Semaglutide, Ozempic, WeGovy & Rybelsus in Singapore

1. Ozempic (Semaglutide)

What is Ozempic (Semaglutide) and How Does It Work?

Semaglutide is part of a family of medicines known as GLP-1 RAs (Glucagon Like Peptide Receptor Agonist). GLP-1 is a protein that is naturally produced by the gut in response to food. Its main effects are to make us feel full (satiated), slow down food from leaving the stomach and bring our blood sugar back down to normal by stimulating the pancreas to produce insulin.

For people who suffer from obesity, their bodies produce little GLP-1 and instead produce more Ghrelin. Ghrelin is the hormone that makes us feel hungry. This is what we call energy dysregulation. In other words, the body loses control over how it takes in and uses energy.

Semaglutide works by enhancing the amount of GLP-1 in the body, consequently giving the body back control over its energy intake and output. Ozempic is taken as a once-weekly injection.

What are Possible Side Effects of Ozempic?

The commonest side effect is nausea. To minimize this, we usually start patients from a small dose. We will also advise patients not to eat if they do not feel hungry and to stop eating once they feel full. Finally, stay away from rich creamy and oily foods. All these will help to alleviate the nausea.

The other possible side effect is constipation. This is usually easily fixed with adequate hydration.

Some patients, however, get the opposite reaction – diarrhoea. This usually stops after a few days and do not require medicines.

2. Ozempic and Saxenda

How do Ozempic and Saxenda Work?

Both Ozempic and Saxenda are GLP-1 RAs. They work in the same way by reducing appetite, increasing satiety and increasing insulin production in response to a meal. The key difference is the body breaks down Ozempic much slower than Saxenda.

How is Saxenda and Ozempic Used?

Both Saxenda and Ozempic are given as a small injection under the skin (subcutaneous injection). Most people inject it into the tummy. However, other approved Ozempic & Saxenda injection sites are the thigh and upper arm.

3. WeGovy

What is WeGovy?

WeGovy contains the same active ingredient as Ozempic (Semaglutide). The only difference is that WeGovy is capable of delivering a higher dose than Ozempic. Suitability will depend on the patient’s individual health and the doctor’s assessment. WeGovy is taken as a once-weekly injection. WeGovy reduces appetite and increases satiety. It also slows down food from leaving the stomach, consequently making you feel full for longer after a meal.

What are the Side Effects of WeGovy?

The commonest side effect with WeGovy is nausea. To minimize this, we will start patients on a smaller dose before adjusting it gradually. We will also advise patients not to eat if they do not feel hungry and to stop eating once they feel full. Finally, stay away from rich creamy and oily foods.

The other possible side effect is constipation which can be resolved with adequate hydration.

Some patients, however, get diarrhoea instead. Fortunately, this usually stops on its own after a few days and do not require treatment.

4. Rybelsus

What is Rybelsus?

Rybelsus is the oral form of Ozempic and WeGovy and contains the same active ingredient (Semaglutide). Rybelsus is taken as a daily tablet.

Rybelsus has to be taken on an empty stomach with just a mouthful (maximum 120ml) of water. Please do not take too much water as water can interfere with the absorption of Rybelsus. You are then not allowed to eat or drink anything (even water) for at least 30 minutes to an hour afterwards.

Does Rybelsus Contain Side Effects?

Rybelsus has the same possible side effects as Ozempic which are nausea, constipation or diarrhoea. We will start you off at a low dose then increase the dose slowly over time in order to minimize the side effects.

Rybelsus contains the same active ingredient as Ozempic and WeGovy (Semaglutide). Semaglutide is a GLP-1 agonist. This is a hormone that is naturally produced by your gut after you have eaten. It reduces your appetite and slows down food from leaving your stomach.

5. Contrave

What is Contrave?

Contrave contains 2 active ingredients - Naltrexone and Bupropion. It works by modifying areas of the brain that control hunger and cravings.

It generally works well for people with a “hungry brain”, which refer to people who do not actually feel hungry but eat because their brains tell them to. Common symptoms include:

1. Addiction eating - Eating to feel good (medically speaking to get the endorphin hit)
2. Subconscious eating - Eating while distracted or tired
3. Emotional eating - Eating for comfort when stressed or in a low mood. Using food as an emotional crutch or comfort.

What are the Side Effects of Contrave?

Possible side effects include nausea, dizziness, dry mouth, constipation and headache. Contrave does not cause palpitations or insomnia. To manage these side effects, we will start you on a low dose and increase the dose slowly over time.

How is Contrave Used?

Contrave is taken as a daily oral tablet and is best absorbed when taken with food.