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Obesity as a Disease - Medication

24

Comments

  • Registered Users, Registered Users 2 Posts: 13,711 ✭✭✭✭fits


    absolutely. We are losing muscle at a frightening rate unless we do something about it. Bone density is another consideration especially with early menopause. Resistance training is so helpful for health.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    My doctor showed me the pen and needle and spoke fairly briefly about the injection. I was apprehensive before doing my own injection two or three weeks later, but to be honest it was so straightforward I couldn't really mess it up (as long as you follow the instructions of course). The instructions say that you have to prime the pen before the first injection from it, and that was also easy to do. By the third injection I could have done it in my sleep. There's also loads of you tube videos with people demonstrating what to do, and that also helped.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I'm on 0.5 now. I titrated slowly upwards, doing 3 x 0.25, 2 x 0.3, and 1 x 0.4. That left 0.25 in my first pen, which I used along with 0.25 from my new 0.5 pen.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    There’s a lot of info online. Various reasons for people to want to know how to do it.

    It’s subcutaneous injection so pretty simple.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Week 8, Day 1.

    189.8lbs this morning, so 1.6lbs lost this week, for an overall total of 15.6lbs lost in seven weeks. I'm delighted to be under the 190 mark. I'm still losing an average of 1.5lb a week which I think is very sustainable and should avoid any of the other problems with quick weight loss e.g. hair loss, gallstones, light headedness.

    I went up to 0.5ml last week and have found an increase in side effects, even when eating relatively clean, and even though I titrated up slowly and took 0.4ml the week before. Again, the side effects aren't too bad - mild headache, fatigue, some gastro issues, but they were definitely across nearly the whole week. I think I'll go back down to 0.4ml today and stick with that until the side effects wane.



  • Registered Users, Registered Users 2 Posts: 911 ✭✭✭Bassfish


    I'm on week two on 0.25. I found on the first week by day 6 after injection my appetite was fully back. I assume that will change as I go up through the doses.

    I was out yesterday and had a few pints, nothing crazy. I ended up getting some chipper food afterwards. Even though I wasn't hungry, I knew I'd better eat something. By christ did I pay for it today. Spent the whole morning vomiting. Couldn't tolerate even a glass of water until the afternoon. Lesson learned. Will be knocking the booze and greasy food on the head for the foreseeable.



  • Registered Users, Registered Users 2 Posts: 88,458 ✭✭✭✭JP Liz V1


    Are pharmacists prescribing to non diabetics?

    I thought only diabetics could get

    It should only be prescribed to diabetics

    OP I would suggest speaking with your GP and a nutritionist or dietician, best of luck



  • Registered Users, Registered Users 2 Posts: 690 ✭✭✭farmerval


    Well done on your progress.

    You're obviously getting great results and the lifestyle adjustments are coming through as well. You seem to be very thoughtful in your approach and are getting the results.

    The great thing is you are losing and finding ways to minimise the side effects. If 0.4 or 0.5 or whatever is the correct level for you then it is.

    Again, well done and keep up the good work, and the progress reports!!



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    pharmacists can’t prescribe medication, only dispense it. My GP prescribed the medication.

    I don’t need a nutritionist- I could practically qualify as one. I’m not obese from a lack of education. I cook from scratch, I know how much protein and fibre I should be eating. I have a lifelong issue with food and sugar cravings that I have been unable to control for more than a few weeks at a time. Until now, that is.

    I understand people saying that diabetics should be prioritised, and that’s fine. But the shortages do seem to be easing- at least I have had no problem getting a pharmacy to dispense my first two pens.

    And ultimately I’m doing something good for society. I’m paying for the medication privately, which if it works should prevent me having to access the public health care system for a myriad of conditions that are co-morbid with obesity. Including diabetes. Basically I am saving you money.


    That’s apart from the health benefit to me, and my children. So forgive me if I don’t feel particularly guilty about taking the medication.



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  • Registered Users, Registered Users 2 Posts: 88,458 ✭✭✭✭JP Liz V1


    I'm glad you are doing good, I didn't realise it was prescribed by GPs to non diabetics, public or privately o



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    Ozempic can be prescribed "off label" for non-diabetics, though its primary use is still for the treatment of diabetes. As I posted earlier, due to shortages pharmacies have been prioritising their diabetic clients for the available supplies.

    Not all diabetics are obese.

    Congrats on your progress. However, having read the thread, I do wonder how much of your progress is due to your changed habits, and how much is down to the medication.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    Why should it only be prescribed to diabetics? Silly attitude imo.

