the next dose, the patient should not take the missed dose and resume the once-daily regimen with the next scheduled dose. An extra dose or increase dose should not be taken to make up for the missed dose | If a dose is missed, it should be administered as soon as possible within 4 days after the missed dose. If more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing schedule |
| Changing dosing day | The day of weekly administration can be changed if necessary as long as the time between two doses is at least 3 days (>72 hours). After selecting a new dosing day, once-weekly dosing should be continued | N/A | The day of weekly administrationcan be changed, if necessary, as long as the time between two doses is at least 3 days |
| Do you need to prescribe needles? | No - 4 x 4mm needles supplied in the box (if person needs more or needle fails then to issue 1 box of needles as an acute prescription) | Yes - 1 box of 4mm needles should last 3 months | Yes - 1 box of 100 needles should last > 2 years |
| What supply do you need for one month? | 1 pen (28 days) | Between 1-5 pens (30 days) - one pre-filled pen contains 18mg of liraglutide in 3mL | 1 pen (28 days) |
| Choosing an ORAL GLP-1 for weight management | ||
| Medication | Semaglutide | Orforglipron |
|---|---|---|
| Brand name | Wegovy | Foundayo |
| Frequency of Administration | Daily | Daily |
| Route of Administration | Oral | Oral |
| Dose at initiation | 1.5mg once daily | 0.8mg once daily |
| Dose titration | After a month at the initial dose, increase to 4 mg, 9 mg and then 25 mg with a minimum duration of one month at each dose level. | After 4 weeks at the intial dose, increase to 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg, with a minimum of one month at each dose level. |
| Directions | Must be taken on an empty stomach |
No restrictions |
| Missed doses | If a dose is missed the missed dose should be skipped and the next dose taken the following day. |
If a dose is missed, the dose should be taken as soon as possible. However, a double dose should not be taken. If 7 or more consecutive doses are missed, dosage escalation should be reinitiated at a lower dosage to reduce the risk of gastrointestinal adverse reactions. |
| Switching from injectable |
Patients treated with semaglutide injection 2.4mg once weekly can be transitioned to semaglutide 25mg tablets once daily. Patients can start semaglutide tablets one week after their last dose of semaglutide injection. |
N/A |