Excipients are not inert from an analytical point of view. A certificate for a formulated tablet has to account for them, and one that reports a purity figure without saying what the figure is a proportion of is ambiguous.
If the premise is wrong, everything after it is decoration.
Picking up post #21: that is the part I would want checked first.
Oral semaglutide's bioavailability is low and variable, which is why the dose numbers are an order of magnitude different from the injectable. That is a formulation consequence and not a difference in potency.
Happy to be the one who is wrong here if it settles the question.
Where I part company with post #30, and it is a narrow parting.
On variability: the between-person spread in exposure for oral semaglutide is wide enough that two people on the same dose can have quite different plasma concentrations. That is inherent to the absorption route.
The strength of my opinion here exceeds the strength of my evidence.
Why administration conditions matter for oral semaglutide and not for injectables: the oral formulation depends on a transient pH effect in the stomach. Anything that changes gastric pH or transit time changes absorption. Food does both.
I would rather be precise about what I do not know than vague about what I do.
Anyone comparing published oral and injectable efficacy should check whether the comparison is within one trial or across two. Across two, the populations differ and the comparison is weak.
None of the above is medical advice and I am not qualified to give any.
Understood, and I withdraw the assumption I opened with.
Missed doses behave differently for a daily oral than for a weekly injection. With a short interval you are near a trough rather than perturbing a slowly moving average, and the labelling reflects that.
I am describing what is, rather than arguing for what should be.
Dose equivalence between oral and injectable formulations is not a simple conversion and no published factor should be used as one. The two were developed and titrated separately.
Read the full topic (136 posts)
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Why fasting instructions for oral semaglutide are not optional advice — does this still hold?
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Coming back to: The SOUL trial and oral semaglutide cardiovascular outcomes
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Why fasting instructions for oral semaglutide are not optional advice
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+70 | 74 | 1.1k | 23d |