GLP-1 receptor agonists are medications used for treating diabetes and managing weight. There are many types, each with unique characteristics. This article explains a list of GLP-1 drugs, their effects, side effects, and precautions for use.
What are GLP-1 Receptor Agonists?
GLP-1 (glucagon-like peptide-1) is a hormone secreted from the small intestine in response to meals. It promotes insulin secretion from the pancreas when blood sugar levels are high, helping to lower blood sugar. It also slows down the emptying of the stomach and acts on the brain to suppress appetite.
How Do GLP-1 Drugs Work?
GLP-1 receptor agonists are drugs designed to work similarly to the body’s own GLP-1. This is expected to help with blood sugar control and lead to weight loss. Their action of promoting insulin secretion is limited to times when blood sugar is high, so the risk of hypoglycemia is considered relatively low when used alone.
Complete List of GLP-1 Drugs (Names and Types)
There are several types of GLP-1 receptor agonists, differing in administration method and duration of effect. They primarily include injectable and oral medications.
Injectable GLP-1 Receptor Agonists
The frequency of administration varies depending on the drug, such as once a week or once a day. Most are self-injectable drugs.
Dulaglutide
Well-known by the brand name “Trulicity”. It is injected subcutaneously once a week. It is used for the treatment of type 2 diabetes. It is also reported to improve blood sugar control and reduce the risk of cardiovascular events.
Exenatide
Brand names include “Byetta” and “Bydureon”. “Byetta” is administered twice a day, while “Bydureon” is administered once a week. It is used for the treatment of type 2 diabetes.
Exenatide Extended Release
This refers to “Bydureon”. It is an improved version of exenatide that only requires a once-weekly injection. It is expected to have a sustained effect.
Liraglutide
Brand names include “Victoza” (for diabetes treatment) and “Saxenda” (for obesity treatment). “Victoza” is injected subcutaneously once a day. It is used for type 2 diabetes treatment and often shows relatively high weight loss effect. “Saxenda” is approved as an obesity treatment drug at a higher dose.
Lixisenatide
The brand name is “Lyxumia”. It is injected subcutaneously once a day before breakfast. It is used for the treatment of type 2 diabetes. One of its features is its effect in suppressing postprandial blood sugar rise.
Semaglutide (Injectable)
Brand names are “Ozempic” (for diabetes treatment) and “Wegovy” (for obesity treatment). It is injected subcutaneously once a week. It is considered potent for both blood sugar lowering and weight loss. It is widely used globally for type 2 diabetes treatment as well as obesity treatment.
Tirzepatide
The brand name is “Mounjaro”. It is injected subcutaneously once a week. It is a “GIP/GLP-1 receptor agonist” that acts on GIP, another hormone, in addition to GLP-1. It is used for type 2 diabetes treatment and is reported to have very powerful blood sugar lowering and weight loss effects.
Oral GLP-1 Drugs
Oral types of GLP-1 drugs that can be taken by mouth instead of injection have also been developed.
Semaglutide (Oral)
The brand name is “Rybelsus”. It is an oral formulation of semaglutide. It is tableted with a special absorption enhancer and is an option for those who dislike injections. It needs to be taken once daily on an empty stomach. It is used for the treatment of type 2 diabetes.
GLP-1 Drugs and Weight Loss
GLP-1 drugs were developed as diabetes medications, but since weight loss was observed in many patients, they have also gained attention as treatments for obesity.
FDA-Approved GLP-1 Drugs for Weight Management
The FDA (U.S. Food and Drug Administration) has approved certain GLP-1 drugs at high doses for weight management in patients with obesity or who are overweight. Representative examples include liraglutide (Saxenda) and semaglutide (Wegovy). Japan also has approved drugs for obesity.
Off-Label Use
GLP-1 drugs approved for diabetes treatment may be used by a doctor’s judgment for the purpose of treating obesity. This is called “off-label use”. However, in many cases, it is not covered by insurance and must be paid for entirely out-of-pocket.
Which GLP-1 Drug is Best for Weight Loss?
It is said that the degree of weight loss effect varies depending on the type of GLP-1 drug. Generally, semaglutide and tirzepatide tend to have a higher weight loss effect compared to other GLP-1 drugs. However, there are large individual differences in effect. Which drug is appropriate is decided by a doctor comprehensively considering the patient’s condition, goals, concerns about side effects, etc.
Combination GLP-1 Drugs
There are also combination injectable drugs that combine a GLP-1 receptor agonist with an insulin preparation.
