I am a retired MD, an internist who focused on diabetes management. I made good use of exenatide and liraglutide but retired before the longer acting forms were available. I prescribe semaglutide to my wife in very low dose. She has a very strong FH of HTN, with both parents dying of hypertensive strokes, which was difficult to control with multiple meds that resulted in excessive fluctuation, with episodes of both moderate hyper and mild hypotension. She was mildly overweight with too much visceral fat and mild CKD with eGFR in the 45-55 range. She, like the great majority, was able to achieve but not sustain weight loss more than a few months and thus the semaglutide. This has resulted in a sustained approximate 6 lb weight loss with marked improvement in BP control on 50mg losartan and HCTZ 12.5mg with much less fluctuation and no hypotension and stable renal function, actually slightly better.
I get the med from a compounding pharmacy which I think is good quality. It's combined with Vit B6 which I think is innocuous. Drug companies object that delivery of the GLP-1's with vial and syringe leave patients subject to dosage error. However, we have been treating diabetes with insulin by vial and syringe for 100 years or so and have accommodated to that more hazardous agent. Vial and syringe delivery has multiple advantages including lower cost than auto injection devices and more importantly the ability to manage dosage, both amount and timing in a much more individualized manner depending on clinical response. This is especially important for an agent with extremely common and significant non-fatal adverse effects that are very dosage and timing dependent. It's my opinion that cheaper and more flexible GLP-1 RA availability, such as from good quality compounding pharmacies, would allow thoughtful doctors and their patients to make much more widespread use of these dramatically effective agents. However, this would demand more rather than less doctor-patient interaction which is what I fear might be happening with the TV advertised online entities.
Excuse my ignorance, but do compounders work to CGMP? Only you comment "I get the med from a compounding pharmacy which I think is good quality" How sure are you on the quality? Has FDA reviewed the CMC details of a compounded drug, as is that case with a licensed drug?
Whenever someone -- usually an elite Wellness Wonder bitch starts to sigh and say, " Do we know about the long term effects of Ozempic, etc."
I stop them and say: 70% of the population won't have a long term. Anyone who is trying to stop the use from the branded version or the compounded one is worried the public will walk form their diets and dopey exercise and endless life style hacks like Get up at 5;00AM!!
I am a retired MD, an internist who focused on diabetes management. I made good use of exenatide and liraglutide but retired before the longer acting forms were available. I prescribe semaglutide to my wife in very low dose. She has a very strong FH of HTN, with both parents dying of hypertensive strokes, which was difficult to control with multiple meds that resulted in excessive fluctuation, with episodes of both moderate hyper and mild hypotension. She was mildly overweight with too much visceral fat and mild CKD with eGFR in the 45-55 range. She, like the great majority, was able to achieve but not sustain weight loss more than a few months and thus the semaglutide. This has resulted in a sustained approximate 6 lb weight loss with marked improvement in BP control on 50mg losartan and HCTZ 12.5mg with much less fluctuation and no hypotension and stable renal function, actually slightly better.
I get the med from a compounding pharmacy which I think is good quality. It's combined with Vit B6 which I think is innocuous. Drug companies object that delivery of the GLP-1's with vial and syringe leave patients subject to dosage error. However, we have been treating diabetes with insulin by vial and syringe for 100 years or so and have accommodated to that more hazardous agent. Vial and syringe delivery has multiple advantages including lower cost than auto injection devices and more importantly the ability to manage dosage, both amount and timing in a much more individualized manner depending on clinical response. This is especially important for an agent with extremely common and significant non-fatal adverse effects that are very dosage and timing dependent. It's my opinion that cheaper and more flexible GLP-1 RA availability, such as from good quality compounding pharmacies, would allow thoughtful doctors and their patients to make much more widespread use of these dramatically effective agents. However, this would demand more rather than less doctor-patient interaction which is what I fear might be happening with the TV advertised online entities.
Excuse my ignorance, but do compounders work to CGMP? Only you comment "I get the med from a compounding pharmacy which I think is good quality" How sure are you on the quality? Has FDA reviewed the CMC details of a compounded drug, as is that case with a licensed drug?
Whenever someone -- usually an elite Wellness Wonder bitch starts to sigh and say, " Do we know about the long term effects of Ozempic, etc."
I stop them and say: 70% of the population won't have a long term. Anyone who is trying to stop the use from the branded version or the compounded one is worried the public will walk form their diets and dopey exercise and endless life style hacks like Get up at 5;00AM!!
Is there any requirement for the product license holders to run phase 4 studies?
The Alabama Board of Medical Examiners recently banned any medical professional from
prescribing peptides despite having no evidence of risks or adverse events.