What is it about?

Semaglutide is a treatment for type 2 diabetes, belonging to a class of medicines called glucagon-like peptide 1 receptor agonists (GLP-1RA). Semaglutide, along with diet and exercise is very effective at managing high blood sugars in people with type 2 diabetes. However, in the past, semaglutide was only available as an injection, since it would have been destroyed by the digestive system if taken by mouth. A tablet, or ‘oral’ version of semaglutide has been created by adding an absorption enhancer called SNAC (sodium N-(8-[2-hydroxylbenzoyl] amino) caprylate), which protects the medicine from stomach acid, allowing semaglutide to be absorbed by the body. This version of semaglutide was the first oral GLP-1RA to be approved as a treatment for type 2 diabetes. Studies in healthy people and in people with type 2 diabetes have shown that levels of semaglutide in the blood are similar when it is given as an injection or a tablet. Oral semaglutide does not affect the absorption of some medicines such as lisinopril, S-warfarin, R-warfarin, digoxin, or oral contraceptives, and the dose of oral semaglutide does not need to be adjusted in people with liver or kidney disease. Side effects such as nausea are common with semaglutide, but these occur at a similar rate with oral semaglutide and the injectable version. Oral semaglutide should be taken upon awakening on an empty stomach, with a sip of plain water (no more than 4 oz). People should wait 30 minutes before eating, drinking or taking any other oral medications.

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Why is it important?

why is it important' explanation: ‘Semaglutide is a treatment for type 2 diabetes, belonging to a class of medicines called glucagon-like peptide 1 receptor agonists (GLP-1RA). In the past, semaglutide was only available as an injection as it would have been destroyed by the digestive system if taken by mouth. An oral (tablet) form of semaglutide has been created by adding an absorption enhancer called SNAC (sodium N-(8-[2-hydroxylbenzoyl] amino) caprylate), which protects the medicine from stomach acid, allowing semaglutide to be better absorbed by the body. This article is important as it summarises the current evidence on SNAC as an absorption enhancer for the tablet form of semaglutide and discusses how SNAC influences what semaglutide does in the human body

Perspectives

The development of oral semaglutide is an important innovation in medicine and it is a good treatment for many patients with conditions such as type 2 diabetes. This article is a timely addition to the literature and provides clear practical guidance for pharmacists dispensing semaglutide tablets. The evidence discussed in the manuscript suggests that SNAC can be effectively used as an absorption enhancer for semaglutide tablets

Curtis Triplitt

Read the Original

This page is a summary of: Current Understanding of Sodium N-(8-[2-Hydroxylbenzoyl] Amino) Caprylate (SNAC) as an Absorption Enhancer: The Oral Semaglutide Experience, Clinical Diabetes, August 2023, American Diabetes Association,
DOI: 10.2337/cd22-0118.
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