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ForumsPublic SquareAlcohol metabolism changes on semaglutide — July 2024 Page 2

Alcohol metabolism changes on semaglutide — July 2024

LondonLisa Tue, Nov 4, 2025 at 9:42 AM 12 replies 1,199 viewsPage 2 of 3
quinn_sf
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Nov 4, 2025 at 7:42 PM#6

The figures, for anyone assembling their own picture. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

Happy to go further on any of that.

30 0tane_welly, Dr.PathRoch, mona_PHX and 27 others
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roxy_nash
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Nov 4, 2025 at 11:39 PM#7

Following on from Dr.RaviCardio — and this may be the naive question:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

Last edited: Nov 5, 2025 at 5:39 AM
29 24roxy_nash, tony_orlando, Dr.NephBHM_UK and 26 others
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anna.melb_AU
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Nov 5, 2025 at 3:36 AM#8
quinn_sf said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Coming at quinn_sf’s question from a different direction. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

That is the short version; the long version is somebody else's post.

28 23emma_london, tammy_FL, Dr.LipidDallas and 25 others
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LondonLisa
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Nov 5, 2025 at 7:33 AM#9

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

Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.

27 22JenPlateau, SallyK_inj, CryptoCarl and 24 others
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MASHdoc_SA
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Nov 6, 2025 at 2:29 AM#10
anna.melb_AU said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

anna.melb_AU has the substance of this right. The condition it depends on is worth stating. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

7 7kate.chem, DataDave, Dr.GutHealth and 4 others
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