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ForumsPharmacology & MechanismsIs there a simple version of how sema vs tirz are different — anyone have experience?

Is there a simple version of how sema vs tirz are different — anyone have experience?

tyler_CSCS Thu, Apr 4, 2024 at 6:23 PM 61 replies 3,286 viewsPage 1 of 13
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tyler_CSCS
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Apr 4, 2024 at 6:23 PM#1

I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer nobody states.

What I am trying to establish is which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.

Practical detail welcome, however dull — the duller the better.

38 8sean_dublin, hannah_MT, Dr.SportsMedIN and 35 others
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Dr.MetabolicMD
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Apr 4, 2024 at 7:09 PM#2
tyler_CSCS said:
I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer…

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.

37 7PedsEndoPhilly, SleepDoc_PDX, RegAffairsDC and 34 others
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NeuroNate
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Apr 4, 2024 at 7:55 PM#3
Dr.MetabolicMD said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

No disagreement with Dr.MetabolicMD. One condition attached. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.

36 6sarah_TO, wendy_avl, jason_paloalto and 33 others
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JakeSmashed95
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Apr 4, 2024 at 8:41 PM#4
tyler_CSCS said:
I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer…

Mine went the same way, slower. Posting only so the count is not one.

Last edited: Apr 5, 2024 at 1:41 AM
35 5Dr.LipidDallas, alex_tucson, kevin_tulsa and 32 others
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MASHdoc_SA
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Apr 5, 2024 at 1:00 AM#5

From the other side of the consultation, briefly.

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 trajectory ever seen for an anti-obesity agent[1].

Amylin receptor agonism enhances satiety signaling through the area postrema and reduces glucagon secretion. Combined with GLP-1R agonism, this dual mechanism may produce even greater efficacy than current agents.

Early-stage data — interpret with caution. But the trajectory is extraordinary.

References:
[1] Novo Nordisk investor presentation, September 2023.
34 4kate.chem, DataDave, Dr.GutHealth and 31 others
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