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ForumsCardiovascular OutcomesHeart failure hospitalization reduction on semaglutide — need advice Page 2

Heart failure hospitalization reduction on semaglutide — need advice

cory_ATX Thu, Jan 9, 2025 at 8:52 AM 12 replies 1,708 viewsPage 2 of 3
PeptideSynthNJ
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Jan 9, 2025 at 11:10 AM#6

The figures, for anyone assembling their own picture. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

5 8wanda_boise, NurseAsh_DET, BenResearch_OR and 2 others
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Dr.EndoEP
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Jan 9, 2025 at 12:04 PM#7

One thing that is still open after BariatricNurseD’s answer:

Whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg?

6 9james_edin, FranDenver, Dr.BariatricHTX and 3 others
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sophie_paris
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Jan 9, 2025 at 12:58 PM#8
PeptideSynthNJ said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

There is a second half to this that has not been said yet. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

Last edited: Jan 9, 2025 at 5:58 PM
7 10MariaRD, AussieAnna, BethLabQueen and 4 others
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cory_ATX
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Jan 9, 2025 at 1:52 PM#9

Reporting back.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

Last edited: Jan 9, 2025 at 3:52 PM
8 11Dr.PathRoch, mona_PHX, andrew_nyc and 5 others
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EndoResFellow
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Jan 9, 2025 at 6:10 PM#10
sophie_paris said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

38 11Dr.ObesityLA, NurseKim_ATL, paul_denver and 35 others
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