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ForumsPharmacology & MechanismsIs there a simple version of how sema vs tirz are different — anyone have experience?

Is there a simple version of how sema vs tirz are different — anyone have experience?

tyler_CSCS Thu, Apr 4, 2024 at 6:23 PM 61 replies 3,286 viewsPage 1 of 13
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tyler_CSCS
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Apr 4, 2024 at 6:23 PM#1

Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience both.

Numbers worth memorising for this class: Tmax one to three days for the weekly peptides, terminal half-life about a week for semaglutide and about five days for tirzepatide, steady state at four to five half-lives, subcutaneous bioavailability high enough that site choice is irrelevant.

So the question, as narrowly as I can put it: which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.

Practical detail welcome, however dull — the duller the better.

38 8sean_dublin, hannah_MT, Dr.SportsMedIN and 35 others
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BethLabQueen
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Apr 4, 2024 at 7:09 PM#2
tyler_CSCS said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

Semaglutide structural biology relevant to the pharmacology: semaglutide is a 31-amino acid peptide with 94% homology to native GLP-1(7-36). Three key modifications enable its pharmacokinetic profile:

  1. Aib8 substitution: DPP-4 resistance (prevents enzymatic degradation)
  2. Arg34 substitution: improved chemical stability
  3. C18 fatty diacid at Lys26: albumin binding → long half-life

These three modifications transform a peptide with a 2-minute half-life (native GLP-1) into one with a 168-hour half-life (semaglutide). A masterclass in peptide engineering.

37 7Dr.PulmRoch, maya_sedona, stefan_berlin and 34 others
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lori_vegas
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Apr 4, 2024 at 7:55 PM#3
BethLabQueen said:
Semaglutide structural biology relevant to the pharmacology: semaglutide is a 31-amino acid peptide with 94% homology to native GLP-1(7-36).

Agreeing with BethLabQueen, and the qualification matters more than the agreement. The mechanism is more central than most summaries suggest. Receptor agonism in the arcuate nucleus activates POMC neurons and inhibits AgRP/NPY signalling, and the downstream MC4R pathway is the same one disrupted in monogenic obesity — convergent genetic evidence that the target is the right one. Peripherally there is glucose-dependent insulin secretion, glucagon suppression and delayed gastric emptying, but the gastric component largely adapts over months while the central effect persists, which is why the durable effect is appetite rather than fullness.

Last edited: Apr 4, 2024 at 9:55 PM
36 6oliver_london, tane_welly, Dr.PathRoch and 33 others
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LondonLisa
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Apr 4, 2024 at 8:41 PM#4
tyler_CSCS said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

Mine went the same way, slower.

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julia.endo
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Apr 5, 2024 at 1:00 AM#5

Adding the clinical framing, because it changes how the question reads.

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.

34 4chris_chi24, tampaLisa73, KarenAZ_mom and 31 others
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