Should oral Semaglutide tablets be taken on an empty stomach?

Semaglutide tablets (Semaglutide) is a human glucagon-like peptide-1 analog that has been approved for the treatment of type 2 diabetes. Taking oral semaglutide tablets with food or plenty of water has been shown to reduce the absorption of the drug into the body. Current prescribing information instructs to take oral semaglutide tablets on an empty stomach (called the fasted state) with 120 mL/4 ounces of water and then wait at least 30 minutes before consuming any food, water, or taking other oral medications.

One study investigated whether different oral semaglutide tablet dosing regimens might provide patients with more flexibility in the timing of oral semaglutide dosing. In patients with type 2 diabetes, the mean population pharmacokinetic estimated steady-state concentrations after oral once-daily semaglutide 7 and 14 mg semaglutide tablets were approximately 6.7 nmol/L and 14.6 nmol/L, respectively. Following oral administration, maximum concentrations of semaglutide are reached 1 hour after dosing, and steady-state exposure is reached 4 to 5 weeks after dosing. Results showed that shorter predose fasting periods (2-6 hours) and 30-minute postdose fasting significantly reduced in vivo semaglutide exposure compared with the recommended overnight fasting period. Similarly, fasting for 2 hours before dosing combined with fasting overnight after dosing also reduced semaglutide exposure. These findings further support current prescribing information that patients should take oral semaglutide tablets after an overnight fast.

Semaglutide tablets have not yet been launched in China. Its injection has been launched in China and is covered by medical insurance, but only eligible patients can be reimbursed.The price of each 3ml tube may be around RMB 1,000. The original drug Semaglutide tablets sold overseas, with a specification of 3 mg*100 tablets, may cost around 2,000 yuan per box (the price may fluctuate due to exchange rates). There are currently no generic versions of semaglutide on the market.