Answers to Your Questions About Using GLP-1 Inhibitors
GLP-1 drugs (liraglutide, orfoglipron, semaglutide, and tirzepatide) are widely used medications to promote weight loss and improve overall health. Many people have questions about the use of these medications and information that they find online and in social media.
I’m currently using injectable semaglutide; can I switch to semaglutide tablets?
Yes! You will not need to start over at the initial dose level but can switch to a similar dose of the tablets. The tablet must be taken every day, first thing in the morning at least 30 minutes before eating or taking other medications. You must take the tablets exactly as directed every day as missed or delayed doses cannot be taken at another time to catch up.
Changing between injectable products or other oral medications is possible but has not been reviewed in clinical studies. It may be necessary to take a break between medications or to start again at a lower dosage and increase it gradually. Your healthcare provider will need to guide you through any changes.
I think I am pregnant. Should I continue to use my weight loss medication?
Based on the manufacturer information approved by the FDA, these medications should NOT be used during pregnancy. Animal studies showed some risk of harm to the fetus. Some early reviews of use during early pregnancy have not shown an increased risk, but due to the potential for risks, the recommendation is to discontinue use at least 2 months prior to becoming pregnant.
In some women that previously had infertility issues, treatment with these drugs to improve glucose control and reduce weight improved fertility by regulating menstrual cycles and causing ovulation. Therefore, you should not assume that pregnancy cannot occur during treatment.
Lastly, you should know that tirzepatide may decrease effectiveness of oral contraceptives (birth control pills). Talk to your doctor about effective birth control methods to use during your treatment.
I’ve heard some positive things about microdosing - should I use a lower dose?
No, if you are already taking a GLP-1 medication you should not alter your dose or frequency of use without first talking with your healthcare provider. There may be a valid reason to adjust your dosage such as side effects or transition to another GLP-1 product. Always follow the instructions for the appropriate dose that is provided by your doctor or pharmacist. Decreasing your dose may cause a significant slowing of your weight loss.
If you are considering beginning a GLP-1 with microdosing to “just lose a little weight” or reduce hunger or food thoughts, you should first have a discussion with your healthcare provider. Currently there is no evidence from clinical studies about using microdoses or expanding the frequency of giving the drug for these purposes. If the dose of the drug is not available from the manufacturer, there are safety and quality concerns of obtaining the usable dose from a compounding pharmacy.
Do I need to use these medications forever?
Obesity is a chronic or ongoing condition, so most people will need to be treated to prevent weight gain. Many people reach a weight loss plateau after about 18 months of use and if they stop the drug find that they regain some or all of the weight lost. Most healthcare providers recommend some type of ongoing treatment to maintain a healthy weight. Before stopping your GLP-1 medication, have a discussion with your healthcare provider about strategies (e.g., diet, medication, exercise) for maintaining your weight loss.
Summary
People considering or using GLP-1 medications often have many questions about use. Be sure to talk directly to your healthcare provider for advice that is specific to your health needs.