    If OP has paid for the medication, it is there property and they are entitled to use it.

    Who would be prescribing it if not their doctor.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    The shortage was a thing of the past afaik If doctors want to be selective with prescriptions, that's their choice. But I don't agree with pharmacists dictating who they dispense to. That sounds questionable, legally.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I do understand that Ezeoul. If someone develops Type 2 diabetes at a normal weight they are very unfortunate. But it is a fact that 90% of Type 2 diabetics are overweight or obese and the condition has developed because of their body weight.

    I have definitely changed habits. Ozempic isn’t some magic pill that allows me to continue to eat the way I did before and still lose weight. But the point is, I have been able to change my habits because of Ozempic. I no longer think about food all day. I can eat one biscuit and stop. This is a revelation to me. Even as a tiny child I was obsessed with cakes and sweets, more than the average child would. My mum did everything right - breastfed, cooked from scratch, limited treats. I was never overweight until my thirties so I had no hangups or anything, and no trauma to hang this food obsession on. I was born like this, I’m convinced of it.



  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    They are not meant to, it isn't approved for weight loss only diabetes.



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  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    Because it is only approved for the treatment of diabetes



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    My maternal grandmother, mother and I all developed diabetes in our late 40s and 50s without obesity as a factor. My daughter is pre-diabetes without obesity as a factor. We must be a very unfortunate family.



  • Moderators, Business & Finance Moderators Posts: 10,524 Mod ✭✭✭✭Jim2007


    You might want to educate yourself on how medicines are approved before talking about silly attitudes….

    Taking medicines that were designed, tested and approved for a specific purpose in order to benefit from a side effect is an incredibly stupid idea. Because you have no idea of the consequences of taking the drug long term will have - you are basically the test dummy.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I am not sure that is quite right. Yes, Ozempic was originally designed for diabetics, and it is a very useful medication for them. But lots of medications end up showing other benefits that were not originally anticipated. Viagra was originally a blood pressure medication. Prednisone was originally developed for inflammatory diseases and is now used to treat Parkinsons. Ozempic itself has been shown to have benefits for those with heart conditions, and it is likely in the future that it will also be prescribed for people with heart issues, whether or not they are diabetic or overweight. They're called "repurposable" drugs in the pharmaceutical industry and it's a massive thing at the moment. AI can trawl through masses of data to see what drugs might also have a benefit on another disease, and it means that you don't have to go through years of safety trials as that data is already known.

    Semaglutide, the active ingredient in Ozempic, has been prescribed for nearly twenty years. If there were shocking unknown side effects to it, at least in the short to medium term, we'd already know about them. As Johann Hari put it, if Ozempic caused you to grow horns, the diabetics would have horns already.

    As to prescribing it off label, essentially you are correct, but it's a weak argument for preventing obese people from accessing the medicine. Irish GPs have no choice but to prescribe it off label. Wegovy, the drug approved in Ireland for weight loss, has yet to be launched here by Novo Nordisk. Wegovy is the EXACT same drug as Ozempic. It's like Opal Fruits and Starburst. Only the label on the pen is different. So GPs are essentially prescribing a drug that is approved and licensed for weight loss, with 20 years of safety information behind it, but the brand name is temporarily different. Wegovy is due to be launched at Halloween.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    I personally have no issue with non-diabetics being prescribed or using a drug licensed for diabetes off label, when supplies are plentiful. Have at it.

    But when supply is very limited (as it has been), then I do think that pharmacies are correct to prioritise supplies for patients with a condition the drug is actually licensed for.



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  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    In general, I agree with this. However, there are some people with morbid obesity who would have more immediate complications from obesity than someone who is Type 2 diabetic and may be able to control their condition through other available medications. It shouldn't just be a blanket ban. But I don't think that someone like me, who is only tipping into the obese category, should get priority over someone who is diabetic and can only control their condition with Ozempic.



  • Registered Users, Registered Users 2 Posts: 827 ✭✭✭taxAHcruel


    Just for info - since you enjoyed the previous podcast - another informative and relatively deep discussion about the drug came out today on the Andrew Hubermann podcast. The discussion is with one Dr. Zachary Knight under the title "The science of hunger".



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    That's not really accurate though. Ozempic is a brand name. The actually drug is called Semaglutide. Semaglutide is licensed for weight loss in Ireland, and across Europe, under the label Wegovy (same manufacturer too).

