Prescribing indications, issues and concerns surrounding semaglutide

Semaglutide is a glucagon-like peptide receptor agonist that regulates blood sugar. It is available as both an injectable and oral medication, and is used to treat several indications such as type-2 diabetes, obesity and obesity-related cardiovascular conditions. However, its varied uses and increasing popularity are leading to several issues that prescribers must be aware of.

Several glucagon-like peptide receptor agonists used to manage blood glucose levels in people living with type 2 diabetes, have been in short supply globally. This includes glucagon-like peptide-1 (GLP-1) analogues such as injectable semaglutide (Ozempic).

One of the main reasons noted for the supply issues is off-label prescribing for weight loss, which has been leaving many with type 2 diabetes without the medications they need (Diabetes UK, 2024).

While other medications have either increased in supply or since become available that are helping to fill the shortages, such as oral semaglutide (Rybelsus) and tirzepatide (Mounjaro), respectively, the intermittent supply and shortages of injectable semaglutide are expected to continue into 2025 (Diabetes UK, 2024). In September 2023, a separate brand of semaglutide (Wegovy) was approved for weight loss (Diabetes UK, 2024). Since March of this year, people in England who are living with type 2 diabetes can be prescribed Mounjaro, Trulicity or other GLP-1 medications where Ozempic is unavailable (Diabetes UK, 2024).