General

What do GLP-1 and GIP stand for?

Glucagon-like Peptide 1 and Glucose Dependent Insulinotropic Peptide (snappy, we know!)

What are GLP-1 and GIP?

GLP-1 and GIP are naturally occurring gut hormones that help us feel full and suppress our appetite to eat.

What are GLP-1 and GIP receptor agonist medications?

GLP-1 and combined GLP-1 and GIP receptor agonists (GLP-1/GIPs) are a class of medicines used in the treatment of type 2 diabetes and obesity. They act in a very similar way to the GLP-1 and GIP hormones naturally found in our bodies (to increase the feeling of fullness and make us less hungry)

How do GLP-1 and GLP-1/GIP medications work?

GLP-1 and GIP have a few actions in the body. They lead to hormonal changes that reduce blood sugar. They also slow how quickly your stomach empties, which reduces your appetite.  This leads to reduced calorie intake and weight loss over time.

What can GLP-1 and GIP medications be used for?

GLP-1 and GLP-1/GIP medications can be used to aid weight management in people with obesity who have already tried lifestyle modifications. They must be used alongside a healthy diet and increased physical activity to promote effective weight loss. They are also prescribed to improve blood sugar and weight in people with type 2 diabetes.

Who can be prescribed a GLP-1 or combined GLP-1/GIP medication for weight loss? 

Generally, GLP-1s and combined GLP-1/GIPs can be prescribed to individuals with a BMI of 30 or higher, or individuals with a BMI of 27 or higher who have at least one weight-related comorbidity (such as high blood pressure, type 2 diabetes, or obstructive sleep apnea) but some conditions means these medications are not for everyone. On the Roczen Plus programme, GLP-1 and GLP1/GIP suitability and assessment will be conducted by our in-house team of medical doctors. 

What are the common brand names for GLP-1 and GLP-1/GIP medications?

Some common brand names for GLP-1  medications include Wegovy (semaglutide), Ozempic (semaglutide), Saxenda (liraglutide), Victoza (liraglutide), Byetta (exenatide), Trulicity (dulaglutide). GLP-1/GIP medication is sold under the brand names Mounjaro and Zepbound (tirzepatide) 

Which GLP-1s and GLP-1/GIPs are licensed for the treatment of obesity?

Currently, the GLP-1 approved for the treatment of obesity are liraglutide (brand name Saxenda) and semaglutide (brand name Wegovy). The GLP-1/GIP approved for treatment of obesity is tirzepatide (brand name Mounjaro) These medications are given via self-injection and are typically prescribed in higher doses compared to their doses in the management of diabetes

How effective are GLP-1s and GLP-1/GIPs for weight loss?

More recent GLP-1s (third generation GLP-1s like Wegovy) have shown to be very effective in some people. Clinical trials have demonstrated significant weight reduction, with the majority individuals achieving over 15% body weight loss or more of their initial body weight. The GLP-1/GIP medication tirzeptide has also been demonstrated to achieve clinically significant weight loss of 20-25% within a year. It’s important to remember that different people will require different treatment options, and what works for others may not work for you.

How long does it take to see weight loss results with GLP-1s and GLP-1/GIPs?

Weight loss results can vary among individuals, but many people start to see noticeable weight loss within the first few weeks to months of starting treatment with GLP-1s or GLP-1/GIPs. If you are prescribed a GLP-1 or GLP-1/GIP medication and you feel like you are not making progress, please speak with your doctor who will be happy to help you.

Are there any side effects associated with GLP-1s or GLP-1/GIPs for weight loss?

Like any medication, GLP-1s and GLP-1/GIPs can have side effects. Common side effects may include nausea, vomiting, diarrhoea, constipation and headaches, however, these side effects are generally mild and tend to improve over time. The medication is often started at a lower dose and gradually increased over time to reduce the risk of side effects. 

How long should I be on a GLP-1 or GLP-1/GIP?

The duration of treatment with GLP-1 or GLP-1/GIP can vary depending on individual needs. Most people require long-term treatment. However, the duration of treatment and continued effectiveness  will be monitored by your Roczen clinician to assess the ongoing benefits and manage any potential risks.

Are there any contraindications for using GLP-1 or a GLP-1/GIP for weight loss?

There are a number of conditions that unfortunately mean GLP-1s or GLP-1/GIPs cannot be prescribed. GLP-1s and GLP-1/GIPs for weight loss cannot be prescribed in people with the following conditions:

History or current pancreatitis - a painful condition where there is inflammation of the pancreas

Personal or family history of Multiple Endocrine Neoplasia syndrome type 2 (MEN2) or Medullary Thyroid Carcinoma (MTC)

Women who are pregnant or breastfeeding as safety data is limited

Can GLP-1 and GLP-1/GIP medications be used in combination with other diabetes medications?

Yes, GLP-1s and GLP-1/GIP medications can be used in combination with other diabetes medications, such as metformin, sulfonylureas, and insulin, however, these may need to be changed at the time you are prescribed a GLP-1.

Can GLP-1 and GLP-1/GIP medications cause low blood sugar?

GLP-1 and GLP-1/GIP medications alone are not usually associated with low blood sugar (also known as hypoglycaemia). However, if used in combination with other diabetes medications that can lower blood sugar (such as insulin or sulfonylureas), there can be an increased risk. Your doctor will give you advice regarding your current medications if you are prescribed a GLP-1 or GLP-1/GIP

Are GLP-1 and GLP-1/GIP medications safe during pregnancy or breastfeeding?

