Usage Instructions for Rybelsus

Rybelsus® (semaglutide) is a prescription medicine used to improve blood sugar (glucose) in adults with type 2 diabetes. It should be used along with diet and exercise. The following guide provides comprehensive instructions for patients and healthcare professionals regarding proper dosing, administration, and considerations.

Initial Considerations

Before starting Rybelsus, healthcare providers should assess the patient's medical history, current medications, and potential contraindications. Rybelsus is not recommended as first-line therapy for patients with type 2 diabetes who have inadequate glycemic control with diet and exercise alone. It is typically used when metformin or other agents are not sufficient.

Dosing Schedule

The dosing of Rybelsus follows a stepwise titration schedule to minimize gastrointestinal side effects:

• 3 mg once daily: For the first 30 days to help the body adjust to the medicine.
• 7 mg once daily: After 30 days, increase to this maintenance dose.
• 14 mg once daily: Can be considered for additional glycemic control after at least 30 days on 7 mg.

How to Take Rybelsus

To ensure maximum absorption and effectiveness, patients must follow these administration instructions:

• Take Rybelsus with a sip (up to 4 ounces) of plain water only.
• Do not crush, split, or chew the tablet.
• Take it first thing in the morning, on an empty stomach.
• Wait at least 30 minutes before eating, drinking anything other than water, or taking other oral medications.

Missed Dose

If a patient forgets to take their dose, it should be taken the next day as usual. Patients should not double the dose to make up for a missed one.

Storage and Handling

Rybelsus tablets should be stored in the original blister packaging to protect them from moisture and should be kept at room temperature, away from excess heat and light.

Adverse Reactions

Common side effects include nausea, diarrhea, vomiting, abdominal pain, decreased appetite, and constipation. These symptoms are typically dose-dependent and often improve with time. Patients experiencing persistent or severe reactions should contact their healthcare provider.

When to Contact a Doctor

Patients should seek medical attention immediately if they experience symptoms such as:

• Severe abdominal pain (possible pancreatitis)
• Changes in vision (possible diabetic retinopathy complication)
• Signs of an allergic reaction (rash, itching, swelling, trouble breathing)
• Lump in the neck (possible thyroid tumor)

Interactions with Other Medications

Rybelsus may alter the absorption of oral medications due to delayed gastric emptying. Healthcare providers should evaluate drug interactions, particularly with:

• Thyroid hormone replacement (e.g., levothyroxine)
• Oral antibiotics
• Oral contraceptives
• Other antihyperglycemic agents (risk of hypoglycemia)

Monitoring Parameters

Patients should have their HbA1c, fasting glucose, renal function, and weight monitored regularly. Eye examinations are also recommended due to potential worsening of diabetic retinopathy during rapid glycemic control.

Patient Education

Educating patients is essential for successful treatment. Ensure patients understand the importance of adherence, lifestyle changes, and regular follow-up appointments. Provide materials and instructions in a language and format that are accessible.

Discontinuation

If discontinuation is necessary, there is no tapering required. However, a transition plan to other antidiabetic therapy should be discussed to prevent uncontrolled blood glucose levels.

Conclusion

Rybelsus is an innovative medication that requires careful administration for optimal effect. Patients and providers must work together to ensure safe and effective treatment. Always follow the prescribing information and consult professional guidelines.