Examples Metformin Dosage Immediate release Initial: 500 mg once or twice daily OR 850 mg once daily Maximum: 2,550 mg daily (dosages above 2,000 mg daily are typically administered in three divided doses) Extended release Initial: 5001,000 mg once daily Maximum: 2,000 mg daily Possible side effects include: Gastrointestinal: diarrhea, nausea, and/or abdominal discomfort Vitamin B12 deficiency (and elevated homocysteine) Testosterone reduction (blood tests can measure this and natural testosterone prescription creams may be considered) Oral glucagon-like peptide-1 (GLP-1) receptor agonist Primary mechanism(s) of action Enhance incretin signaling to increase glucose-dependent insulin secretion, reduce post-prandial glucagon, and delay gastric emptying (resulting in reduced after-meal glucose levels and increased satiety) Examples Semaglutide (Rybelsus) is the only approved medication in this class as of early 2022

In addition, potential differences in the magnitude or trajectory of weight loss between semaglutide-treated patients and those achieving weight loss through nonpharmacologic approaches could not be quantified within the platform
For plans that are open to GLP-1 coverage for obesity, the average amount they are willing to pay annually is $3,000
Mioduchoski, FNP-BC These lesser-known side effects often come as a surprise because patients dont read about them in the standard medication guides