    The brand name is irrelevant medical speaking. I find it kinda strange that we license the brand and not the drug. In the future there will be generic semaglutide (like neurofen vrs ibuprofen). But a GP, not being total misinformed like some here, is aware of that, so he safely prescribes Semaglutide for a usage that it is approved for.

    A pharmacist has no business interfering with peoples private prescriptions imo.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    Hilarious that you say I should educate myself, and then follow up with that ignorant nonsense.

    Semaglutide was designed as a longer acting GLP-1 receptor agonist. That's exactly the pathway that aids weight loss, there were existing GLP-1 weight loss drugs at the time. This is not some shocking side effect, where people taking risks with unknown consequences. It's was literally be designed, tested and approved as both an anti-diabetic and an anti-obesity medication used.

    Phase 3 testing for weight loss took place in 2021. https://www.nejm.org/doi/10.1056/NEJMoa2032183

    Taking a medicine that is tested and licensed for weight loss, prescribed by a medical professional is not being a test dummy. It's literally taking tested and approved medicine, that due to the brand name is considered off label.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    Wegovy is not available in Ireland at the moment.



  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    not just a brand name. a very different dose as well. Ozempic is only licenced for diabetes treatment in ireland.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I'm afraid I have to pull you up on this one too. The diabetic trials showed that a 1mg dose was the optimum dose to obtain blood sugar control benefits. The obesity trials showed that 2.4mg was the optimum dose for weight loss, where participants lost approx 15% of their body weight. However, weight loss also occurred at the 1mg dose, where participants lost approximately 10% of their body weight. At the moment, in Ireland, weight loss patients are restricted to taking a maximum of 1mg because the highest dose of Ozempic is 1mg. Of course you could buy two pens, or even three, in order to get up to the 2.4mg dose, and some GPs do prescribe that. But that makes the medication prohibitively expensive, apart from exacerbating the shortages of the 1mg pen, so most weight loss patients don't do that.

    The main point is, there is no downside for weight loss patients taking the 1mg dose (which they have to titrate upwards through anyway, in order to get to the 2.4mg dose) and staying on it for a length of time. In fact, losing 10% of your body weight has massive benefits for your health, including reducing the chances of developing Type 2 diabetes by over 80% and the chances of developing all types of cancer by 33%.

    It'd be different if it was the other way around - e.g. weight loss patients were only meant to take a 1mg dose and were taking the 2.4mg dose instead.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    According to my endocrinologist 1mg is not the optimum dose for diabetics, and has told me the max dosage they can prescribe will be increased, they're just waiting on whatever permissions are required.



  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    2.4mg is the dose used for weight loss. it isnt sold her because the drug is not approved for weight loss here. and if somebody brings in a prescription for multiple ozempic pens to a pharmacy the pharmacist should tell them to feck off.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    But it isn't the only dose that is beneficial for weight loss, as explained above.

    It isn't sold here because Novo Nordisk have decided not to launch the 1.7mg and 2.4mg pens (branded as Wegovy) in smaller countries until they can guarantee supply. The 2.4mg dose is in fact licensed and approved here by the Irish Medicines Board. We are just waiting for NN to launch it.

     if somebody brings in a prescription for multiple ozempic pens to a pharmacy the pharmacist should tell them to feck off.

    What you should mean is doctors should not be prescribing it. A pharmacist should never have the power to decide what medication or what dosage is right for a stranger presenting themselves in their pharmacy, in circumstances where the person has attended a GP, who is qualified to make that decision.



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  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    That's really interesting Ezeoul. Have they done trials on the higher doses with diabetics? I hadn't read anything and I've been keeping a really close eye.

    By the way @taxAHcruel thank you for the heads up on the podcast. I'll start it on the way home. You are a mine of information!!



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul




  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun




  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    A pharmacist is more than qualified to make that decision. that IS their qualification.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Pharmacists should only refuse to fill a prescription where there is a medical reason that the medication is unsuitable or unsafe for the patient. They should not be making moral judgements on who should or shouldn't get medication. If that was the case, every pharmacist in the country could refuse to fill prescriptions for the pill.



  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    they are not obliged to fulfill any prescription. i'm sure there are some that wont fill a prescription for the pill. as for somebody coming in with a prescription for multiple ozempic pens, if they have to decide between filling that prescription or filling ozempic prescriptions for diabetic patients then I hope they would decide on the latter.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    You've tried to make this argument before, that pharmacists were making some kind of moral judgement on obese patients. That's in your head.