Insulin Degludec / Liraglutide
This is a combination injectable drug of the basal insulin insulin degludec and the GLP-1 receptor agonist liraglutide (brand name “Xultophy”, etc.). It is expected to enhance blood sugar control.
Insulin Glargine / Lixisenatide
This is a combination injectable drug of the basal insulin insulin glargine and the GLP-1 receptor agonist lixisenatide (brand name “Soliqua”, etc.). This is also used for the treatment of type 2 diabetes.
Side Effects of GLP-1 Drugs
GLP-1 drugs are generally considered safe, but they do have some side effects.
Common Side Effects
The most common are gastrointestinal symptoms such as nausea, vomiting, diarrhea, constipation, and abdominal pain. These symptoms tend to occur particularly when starting administration or increasing the dose. These symptoms often lessen as the body gets used to the medication.
Potential Serious Side Effects
Although rare, there are also side effects that require attention.
- Pancreatitis: Acute pancreatitis has been reported. If you experience persistent severe abdominal pain or vomiting, you need to contact your doctor immediately.
- Gallstones, Cholecystitis: It has been pointed out that there is a possibility of increased risk of developing gallstones.
- Thyroid C-cell Tumors: Reported in animal studies, but a clear increase in risk has not been confirmed in humans. However, you must inform your doctor if you have a history or family history.
- Hypoglycemia: Hypoglycemia is unlikely when used alone, but the risk of hypoglycemia increases when combined with other blood sugar lowering drugs such as insulin preparations or sulfonylurea (SU) drugs.
Are GLP-1 Drugs Available Over-the-Counter? Facts and Misconceptions
GLP-1 receptor agonists are “prescription-only drugs” that require a doctor’s prescription.
They cannot be purchased freely at pharmacies or drugstores. Many products sold on overseas personal import websites are counterfeit drugs or have unassured quality, and the risk of health damage is very high, so they should be absolutely avoided. You must always consult a medical institution and get a prescription under the doctor’s examination.
GLP-1 Drug Cost Range
GLP-1 drugs are relatively new medications and tend to be expensive.
Even when covered by insurance for diabetes treatment, the out-of-pocket cost tends to be higher compared to other diabetes medications. If used off-label for obesity treatment, the full amount is self-paid, making it even more expensive. The cost varies depending on the type of drug, dose, and medical institution. It is recommended to check the specific amount with the medical institution where you will receive treatment.
Who Should Not Use GLP-1 Drugs?
The following individuals may not be able to use GLP-1 drugs. Please be sure to tell your doctor about any history of illness or allergies.
- Those with a history of hypersensitivity to GLP-1 receptor agonists.
- Those with diabetic ketoacidosis or type 1 diabetes.
- Those with severe infections, before/after surgery, or severe trauma.
- Those with severe gastrointestinal disorders (as delayed gastric emptying has been reported).
- Those with a history of pancreatitis.
- Those with a personal or family history of medullary thyroid carcinoma, or with Multiple Endocrine Neoplasia type 2 (MEN2).
- Those who are pregnant or breastfeeding.
- Others deemed inappropriate by a doctor.
Alternatives to GLP-1 Drugs
There may be cases where GLP-1 drugs are not suitable or where other options should be considered.
Non-Drug Therapy
The foundation of diabetes and obesity treatment is diet therapy and exercise therapy. Even when using GLP-1 drugs, these lifestyle improvements are very important. Not relying solely on drug therapy and continuing to review your diet and engage in moderate exercise can enhance treatment effects and lead to long-term health maintenance.
Other Diabetes Medications and Weight Management Drugs
In addition to GLP-1 drugs, there are various types of diabetes medications with different mechanisms of action. Examples include SGLT2 inhibitors, DPP-4 inhibitors, and biguanides (metformin). These drugs are selected considering the patient’s condition, complications, lifestyle, etc. For obesity, options may include appetite suppressants other than GLP-1 drugs, or surgical treatment.
Important Considerations for GLP-1 Drug Use
To use GLP-1 drugs safely and effectively, there are some important points to consider.
Method of Administration and Timing
For injectable drugs, you need to receive sufficient instruction from a doctor or nurse on the correct method of self-injection. It is important to follow the administration frequency (daily, weekly, etc.) and timing (e.g., before breakfast, depending on the drug). Rybelsus, an oral drug, needs to be taken once daily on an empty stomach with about half a glass of water (approx. 120 ml) immediately upon waking, and eating or taking other medications should be avoided for at least 30 minutes after administration, due to its absorption characteristics.
