General

What do GLP-1 medications stand for?

Glucagon-like Peptide 1.

What are GLP-1?

GLP-1 are naturally occurring gut hormones that help us feel full and suppress our appetite to eat.

What are GLP-1 receptor agonist medications?

GLP-1 receptor agonists are a class of medicines used in the treatment of type 2 diabetes and obesity. They act in a very similar way to the GLP-1 hormones naturally found in our bodies (to increase the feeling of fullness and make us less hungry).

How do GLP-1 medications work?

GLP-1 have a few actions in the body. They lead to hormonal changes that reduce blood sugar. They also slow how quickly your stomach empties, which reduces your appetite. This leads to reduced calorie intake and weight loss over time.

What can GLP-1 medications be used for?

Depending on brands available and their indications, GLP-1s can be used to aid weight management in people with obesity alone, or improve blood sugar and weight for people with obesity and type 2 diabetes.

Who can be prescribed a GLP-1 medication?

Depending on each medication brand's indicated use, GLP-1s can be prescribed to individuals with obesity alone, or obesity with type 2 diabetes. On Roczen Plus, GLP-1 suitability and assessment will be carried out by our in-house medical doctors.

What are the common brand names for GLP-1 medications?

Some common brand names for GLP-1 medications include Wegovy (semaglutide), Ozempic (semaglutide), Saxenda (liraglutide), Victoza (liraglutide), Byetta (exenatide), Trulicity (dulaglutide).

Which GLP-1s are licensed for the treatment of diabetes and obesity?

Currently, the GLP-1 approved for the treatment of obesity are liraglutide (brand name Saxenda) and semaglutide (brand name Wegovy), while the semaglutide (brand name Ozempic) is indicated for type 2 diabetes. Oral semaglutide (Rybelsus) is indicated for type 2 diabetes management for people who are also living with obesity.

How effective are GLP-1s for blood sugar management & weight loss?

Oral semaglutide (Rybelsus) effectively reduces HbA1c by up to 1.5% and promotes weight loss of 5-7% over a year. Its benefits in glycemic control, weight management, and ease of oral use make it a valuable option for managing type 2 diabetes. GLP-1 injectables for weight loss offer varying degrees of results, with Wegovy showing the most substantial effects (10-15%), followed by Saxenda (5-10%), and Trulicity (2-3%). More recent GLP-1s (third generation GLP-1s like Wegovy) have shown to be very effective in some people. Clinical trials have demonstrated significant weight reduction, with the majority individuals achieving over 15% body weight loss or more of their initial body weight. It’s important to remember that different people will require different treatment options, and what works for others may not work for you.

How long does it take to see results with GLP-1s?

Weight loss results can vary among individuals, but many people start to see noticeable weight loss within the first few weeks to months of starting treatment with GLP-1s. If you are prescribed a GLP-1 medication and you feel like you are not making progress, please speak with your doctor who will be happy to help you.

Are there any side effects associated with GLP-1s?

Like any medication, GLP-1s can have side effects. Common side effects may include nausea, vomiting, diarrhoea, constipation and headaches, however, these side effects are generally mild and tend to improve over time. The medication is often started at a lower dose and gradually increased over time to reduce the risk of side effects.

How long should I be on a GLP-1?

The duration of treatment with GLP-1 can vary depending on individual needs. Most people require long-term treatment. However, the duration of treatment and continued effectiveness will be monitored by your Roczen clinician to assess the ongoing benefits and manage any potential risks.

Are there any contraindications for using GLP-1?

There are a number of conditions that unfortunately mean GLP-1s cannot be prescribed. GLP-1s for weight loss cannot be prescribed in people with the following conditions:



History or current pancreatitis - a painful condition where there is inflammation of the pancreas



Personal or family history of Multiple Endocrine Neoplasia syndrome type 2 (MEN2) or Medullary Thyroid Carcinoma (MTC)



Women who are pregnant or breastfeeding as safety data is limited

Can GLP-1 medications be used in combination with other diabetes medications?

Yes, GLP-1 medications can be used in combination with other diabetes medications, such as metformin, sulfonylureas, and insulin, however, these may need to be changed at the time you are prescribed a GLP-1.

Can GLP-1 medications cause low blood sugar?

