The short version of GLP-1 analogue fits in a sentence. The long version — which is the one that helps — is below.
Reviewed 2025-10-05. Anything still debated is marked as such rather than presented as settled.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released by intestinal L cells after food intake. The natural hormone acts on pancreatic and central receptors but is degraded within minutes by dipeptidyl peptidase-4 and other peptidases. Semaglutide belongs to the class of long-acting GLP-1 receptor agonists, a group distinguished by structural changes that slow breakdown and extend circulation time. Its development followed earlier short-acting analogues and reflects a general strategy in peptide drug design: preserve receptor activity while blocking proteolytic clearance.
Three structural changes define the molecule. At position 8 an alpha-aminoisobutyric acid residue replaces alanine, which blocks dipeptidyl peptidase-4 cleavage. At position 34 arginine replaces lysine, and at position 26 a lysine carries a C18 fatty diacid attached through a short linker. The fatty chain binds serum albumin, and this albumin association reduces renal filtration and enzymatic attack. The unchanged backbone retains the receptor contacts that produce signalling. The free base has the formula C187H291N45O59 and a molecular weight near 4114 daltons.
关于降解产物的免疫原性风险，文献中仍有讨论空间。体外聚集水平与临床免疫反应之间的定量关系尚未确立。多数公开研究只报告理化指标，缺少长期随访的对应数据。这一问题在生物类似物比对中尤其受到关注。
市售注射用制剂通常要求在二至八摄氏度冷藏保存，并避免光照与冻结。部分多剂量笔在首次使用后允许在不超过三十摄氏度的环境中存放有限周数，具体期限由辅料与防腐剂体系决定。反复冻融会促进肽链聚集并改变可见颗粒计数，因此应予避免。冻干粉末在干燥、避光、低温条件下更为稳定。溶液配制后宜使用低吸附容器，以减少肽类在塑料或玻璃表面的损失。
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C187H291N45O59 | free base, without counter-ion |
| Molecular weight | About 4114 Da | peptide backbone plus attached lipid chain |
| Plasma half-life | About 165 hours | supports once-weekly dosing in humans |
| Plasma protein binding | Greater than 99 percent | attributed mainly to serum albumin |
| Receptor target | GLP-1 receptor | Gs-coupled, raises intracellular cyclic AMP |
Lyophilised material appears as a white to off-white cake or powder that is hygroscopic, and containers are usually equilibrated to room temperature before opening to limit condensation. Dissolution is performed in water, phosphate-buffered saline, or a mildly alkaline buffer, since solubility rises above neutral pH. Gentle inversion or low-speed mixing is preferred, because vigorous vortexing can promote surface denaturation and aggregation. Complete dissolution may require several minutes, and brief sonication is sometimes applied. Passing the solution through a 0.22 micrometre membrane removes particulates but does not by itself sterilise the liquid.
Storage at minus 20 degrees Celsius or lower in a desiccated container preserves the peptide for extended periods, while working solutions are commonly held at two to eight degrees Celsius for short intervals. Light exposure and repeated freeze-thaw cycles accelerate degradation, so dividing material into single-use aliquots is generally recommended. Adsorption to glass and plastic surfaces can lower the measured concentration of dilute solutions, particularly below one milligram per millilitre. The degradation routes most often reported for GLP-1 analogues are deamidation, methionine oxidation, and backbone hydrolysis. Relative rates under specific conditions are frequently described only for individual formulations.
Reverse-phase high-performance liquid chromatography with ultraviolet detection near 214 or 280 nanometres is widely used to assess purity and to resolve related impurities. Liquid chromatography coupled to mass spectrometry confirms identity through the protonated molecular ion and fragment ions formed in tandem experiments. Capillary electrophoresis and peptide mapping after enzymatic digestion supply complementary information on charge variants and modification sites. Circular dichroism and nuclear magnetic resonance can report on secondary structure in solution. Absolute quantification usually depends on an external standard, and reported purity depends on the detection wavelength and integration parameters chosen.