Drug Interactions
Caution is needed when combining GLP-1 drugs with other medications. Particularly, the risk of hypoglycemia increases when used with insulin preparations or SU drugs. If you are using these medications, their doses may need to be adjusted when starting GLP-1 drugs. Always inform your doctor or pharmacist if you are taking any other medications (prescription drugs, over-the-counter drugs, supplements, etc.).
Regarding Long-Term Use
Various questions from patients are heard regarding the continuous use of GLP-1 drugs.
Does Tolerance Develop? Does the Effect Diminish?
Generally, it is not considered that tolerance develops to GLP-1 drugs and their effect diminishes with long-term use. Continuous use is expected to maintain the effects on blood sugar control and weight management.
Is it Addictive?
GLP-1 drugs are not considered to have mental or physical dependence. This is different from addictive drugs like narcotics or some sleeping pills. However, getting used to the appetite suppression effect of the drug and feeling unable to control appetite without it can cause psychological changes.
Do Side Effects Worsen?
Gastrointestinal side effects like nausea, which are often seen in the initial phase of administration, tend to lessen as the body gets used to the medication. Rather than specific side effects worsening with long-term use, continuous attention is needed regarding the risk of rare side effects (such as pancreatitis). It is important to have your physical condition checked at regular medical appointments.
Other Health Benefits (e.g., Arteriosclerosis)
Many studies have shown that GLP-1 drugs, in addition to lowering blood sugar and causing weight loss, also have the effect of reducing the risk of cardiovascular events (such as heart attack and stroke). This suggests the possibility of suppressing the progression of arteriosclerosis and is expected to contribute to improving the prognosis for patients with diabetes and obesity.
Consulting a Medical Institution
Expert knowledge is required regarding the types, effects, side effects, and usage of GLP-1 receptor agonists. Self-medication is extremely dangerous.
If you are considering using GLP-1 drugs or have questions or concerns about using them currently, please be sure to consult a medical professional such as a doctor or pharmacist. They can suggest the optimal treatment method tailored to each patient’s health condition, lifestyle, and treatment goals.
The number of medical institutions offering online consultations is also increasing, making it a convenient option for those who are busy or have difficulty visiting a clinic. Even with online consultations, you can receive a proper prescription after a doctor’s examination.
Frequently Asked Questions (GLP-1 Drugs)
Here are answers to common questions about GLP-1 drugs asked by patients.
Q1: How long do the effects of GLP-1 drugs last?
It depends on the type of drug. Some drugs are administered once daily, while others are administered once a week and their effect lasts for a week. For example, semaglutide and dulaglutide are once-weekly types. The oral drug Rybelsus needs to be taken daily.
Q2: Can GLP-1 drugs cure diabetes?
GLP-1 drugs are medications for type 2 diabetes treatment and are expected to improve blood sugar control and slow down disease progression, but they are not drugs that fundamentally “cure” diabetes. In most cases, continuous treatment is necessary. The goal is to maintain a good state by combining them with lifestyle improvements.
Q3: Are GLP-1 drugs safe?
When used correctly under a doctor’s instructions, they are considered safe medications. Their effectiveness and safety have been confirmed in many clinical trials. However, they are not suitable for everyone, and there is a risk of side effects. It is very important for safe use to accurately inform your doctor about your medical history and current health condition.
Q4: Can I stop using GLP-1 drugs on my own?
If you want to stop using GLP-1 drugs, please consult your doctor beforehand. Suddenly stopping on your own can worsen blood sugar control or cause weight rebound. Stopping or switching to other medications must be done under the guidance of a doctor.
Q5: What is the difference between GLP-1 drugs and SGLT2 inhibitors?
Both are new types of diabetes medications, but their mechanisms of action are different. GLP-1 drugs work by promoting insulin secretion, suppressing appetite, etc., while SGLT2 inhibitors lower blood sugar by increasing the excretion of sugar from the kidneys. Which drug is suitable depends on the patient’s condition, complications (such as heart failure or kidney disease), and treatment goals. They may also be used in combination.
Summary
There are various types of GLP-1 receptor agonists, administered either by injection or orally. In addition to improving blood sugar control in type 2 diabetes, many patients experience weight loss, and they are also expected as treatments for obesity.
Effects vary individually, and side effects such as nausea may occur, but when used correctly under a doctor’s guidance, they are effective and relatively safe medications.
If you are considering using GLP-1 drugs, be sure to consult a medical institution and have a thorough discussion with a doctor. Selecting the optimal treatment method for your condition is most important. Online consultation is also a convenient option.
Disclaimer: The information in this article is for general knowledge and is not individual medical advice. Decisions regarding the use of GLP-1 drugs should always be made in consultation with a doctor or qualified healthcare professional.
コメント