Glucagon-Like Peptide-1 (GLP-1) receptor agonists

Remember that one pen is enough for 4 weeks supply. At this time it is even more important to maintain supply and ensure that the correct quantity of pens is prescribed.

Please prescribe by brand as the different brands are used for different indications.

Wegovy is recommended as an option for weight management, including weight loss and weight maintenance, alongside a reduced-calorie diet and increased physical activity in adults, only if:

• it is used for a maximum of 2 years, and within a specialist weight management service providing multidisciplinary management of overweight or obesity via Tier 3 services within Kent and Medway, and
• they have at least 1 weight-related comorbidity and:
  - a body mass index (BMI) of at least 35.0 kg/m2, or
  - a BMI of 30.0 kg/m2 to 34.9 kg/m2 and meet the criteria for referral to specialist weight management services in NICE's guideline on obesity: identification, assessment and management.
• the company provides it according to the commercial arrangement.
• Use lower BMI thresholds (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds.
• Consider stopping if less than 5% of the initial weight has been lost after 6 months of treatment.

Ozempic® and Rybelsus® are licensed in the UK for use in type 2 diabetes only – do not prescribe solely for weight loss.

• For Ozempic®: for once weekly dosing, one pen (4 doses) = one month’s supply.
• For Rybelsus®: 30 tablets = 30 days’ supply.

Rybelsus® (oral semaglutide): new tablet strengths

Rybelsus® tablets have been reformulated with increased bioavailability. The current 3 mg, 7 mg and 14 mg tablets will be discontinued by 31 January 2026 and replaced by 1.5 mg, 4 mg and 9 mg tablets, which are bioequivalent:

• The new formulations should be used for all new initiations.
• Do not mix old and new formulations for titration.
• Patients should take ONE tablet ONCE daily only. Do not double dose based on tablet strength.
• During the transition period, both formulations may be available; extra care is required to avoid prescribing, dispensing or administration errors.
• Primary care should switch existing patients to the new strengths by January 2026 and remove old formulations from patient records.