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The following table describes GLP-1 receptor agonists, their dosing frequency and key pharmacokinetic parameters: Cautions and Contraindications Adverse Effects Acute pancreatitis (rare) Injection site reactions Gastrointestinal disturbances (nausea, vomiting, diarrhoea dehydration and possible renal impairment) Increase in pancreatic enzymes: lipase and amylase (dulaglutide, tirzepatide and semaglutide) Cholecystitis and cholelithiasis Delayed gastric emptying (semaglutide, exenatide, dulaglutide, tirzepatide (diminishes over time)) Increased heart rate Diabetic retinopathy complications (semaglutide, particularly in insulin-treated patients with known diabetic retinopathy) Interactions GLP-1 receptor agonists do not interact via cytochrome P450 , but delayed gastric emptying may alter drug absorption

References and Further Reading: Patel, S., & Niazi, S

37 CONCLUSION In consideration of clinical trials published thus far, oral semaglutide has demonstrated efficacy in terms of A1C and weight reduction when used as an addon to a variety of background glucose-lowering regimens in patients with T2DM and inadequate glycemic control