    And I'll say to you again, that is a very unfair accusation to make. Pharmacists are not in the business of making any moral judgements, (as you say, if they were they could refuse to dispense the pill or emergency contraception).

    What they are doing is prioritising limited supplies based on medical need. And they are qualified to make that judgement, even if there are some who think otherwise.

    I've often found the advice of an experienced pharmacist more helpful and knowledgeable than that of a GP.

    Post edited by Ezeoul on


  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Look, I’m not saying pharmacists can’t prioritise limited supplies. I’m just saying that a blanket ban on weight loss prescriptions is inherently unfair. People with a bmi of 40+, or those with a bmi of 35+ and a heart condition may well be at a higher risk of serious complications than a diabetic who has been prescribed ozempic as their first port of call.

    It shouldn’t be an outright no without asking the patient further questions. Even where they present a prescription for two pens, rather then to be told to “feck off”.

    This is all rather moot though. 1mg ozempic has been taken off the IMB shortages list.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    Still shortages of the 0.25mg and 0.5mg Ozempic pens.

    https://www.hpra.ie/docs/default-source/clinical-trial---hpra-pilot-project/ie_shortage-comms_hcp_ozempic-0-25-mg---0-5-mg_june-2024_final.pdf?sfvrsn=2

    There is no blanket blanket "ban" on weight loss prescriptions and there never was. Doctors were still prescribing it, even when there were limited supplies available.

    Also Ozempic is not typically the first port of call for the treatment of diabetes. You may be knowledgeable about weight loss drugs, but not so much about the treatment (and complications) of diabetes, especially uncontrolled diabetes. It is an extremely complex condition which takes daily management and sometimes a cocktail of drugs to get, and keep it under control.

    I wonder if it was a cardiac or cancer treatment drug, and not just a diabetes one, would the attitude be the same.

    Post edited by Ezeoul on


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  • Registered Users, Registered Users 2 Posts: 14,555 ✭✭✭✭Goldengirl


    I think this is a really good thread and credit to you for it.

    However I have to disagree with your characterisation of diabetics with type 2 as due to obesity .

    Yes , a large proportion of diabetics are overweight hence the emphasis on weight loss to try to improve health and control blood sugar .

    But it is not as simple as that .

    It is a fact that many diabetics gain weight precisely because of their inability to metabolise sugars and carbs and not the other way round .

    I am lucky enough to be one of the skinny type 2 Diabetics as are my siblings and our disease is 100% genetic . ( Father ,grandparent )

    I had gestational diabetes on three pregnancies requiring insulin .

    Before I was diagnosed I gained weight over the course of a year just a couple of stone but uncharacteristic for me , felt very unwell and tired and craved carbs .

    I had always been slim , a healthy eater and physically active .Walking swimming cycling and worked in an active job .

    The diagnosis coincided with an inflammatory illness which the doctors think triggered my diabetes . which caused the weight gain

    That weight fell off quickly as soon as my blood sugars came under control but I felt unwell for a good few months after that until I got a handle on my diet and other complications .

    I still do whenever I get an infection which diabetics are more susceptible to or if I have any strain which triggers inflammation and high sugars . But that is daily life for most diabetics .

    I am on other meds , not on Ozempic but do agree that it should be widely available to those with high BMI over 30 if at all possible .

    But I can totally understand why its use presently is restricted to those with Diabetes who don't respond to other medications .

    Diabetics , even without high blood sugars can have a cascade of progressive illness (cardiac ,kidneys, nervous system, feet , eyes , high blood pressure and high cholesterol ) all of which are exacerbated by their diabetes which is a chronic inflammatory condition .

    Every effort has to be made to prevent all the other co-morbidities from developing .

    Obese people suffer some of these co- morbidities as well , but with all due respect it is incorrect to say it is the same as being a diabetic .It is not .

    If you are obese AND diabetic your risk factor is multiples for all the co morbidities mentioned above over a person who is just obese .

    On the Ozempic and it's side effects I have no issue with this discussion

    But it's not suitable to discuss a serious chronic and progressive illness as if it was just a matter of t2 diabetics " eating healthily and reversing it ". Once a diabetic , always diabetic whether under control or not .

    I am not sure if you meant to minimise Diabetes , but that is how it comes across ...

    I hope that Wegovy which has been recommended for treatment of obesity will soon be available in Ireland for those who want it .

