The figures, for anyone assembling their own picture. The practical numbers: about 1% oral bioavailability, 30 minutes fasted before food, no more than 120ml of plain water, and coffee counts as food for this purpose.
One thing that is still open after Dr.EM_Chicago’s answer:
Whether the fasting requirement is as strict in practice as the label implies, and what people actually see when they get it wrong?
raj_cambridge said:The practical numbers: about 1% oral bioavailability, 30 minutes fasted before food, no more than 120ml of plain water, and coffee counts as food for…
There is a second half to this that has not been said yet. Oral semaglutide is absorbed in the stomach with the help of SNAC, which locally raises pH and protects the peptide long enough to cross. That mechanism is fragile: bioavailability is roughly 1% and highly sensitive to gastric contents, so a mouthful of coffee genuinely changes the exposure. This is why the label wants 30 minutes and no more than half a glass of plain water.
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View ResultsClosing the loop on my own question.
I moved the tablet to the moment I wake up rather than trying to fit it around breakfast, and the difference in the following weeks was obvious. It was a timing problem, not a dose problem.
Dr.NephBHM_UK said:Oral semaglutide is absorbed in the stomach with the help of SNAC, which locally raises pH and protects the peptide long enough to cross.
Dr.NephBHM_UK has the substance of this right. The condition it depends on is worth stating. Worth adding that the tablet is taken daily, so a missed dose costs far less than a missed weekly injection. That is a genuine advantage nobody lists.