Dr.PainCLE 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.

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

I would rather be corrected than agreed with, if it comes to it.

Adding the numbers, since they settle part of this. If you are going to change something, change one thing and give it long enough to express itself. Four weeks is the usual minimum for anything pharmacological on this board, and two weeks of data has told you almost nothing.

Dr.ObesityLA said:

I do not accept that the fasting window is a minor inconvenience.

There is a second half to this that has not been said yet. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

Following on from JakeSmashed95 — and this may be the naive question:

Whether the fasting requirement is as strict in practice as the label implies, and what people actually see when they get it wrong?

OP back with an update, since a thread like this is useless without one.

Follow-up: moving the tablet to the moment I wake, before anything else, was the whole fix. The dose never changed.