    The more medication available so there is not such competition between those who would LIKE a medication to help them loose weight , impacting on the requirements of those who actually medically NEED it .



  • Registered Users, Registered Users 2 Posts: 690 ✭✭✭farmerval


    It would be lovely if the thread could get back to the couple of posters led by Apache who are willing to share their experiences in a new treatment for obesity.

    Whether a pharmacist or doctor will or won't prescribe offer or whatever maybe can go to a separate thread? For whatever reason(s) the western world is experiencing an obesity epidemic as well as a diabetes epidemic. Ozempic or the proposed other treatments are of huge interest to so many people. That some posters are willing to share their experiences is very enlightening for many.

    Diabetics are under medical care and supervision, with regular testing and monitoring to measure and adjust medications and dietary regimes to assist our treatment. The likely outcome if/when Wegovy is available here or Ozempic as it currently is, will be that many people will be taking it with minimal medical oversight so any experiences and benefits /downsides shared will help people in deciding to try this route as a solution to their weight problems.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Thanks Farmerval.

    Apologies if I have come across as flippant about diabetes, that was certainly not my intention and I do understand that it is a complex and debilitating disease. I don’t mean to turn this into an obesity vs diabetic debate. Not least because you are quite right that I am no expert on diabetes. Ideally everyone who needs this medication should have access to it and if there are shortages there are those who are way more qualified than me to decide who has the greatest medical need.

    Had I been taken aside by a pharmacist when I went with my first prescription and explained that they couldn’t take on any more patients in order to keep supply for their current patients, I would have accepted it. Honestly I’m not sure I would have had the tenacity to try elsewhere- I probably would have chalked it up to just another failed attempt to lose weight. I just didn’t come across it.

    Moving back to current experience, despite moving down to 0.4 ml last week I’m still getting side effects. Again for me it was the dreaded D, which led to me actually attempting to sleep on the bathroom floor on Friday night. While I stayed away from the takeaway I found I was eating beyond my fullness levels just because someone else had cooked it and I didn’t want to be rude and that’s what led to the side effects. It brought to the fore my people pleasing tendancies. Now that I have pretty immediate consequences if I slip up, I will have to prioritise my own physical wellbeing. This drug is like therapy.

    Today I felt great. Full of energy, upbeat and very easy to stick to protein and fibre.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Well here we are, Week 9 Day 2.

    I didn't lose anything at all this week. It was bound to happen sometime, and if I am being very honest I don't think my diet was at all healthy over the past week. Even the stomach issues over the weekend couldn't rescue the week. It's disheartening, especially when I definitely still eating less than I did before, but I have to use it to look very honestly at what I'm eating, rather than how much.

    I've found a certain pattern over the past three weeks, and many apologies for going into bowel movements in advance. But I have found that I can go days during the week without needing a No.2. It doesn't even feel like constipation, it's just like I completely forget about it. Then I eat something bad/high fat over the weekend, which obviously slows the movement of food even further. My body appears to get a shock, and decides to clear everything out quick smart (not pleasant). And then the cycle starts again.

    I was very good in the first couple of weeks at tracking my fibre and protein, but I've fallen off the wagon somewhat as I had been blaming the clear out on the takeaway, rather than my whole week's choices. I also definitely have not been drinking enough water.

    So back with a clean slate. I've eaten only whole foods and lots of fibre today. I took some psyllium husk last night and will do again tonight. I've drunk 3.5 pints of water, a coffee and a tumeric latte, so I'm hoping the fluids will help the movement. And home cooked dinners over the weekend, with lots of fibre. And we'll see how we go.

    Someone on a US forum recommended nausea patches, like the ones you get for travelling, to help with the low level nausea. I have one on today - can't say if it's working or not but they last for three days so we'll see if it makes a difference.

    Last thing to note: I got my 1mg pen at the pharmacy yesterday. I won't be on it for another three weeks but I thought it'd be better to get it early. Cost wise, the 0.25mg pen was €142, the 0.5mg pen was €145 and the 1 mg pen was €149. So barely a difference in price between the doses, which might be a relief to some people. I know the UK that the price can go up 30% between 0.25mg and 1mg.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    I'm aware. But as above, it's a brand name. Semaglutide is the drug and is available so doctors are perscribing.
    The claims that is reckless, untested, test dummy stuff is simply not true.

    Incorrect again. Semaglutide is approved in a range of doses for each. Each person is prescribed the appropriate dose for their treatment - which is the case for all medication.
    Starting does for both are the same.

