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ForumsPublic SquareAlcohol metabolism changes on semaglutide — anyone have experience?

Alcohol metabolism changes on semaglutide — anyone have experience?

MarkLI_maint Thu, May 16, 2024 at 6:00 PM 13 replies 2,158 viewsPage 1 of 3
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MarkLI_maint
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May 16, 2024 at 6:00 PM#1

Started at 0.25mg with a fairly bad first week, held each step the full four weeks, and I am now at 1mg with no side effects worth naming.

The bit I cannot resolve on my own is what the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss.

Numbers rather than impressions, if you have them.

27 5RunnerRach, TrialNerd_Beth, HPLC_Greg and 24 others
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PeptideChemSF
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May 16, 2024 at 6:27 PM#2

Taking the question as asked, rather than the general version of it. 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".

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

28 6dave_SLC, FDA_TrackerJim, ricardo_MIA and 25 others
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quinn_sf
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May 16, 2024 at 6:54 PM#3
PeptideChemSF said:
The dose-response is real but shallow at the top.

Agreeing with PeptideChemSF, and the qualification matters more than the agreement. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

29 7mona_PHX, andrew_nyc, Dr.EndoEP and 26 others
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claudia_zurich
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May 16, 2024 at 7:21 PM#4
MarkLI_maint said:
Started at 0.25mg with a fairly bad first week, held each step the full four weeks, and I am now at 1mg with no side effects worth naming.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

30 8alex_tucson, kevin_tulsa, Dr.PainCLE and 27 others
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julia.endo
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May 16, 2024 at 9:48 PM#5

Adding the clinical framing, because it changes how the question reads.

MarkLI_maint said:
...but the FDA says semaglutide...

Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.

Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.

31 9chris_chi24, tampaLisa73, KarenAZ_mom and 28 others
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