As a peptide, semaglutide is sensitive to conditions that break amide bonds or modify side chains. Deamidation of asparagine and glutamine residues, oxidation of methionine and tryptophan, and non-covalent aggregation are the main degradation routes described in published stability work. Rate depends strongly on pH, buffer species, ionic strength, temperature and exposure to light. Formulators therefore choose a defined solution pH and often add excipients such as phosphate buffer, propylene glycol and phenol, each of which plays a separate role in pH control, tonicity or preservation.
Storage guidance for the finished injectable product distinguishes the unused state from the in-use state. Before first use, pens are kept refrigerated between 2 and 8 degrees Celsius, protected from light, and never frozen, since freezing can disrupt the peptide or the device. After first use, label instructions in several markets permit storage at room temperature up to about 30 degrees Celsius for a limited number of days. Solid research-grade material is normally held at or below minus 20 degrees Celsius, often with desiccant, and allowed to equilibrate before opening.
Quantification and purity assessment rely on separation methods coupled to optical or mass detection. Reversed-phase high-performance liquid chromatography resolves the intact peptide from related impurities and is the standard assay technique. Size-exclusion chromatography measures aggregates, while ion-exchange chromatography separates charge variants produced by deamidation. Mass spectrometry confirms identity and detects mass shifts of a few daltons. In biological matrices, liquid chromatography with tandem mass spectrometry is often used because immunoassays can cross-react with endogenous GLP-1 or with circulating fragments.
13. Ir Med J. 2026 Sep 28;119(8):160. Non-Arteritic Anterior Ischaemic Optic Neuropathy Associated with Semaglutide use. Kearney M, Smyth NM, Hassan HSA, Khan MS. PRESENTATION: Non-arteritic ischaemic optic neuropathy (NAION) is a common cause of acute, painless monocular visual disturbance in older adults. This case discusses a woman in her 70s with vascular risk factors who presented with a three-day history of progressive left sided visual disturbance. Examination demonstrated a left relative afferent pupillary defect and inferior quadrantopia. DIAGNOSIS: Haematological investigations and neuroimaging were unremarkable. Formal ophthalmological assessment demonstrated superior optic disc swelling with an inferior visual field defect, consistent with NAION. TREATMENT: The patient had been taking semaglutide, as prescribed, for the six months prior to presentation. This was identified as a potential contributory agent and was discontinued. Visual acuity partially improved following cessation of semaglutide. DISCUSSION: This case seeks to highlight a possible association between semaglutide use and NAION. Although causality remains unproven, it underscores the importance of pharmacovigilance when manging patients presenting with ophthalmological symptoms.
5-HT2C receptor agonists reduce appetite by working on serotonin receptors in a region of the brain called the hypothalamus. Lorcaserin (Belviq) was FDA approved for weight loss but was withdrawn from the market because a safety clinical trial shows an increased occurrence of cancer. Cannabinoid receptor antagonists were developed to treat obesity because researchers noticed that cannabinoid agonists (such as THC, the main pharmacologically active component of cannabis), increased appetite. However, some drugs in this class such as rimonabant were withdrawn or ceased development due to concerns about mental health and suicide. More selective drugs—some are in development that act only in peripheral tissues, not the brain—may be able to achieve this result with fewer adverse effects. GLP-1 agonists such as tirzepatide, semaglutide, and liraglutide slow gastric emptying and also have neurologically driven effects on appetite. It is unknown if GLP-1 agonists or dual/triple agonists of GLP-1 and/or the glucagon or GIP receptors act solely by reducing energy intake or if they also increase energy expenditure. Setmelanotide is an agonist of the melanocortin 4 receptor and is used in people with certain rare genetic conditions that cause obesity. It is less effective and not approved for general obesity.