GLP-1 and GLP-1/GIP medications should not be used during pregnancy or breastfeeding, as there is limited safety data available

Is a GLP-1 right for me?

Are there any dietary restrictions while taking GLP-1 or GLP-1/GIP medications?

There are no specific dietary restrictions while taking GLP-1 or GLP-1/GIP medications. However, it's important to follow a healthy diet as part of a lifestyle management programme in addition to the medication.

Can GLP-1 and GLP-1/GIP medications be used by people with kidney or liver disease?

GLP-1 and GLP-1/GIP medications can generally be used in people with mild to moderate kidney or liver disease. Your Roczen clinician will do a full assessment of your health to assess your suitability. 

How do I properly store and handle the GLP-1 and GLP-1/GIP medication?

It's important to follow the specific storage instructions provided with your medication. Generally, GLP-1 and GLP-1/GIP medication should be stored in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C). Pens in use should be thrown away after 30 days even if they still have medication left. 

Side effects

How are GLP-1 and GLP-1/GIP medications administered?

GLP-1 and GLP-1/GIP medications are typically injected subcutaneously (under the skin). They are available as pre-filled pens or syringes, and the injections are usually self-administered. Roczen will ensure you are comfortable and confident with administering the medication independently.

What do I do with used needles?

You will be provided with a sharps bin to allow for safe disposal of used needles. Your local pharmacy should accept the sharps bin or we can arrange for collection from your home. 

Results

When should I take a GLP-1 or GLP-1/GIP?

Injectable GLP-1s and GLP-1/GIPs can be taken at any time of day - regardless of meals. They are taken once weekly and should be taken on the same day of the week, at roughly the same time of day.  

Are there any signs or symptoms I should watch out for that may indicate a problem or require medical attention when using GLP-1 s or GLP-1/GIP?

While rare, there are potential signs or symptoms that may indicate a problem while taking GLP-1 or GLP-1/GIP medication.  These can include signs of allergic reactions (such as rash, itching, swelling or change to your breathing), or symptoms of pancreatitis  (such as severe abdominal pain in, persistent sickness or vomiting). If you experience any concerning symptoms, it's important to seek urgent medical attention.

Taking the medication

What should I do if I miss a dose of the GLP-1 or GLP-1/GIP?

If you miss a dose, it's generally recommended to take the missed dose as soon as you remember, unless it is close to the time for your next scheduled dose. In that case, you should skip the missed dose and resume your regular dosing schedule. It's important to consult the specific medication instructions or contact your Roczen clinician for guidance if you’re not sure.

Will I need to adjust the dosage of the GLP-1 or GLP-1/GIP over time?

GLP-1s and GLP-1/GIPs are normally started at a low dose, which is increased over time on a standardised  protocol. Your maintenance dose is based on your individual response to the medication.

Are there any specific precautions I should take while travelling with this medication? 

You can safely travel with GLP-1 and GLP-1/GIP medication but it's important to ensure proper storage and handling of the medication, especially in terms of temperature control. It's advisable to pack the medication in a travel cooler or insulated bag if necessary. Carry a sufficient supply of medication and keep it easily accessible during travel. If travelling internationally, familiarise yourself with any regulations or documentation requirements related to carrying medications. This can be further discussed with your Roczen clinician. 

What is the meaning of an off-licence medication?

The term "off-licence" refers to the use of a medication to treat a condition that is not explicitly specified in the manufacturer's product licence. 

How does a medication become licensed for use?

A pharmaceutical company must conduct thorough safety checks on new medications and gain confidence in their safety for prescribing. They then apply for a licence for the medication, submitting evidence to regulatory agencies such as the Medicines and Healthcare Products Regulatory Agency (MHRA) or the European Medicines Agency (EMA). These authorities review the evidence and, if satisfied with the medication's proven safety and safety profile, grant a licence. The licence specifies the medication's doses, known side effects, precautions, and the specific conditions for which it can be used.

Why is this important for GLP-1 and GLP-1/GIP medications?

GLP-1 agonists were initially licensed specifically for the treatment of type 2 diabetes and have been established as safe and effective for this purpose. However, subsequent evidence and clinical trials have shown that the same GLP-1 agonists (for example, semaglutide) and GLP-1/GIP agonists (for example tirzepatide) are also safe and effective in managing weight, leading to their widespread use for weight management.

Is it safe for me to receive an off-licence prescription of a GLP-1 or GLP-1/GIP for weight loss?

An off-licence medication still holds a licence and has undergone rigorous testing to ensure its safety. Like any medication, there can be side effects or specific reasons why it may not be safe to prescribe. At Roczen, our clinical team conducts a comprehensive health assessment to determine your suitability for the medication and ensure it is safe for you to receive a prescription.

Do you have a video that provides instructions on taking Wegovy/Semaglutide medication?

Here is a handy video explaining everything you need to know about taking Wegovy GLP-1 medication:

Watch video here
I would like to read more about Wegovy/Semglutide. Do you have a patient information leaflet?

You can read more on the side effects and further information on Wegovy/Semaglutide in thid document here:

Wegovy LeafletMounjaro leaflet