    Semaglutide is licensed for both obesity and diabetes. The fact they are labelled separately is irrelevant medically. Besides, obesity treatment is the higher dose. So the claims that ozempic is unsafe to treat obesity is totally baseless.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    The drug is approved here, as was already pointed out to you.

    And for weight loss you don't just jump into the highest dose of 2.4mg. You titrate up, in all cases.

    The starting dose in all cases is .25mg, then .5mg, then 1mg. It's only at higher doses that the to brands deviate.

    A pharmacist may legally be able to decline a prescription. That doesn't validate any decision they make.

    If a patient has a prescription for say 1mg semaglutide, there are no valid grounds to refuse it.
    Pharmacists are qualified to advise on medicine, they are got qualified to appraise a GP or other doctor's treatment that is medically approved.



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  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    The claims that is reckless, untested, test dummy stuff is simply not true.

    So the claims that ozempic is unsafe to treat obesity is totally baseless.

    Please quote the post where I made any of those claims. Please don't attribute another poster's words to me.

    My only issue is about supplies, and it is my unchanged view that where there are limited supplies, the treatment of diabetes takes priority.

    See the excellent post from @Goldengirl who put it better than I did. Also note the point made that Ozempic is often prescribed to diabetics who have stopped responding to other diabetes medications.

    Contrary to what is posted above, there are still supply issues. If you would like to check out the living with diabetes threads, you will see recent posts from diabetics about difficulties in supplies as recently as this month.



  • Registered Users, Registered Users 2 Posts: 14,555 ✭✭✭✭Goldengirl


    It still is not licensed here to treat obesity regardless of doctors prescribing it " off label " .Pharmacists are not making judgements, moral or otherwise , they are simply not allowed to order in drugs prescribed off label as they can be sanctioned .

    Some seem to find ways around this , don't know how .

    It is hoped that both Sandexa and Wegovy which come in dosages more suitable to treating obesity , will be available this year .

    While I am commenting I make no judgements either as can totally understand people being desperate for this life changing treatment .

    It's just coming in direct competition to some diabetics who can frankly become very seriously unwell and quickly if they cannot access their medication , hence the restrictions .

    Good article here ..

    https://www.independent.ie/irish-news/more-than-25000-irish-people-now-receiving-weight-loss-jab-ozempic-for-free-but-only-to-treat-diabetes/a7218535.html



  • Registered Users, Registered Users 2 Posts: 40,589 ✭✭✭✭ohnonotgmail


    If a patient has a prescription for say 1mg semaglutide, there are no valid grounds to refuse it.

    If they have a diabetic patient that requires it then that is a valid ground to refuse.

    they are got qualified to appraise a GP or other doctor's treatment that is medically approved

    that is just plain incorrect.



  • Registered Users, Registered Users 2 Posts: 39,759 ✭✭✭✭Mellor


    Where did I attribute another posters words to you?

    I said THE claims not YOUR claims. As in the claims in the thread, obviously you've seen them so should have know that. That second sentence you quoted wasn't even in response to you 🙄. That compliant is a bit of a reach.

    My only issue is about supplies, and it is my unchanged view that where there are limited supplies, the treatment of diabetes takes priority.

    And I previously said I understood pharmacies being selective when supplies are limited. I wouldn't want to see anybody unable to get a medically necessary medicine.

    1mg appears to be more available now. Logically the 1mg is what the country needs to most of, so Novo are obviously making more of 1mg compared to .25mg.

    FWIW it's probably incorrect to lump all diabetics in one equal category. T

    See the excellent post from @Goldengirl who put it better than I did. Also note the point made that Ozempic is often prescribed to diabetics who have stopped responding to other diabetes medications.
    Contrary to what is posted above, there are still supply issues. If you would like to check out the living with diabetes threads, you will see recent posts from diabetics about difficulties in supplies as recently as this month.

    My post (that you replied to) had nothing to do supply. I was simply responding to the misinformation about the drug in question. Semaglutide is licensed for weight loss in ireland. It has been through extensive testing and studies, and it is an expected result not a wild uncharter side effect. The poster (that wasn't you 😉) that claimed that was grossly mistaken.



  • Registered Users, Registered Users 2 Posts: 3,751 ✭✭✭Ezeoul


    You attributed it to me by specifically quoting one of my posts, and then responding to it in a way that made it look to anyone reading like it was I who made those claims.

    Please do not do that again.



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