Semaglutide (Ozempic®): a comprehensive review of its pharmacology, efficacy, and safety profile in type 2 diabetes mellitus and weight management

Semaglutide, sold under the trade name Ozempic®, is a modified human glucagon-like peptide-1 receptor agonist (GLP-1 RA) indicated for the treatment of type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 receptor-agonists have shown improved renal and cardiovascular outcomes in patients with chronic kidney disease and established atherosclerotic cardiovascular disease (ASCVD). They work by binding to GLP-1 receptors which are found in different locations in the body. In the brain, they decrease appetite, increase the gastric emptying time in the gastrointestinal tract and promote weight loss. Due to the increased use of semaglutide, there has been a significant increase in reporting of adverse effects (AEs), such as pancreatitis, thyroid tumours, and hypersensitivity. Prescribing semaglutide for weight loss is seen as an off-label use since it is not registered in South Africa for weight management.