During the last few years, a group of injectable anti-diabetic medication Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist under the brand names: Ozempic, Wegovy, Victoza, Mounjaro and Saxenda.or Rybelsus gain popularity among ordinary people and advertised by celebrities. Ozempic and Rybelsus are used in type II DM and Wegovy in treatment of weight management. There is no generic form of this medication in the USA. The GLP-1 medications mimic the effect of Glucagon to feel full and have no desire to eat.

On TikTok, videos hashtagged #Ozempic have 600 million views. The popularity of this medication increases by celebrities taking it and confirming that.

I receive calls from my patients almost every day, asking to prescribe this injectable. Let’s see if this is a miracle or a curse?

Have you heard that this medication is contraindicated (means not allowed to use) in patients with personal or family history of thyroid tumor and a condition called MEN 2 (Multiple Endocrine Neoplasia syndrome type 2)?

Hazardous Drugs Handling Considerations

Semaglutide may cause carcinogenicity, teratogenicity, reproductive toxicity, and has a structural/toxicity profile similar to existing hazardous agents.

Wegovy: As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of 230 kg/m2 (obesity), or 227 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, dyslipidemia)

Ready for the significant side effects?

Here you go:
1. Acute kidney injury (AKI), which sometimes requires dialysis
2. An increased incidence of diabetic retinopathy complications (DRC) was noted
3. Gallbladder disease and biliary tract disease, including cholelithiasis and cholecystitis
4. Gl effects, mainly abdominal pain, constipation, diarrhea, nausea, and vomiting, are the most common adverse reactions associated with glucagon-like peptide-1 receptor agonists, including semaglutide (Ref). Decreased appetite and dyspepsia may also occur.
5. Serious, immediate hypersensitivity reactions, including anaphylaxis and angioedema
6. Medullary thyroid carcinoma in animal studies, occurrence in Human unclear.
7. Pancreatitis
Cases of acute pancreatitis (including hemorrhagic pancreatitis and necrotizing pancreatitis with some fatalities), chronic pancreatitis, and pancreatic adenocarcinoma

Concerns related to adverse effects:

• Psychiatric effects: Suicidal behavior has been reported with other medications used for weight management. Avoid use in patients with history of suicidal attempts or active suicidal ideation. Every 0.5 ml of this medication is over $400 !! Imagine how rich became the pharmaceutical companies taking advantage of advertisements by celebrities!Before asking your doctor to order this medication for you (which does not work as the only treatment for wt loss) think about other healthy ways to drop those extra pounds without risking your life.To all my patients who have asked for this medication: In functional/Integrative medicine, we look for the root cause of the disease and try to help our patients to change their lifestyle to gain a more permanent solution without risking their lives. Of course, when it is indicated, I do not hesitate prescribing it but always discuss the risk and benefit before doing it.
  Reference: uptodate (data bank for physicians)