GLP-1 medications alone are not usually associated with low blood sugar (also known as hypoglycaemia). However, if used in combination with other diabetes medications that can lower blood sugar (such as insulin or sulfonylureas), there can be an increased risk. Your doctor will give you advice regarding your current medications if you are prescribed a GLP-1.

Are GLP-1 medications safe during pregnancy or breastfeeding?

GLP-1 medications should not be used during pregnancy or breastfeeding, as there is limited safety data available.

Is a GLP-1 right for me?

Are there any dietary restrictions while taking GLP-1 medications?

There are no specific dietary restrictions while taking GLP-1medications. However, it's important to follow a healthy diet as part of a lifestyle management programme in addition to the medication.

Can GLP-1 medications be used by people with kidney or liver disease?

GLP-1 medications can generally be used in people with mild to moderate kidney or liver disease. Your Roczen clinician will do a full assessment of your health to assess your suitability.

How do I properly store and handle the GLP-1 medication?

It's important to follow the specific storage instructions provided with your medication. Generally, oral GLP-1 medication should be kept in a dry area away from sunlight, while GLP-1 injectables should be stored in the refrigerator at a temperature between 36'F to 46'F (2'C to 8'C). Pens in use should be thrown away after 30 days even if they still have medication left.

Results

When should I take a GLP-1?

Currently, Roczen Plus Malaysia only uses oral GLP-1 medications which should be taken by mouth on an empty stomach, preferably 30 minutes or more before a meal.

Are there any signs or symptoms I should watch out for that may indicate a problem or require medical attention when using GLP-1s?

While rare, there are potential signs or symptoms that may indicate a problem while taking GLP-1 medication. These can include signs of allergic reactions (such as rash, itching, swelling or change to your breathing), or symptoms of pancreatitis (such as severe abdominal pain in, persistent sickness or vomiting). If you experience any concerning symptoms, it's important to seek urgent medical attention.

Taking the medication

What should I do if I miss a dose of the GLP-1?

If you miss a dose, it's generally recommended to take the missed dose as soon as you remember, unless it is close to the time for your next scheduled dose. In that case, you should skip the missed dose and resume your regular dosing schedule. It's important to consult the specific medication instructions or contact your Roczen clinician for guidance if you’re not sure.

Will I need to adjust the dosage of the GLP-1 over time?

GLP-1s are normally started at a low dose, which is increased over time on a standardised protocol. Your maintenance dose is based on your individual response to the medication.

Are there any specific precautions I should take while travelling with this medication?

You can safely travel with GLP-1 medication but it's important to ensure proper storage and handling of the medication, especially in terms of temperature control. Carry a sufficient supply of medication and keep it easily accessible during travel. If travelling internationally, familiarise yourself with any regulations or documentation requirements related to carrying medications. This can be further discussed with your Roczen clinician.

What is the meaning of an off-licence medication?

The term "off-licence" refers to the use of a medication to treat a condition that is not explicitly specified in the manufacturer's product licence.

How does a medication become licensed for use?

A pharmaceutical company must conduct thorough safety checks on new medications and gain confidence in their safety for prescribing. They then apply for a licence for the medication, submitting evidence to regulatory agencies such as the Medicines and Healthcare Products Regulatory Agency (MHRA) or the European Medicines Agency (EMA), or in Malaysia, the National Pharmaceutical Regulatory Agency (NPRA). These authorities review the evidence and, if satisfied with the medication's proven safety and safety profile, grant a licence. The licence specifies the medication's doses, known side effects, precautions, and the specific conditions for which it can be used.

Why is this important for GLP-1 medications?

GLP-1 agonists were initially licensed specifically for the treatment of type 2 diabetes and have been established as safe and effective for this purpose. However, subsequent evidence and clinical trials have shown that the same GLP-1 agonists (for example, semaglutide) are also safe and effective in managing weight, leading to their widespread use for weight management.

Is it safe for me to receive an off-licence prescription of a GLP-1?

An off-licence medication still holds a licence and has undergone rigorous testing to ensure its safety. Like any medication, there can be side effects or specific reasons why it may not be safe to prescribe. At Roczen, our clinical team conducts a comprehensive health assessment to determine your suitability for the medication and ensure it is safe for you to receive a prescription.