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ForumsPharmacology & MechanismsTachyphylaxis vs tolerance — need advice Page 2

Tachyphylaxis vs tolerance — need advice

Dr.NateNeph Sat, Jun 14, 2025 at 3:20 AM 10 replies 1,406 viewsPage 2 of 2
Dr.SportsMedIN
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Jun 14, 2025 at 6:45 AM#6
BenResearch_OR said:
Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest…

Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].

Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.

For the pharmacology, the pharmacology explains the clinical differences between these agents.

References:
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
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LabKate
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Jun 14, 2025 at 8:05 AM#7
Dr.NateNeph said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

Last edited: Jun 14, 2025 at 11:05 AM
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PedsEndoPhilly
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Jun 14, 2025 at 9:25 AM#8
Dr.SportsMedIN said:
Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%),…

Semaglutide structural biology relevant to the pharmacology: semaglutide is a 31-amino acid peptide with 94% homology to native GLP-1(7-36). Three key modifications enable its pharmacokinetic profile:

  1. Aib8 substitution: DPP-4 resistance (prevents enzymatic degradation)
  2. Arg34 substitution: improved chemical stability
  3. C18 fatty diacid at Lys26: albumin binding → long half-life

These three modifications transform a peptide with a 2-minute half-life (native GLP-1) into one with a 168-hour half-life (semaglutide). A masterclass in peptide engineering.

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tony_orlando
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Jun 14, 2025 at 10:45 AM#9

One thing that is still open after TrialTracker_MD’s answer:

Did your prescriber agree with that reading, and if not what was their objection?

Last edited: Jun 14, 2025 at 11:45 AM
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Dr.NateNeph
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Jun 14, 2025 at 5:08 PM#10

OP back with an update, since a thread like this is useless without one.

Update — tachyphylaxis to the gastric effect, persistence of the appetite effect. Two curves, and I had been watching the wrong one.

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