Evaluating gastrointestinal side effects and discontinuation rates of semaglutide in routine clinical practice: A prospective observational study.

Monika Patel  Kodela; Dr.N.O.A. Sasi; Rama  Rao

doi:10.51168/sjhrafrica.v6i9.2037

Authors

Monika Patel Kodela Assistant Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
Dr.N.O.A. Sasi Assistant Professor, Department of General Medicine, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
Dr . P. P. Rama Rao Pamarthy Assistant Professor, Department of General Medicine, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2037

Keywords:

Semaglutide, Gastrointestinal Side Effects, Discontinuation Rate, Glucagon-Like Peptide-1 Receptor Agonists, Type 2 Diabetes Mellitus, Drug Tolerability

Abstract

Background:
Semaglutide, a GLP-1 receptor agonist, has demonstrated significant efficacy in glycemic control and weight reduction in Type 2 Diabetes Mellitus (T2DM). However, gastrointestinal (GI) side effects remain a common barrier to long-term adherence in real-world clinical practice. This study aimed to evaluate the prevalence, severity, and impact of gastrointestinal (GI) adverse events on discontinuation rates among patients initiated on semaglutide therapy.

Methods:

A prospective observational study was conducted on 100 adult T2DM patients prescribed semaglutide in a routine outpatient setting. Data on demographics, GI side effects (nausea, vomiting, diarrhea, constipation), severity grading (mild, moderate, severe), dose adjustments, and discontinuation rates were collected over a 12-week follow-up period. Descriptive statistics were applied to analyze frequency distributions.

Results:

The mean age of participants was 54.6 ± 10.8 years, with 52% being male. GI side effects were reported in 43% of patients. Nausea (28%) was the most common symptom, followed by vomiting (12%), diarrhea (10%), and constipation (6%). Multiple GI symptoms occurred in 14% of patients. Among affected individuals, 58.1% experienced mild symptoms, 27.9% required dose reduction for moderate symptoms, while 14% discontinued due to severe intolerance. The overall discontinuation rate was 9%, with GI side effects accounting for 6% of treatment cessations. Dose reductions were performed in 18% of patients, with 66.7% of them successfully continuing therapy post-titration.

Conclusion:

Gastrointestinal side effects are common but generally mild to moderate with semaglutide therapy. Proactive management, including gradual dose escalation and patient education, can mitigate side effects and improve adherence. Despite initial intolerance, most patients can continue therapy with appropriate interventions.

Recommendations:

Routine counseling, slow titration schedules, and early side-effect management strategies are crucial to optimize semaglutide adherence in clinical practice.

Author Biographies

Monika Patel Kodela, Assistant Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

holds an MBBS degree from Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram (2009–2014), and pursued her MD in Pharmacology at Siddhartha Medical College, Vijayawada (2017–2020). She is currently serving as an Assistant Professor in the Department of Pharmacology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. Her academic interests include clinical pharmacology, drug safety, and rational therapeutics, with a focus on advancing pharmacovigilance and evidence-based prescribing practices. She is actively engaged in teaching undergraduate and postgraduate students while contributing to departmental research activities. ORCID iD: https://orcid.org/0009-0001-5176-5631

Dr.N.O.A. Sasi, Assistant Professor, Department of General Medicine, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

completed his MBBS from Alluri Sitarama Raju Academy of Medical Sciences (ASRAM), Eluru (2005–2010), followed by MD in General Medicine at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram (2012–2015). He further specialized in Gastroenterology, earning his DM from Andhra Medical College, Visakhapatnam (2015–2018). He is currently serving as an Assistant Professor in the Department of General Medicine at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. His clinical and academic interests lie in gastroenterology, hepatology, and advanced endoscopic procedures, with active involvement in both patient care and medical education.

Dr . P. P. Rama Rao Pamarthy , Assistant Professor, Department of General Medicine, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

holds an MBBS and MD in General Medicine and is presently working as an Assistant Professor in the Department of General Medicine at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. He is actively engaged in clinical practice, teaching, and mentoring medical students. His academic interests include internal medicine, preventive healthcare, and evidence-based management of chronic diseases.ORCID iD: https://orcid.org/0009-0002-2952-8530

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