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Evidence-based GLP-1 & peptide discussion since 2023
ForumsPharmacology & MechanismsHas anyone dealt with so the drug literally changes your brain?? that is wild? Page 2

Has anyone dealt with so the drug literally changes your brain?? that is wild?

Dr.Martinez Wed, Sep 10, 2025 at 1:38 PM 19 replies 1,556 viewsPage 2 of 4
quinn_sf
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Sep 11, 2025 at 2:09 PM#6
Dr.Martinez said:
The pharmacokinetics explain nearly every practical question asked here.

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.
Last edited: Sep 11, 2025 at 8:09 PM
27 22tane_welly, Dr.PathRoch, mona_PHX and 24 others
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AmyNC_wife
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Sep 11, 2025 at 11:54 PM#7

Following on from JenPlateau — and this may be the naive question:

How would you tell the difference between that and the alternative explanation?

26 21julia.endo, JessicaM_2024, TomFromTexas and 23 others
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hyun_seoul
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Sep 12, 2025 at 9:39 AM#8
quinn_sf said:
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…

Pharmacist here. I want to add the drug interaction perspective on the pharmacology.

Key points from a pharmacokinetic standpoint:

  • GLP-1 agonists delay gastric emptying, which can affect Tmax of co-administered oral medications
  • Monitor patients on warfarin (INR), levothyroxine (TSH), and oral contraceptives during dose titration
  • The albumin-binding mechanism of semaglutide (C-18 fatty acid linker) gives it the ~168-hour half-life that enables weekly dosing
  • Steady state is reached at approximately 4-5 weeks after dose initiation or adjustment

Re: the pharmacology specifically — the pharmacology here is well-characterized and the clinical implications are straightforward.

25 20MASHdoc_SA, GenomicsKate, Dr.ObesityMed and 22 others
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Dr.Martinez
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Sep 12, 2025 at 7:24 PM#9

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.

Last edited: Sep 13, 2025 at 12:24 AM
24 19Dr.SurgeonPGH, rachel_ABQ, traveltech_sara and 21 others
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lori_vegas
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Sep 14, 2025 at 6:10 PM#10
hyun_seoul 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.

Last edited: Sep 14, 2025 at 8:10 PM
10 8Dr.PathRoch, mona_PHX, andrew_nyc and 7 others
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