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ForumsPharmacology & MechanismsSo the drug literally changes your brain?? That is wild — my results so far Page 2

So the drug literally changes your brain?? That is wild — my results so far

LarryQC_SD Thu, Apr 18, 2024 at 6:32 PM 14 replies 2,230 viewsPage 2 of 3
Dr.LipidDallas
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Apr 18, 2024 at 7:54 PM#6
PeptideChemSF said:
I want to add the drug interaction perspective on the pharmacology.

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

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PeptideSynthNJ
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Apr 18, 2024 at 8:26 PM#7
LarryQC_SD said:
I went looking for why the dosing schedule is what it is and found that almost every practical question on this board has a pharmacokinetic answer…

Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].

Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.

For the pharmacology, the pharmacology explains the clinical differences between these agents.

References:
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
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Dr.PathRoch
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Apr 18, 2024 at 8:58 PM#8
Dr.LipidDallas said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest trajectory ever seen for an anti-obesity agent[1].

Amylin receptor agonism enhances satiety signaling through the area postrema and reduces glucagon secretion. Combined with GLP-1R agonism, this dual mechanism may produce even greater efficacy than current agents.

Early-stage data — interpret with caution. But the trajectory is extraordinary.

References:
[1] Novo Nordisk investor presentation, September 2023.
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adam_van
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Apr 18, 2024 at 9:30 PM#9

One thing that is still open after Dr.NutriCornell’s answer:

What would you measure differently if you were starting again?

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LarryQC_SD
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Apr 19, 2024 at 12:05 AM#10

Reporting back.

Closing this out: the trough rather than the peak explains the pattern I was seeing on day six, which I had been blaming on the vial.

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