13. Ir Med J. 2026 Sep 28;119(8):160. Non-Arteritic Anterior Ischaemic Optic Neuropathy Associated with Semaglutide use. Kearney M, Smyth NM, Hassan HSA, Khan MS. PRESENTATION: Non-arteritic ischaemic optic neuropathy (NAION) is a common cause of acute, painless monocular visual disturbance in older adults. This case discusses a woman in her 70s with vascular risk factors who presented with a three-day history of progressive left sided visual disturbance. Examination demonstrated a left relative afferent pupillary defect and inferior quadrantopia. DIAGNOSIS: Haematological investigations and neuroimaging were unremarkable. Formal ophthalmological assessment demonstrated superior optic disc swelling with an inferior visual field defect, consistent with NAION. TREATMENT: The patient had been taking semaglutide, as prescribed, for the six months prior to presentation. This was identified as a potential contributory agent and was discontinued. Visual acuity partially improved following cessation of semaglutide. DISCUSSION: This case seeks to highlight a possible association between semaglutide use and NAION. Although causality remains unproven, it underscores the importance of pharmacovigilance when manging patients presenting with ophthalmological symptoms.
8 October – Tánaiste Micheál Martin said that the Department of Foreign Affairs had been in touch with the family of Kim Damti (22), an Irish-Israeli woman who was unaccounted for following the previous day's series of attacks launched by Hamas on Israel. On 11 October, Damti was confirmed dead. 10 October – Minister for Finance Michael McGrath and Minister for Public Expenditure, National Development Plan Delivery and Reform Paschal Donohoe announced Budget 2024, with three electricity credits for all households, a €12 increase to core social welfare payments and half-price travel for those aged under 25. 23 October – Yousef Palani was sentenced to two life sentences plus 20 years for the murder of two men and the stabbing of a third in Sligo, all of who he had sought out on a pretence of dating. 25 October – The Health Products Regulatory Authority (HPRA) said it had seized 254 units of falsified Semaglutide, a drug used for type 2 diabetes and as an unofficial aide to weight loss, during 2023. 27 October – Latest figures showed that homelessness in Ireland hit new records: 8,923 adults and 3,904 children accessed emergency accommodation in September 2023, bringing the total to 12,827 people.
Sources: pubmed.ncbi.nlm.nih.gov
Dysphoria and apathy (due to dopamine receptor blockade) Sedation (particularly common with asenapine, clozapine, olanzapine, quetiapine, chlorpromazine and zotepine) Headaches Dizziness Diarrhea Anxiety Extrapyramidal side effects (particularly common with first-generation antipsychotics), which include: Akathisia, an often distressing sense of inner restlessness. Dystonia, an abnormal muscle contraction Pseudoparkinsonism, symptoms that are similar to what people with Parkinson's disease experience, including tremulousness and drooling Hyperprolactinaemia (rare for those treated with clozapine, quetiapine and aripiprazole), which can cause: Galactorrhoea, the unusual secretion of breast milk. Gynaecomastia, abnormal growth of breast tissue Sexual dysfunction (in both sexes) Osteoporosis Orthostatic hypotension Weight gain (particularly prominent with clozapine, olanzapine, quetiapine and zotepine, can be counteracted by starting the drug with metformin) Antipsychotic medication-induced weight gain (AIWG) is a difficult-to-manage condition. In a meta-analysis analyzing data from 9 studies having more than 40,000 patients with AIWG, use of semaglutide was on an average was associated with 7.37kg weight loss with a good reduction in waist circumference. The occurrence of psychiatric adverse events was lower in semaglutide users.
Dysphoria and apathy (due to dopamine receptor blockade) Sedation (particularly common with asenapine, clozapine, olanzapine, quetiapine, chlorpromazine and zotepine) Headaches Dizziness Diarrhea Anxiety Extrapyramidal side effects (particularly common with first-generation antipsychotics), which include: Akathisia, an often distressing sense of inner restlessness. Dystonia, an abnormal muscle contraction Pseudoparkinsonism, symptoms that are similar to what people with Parkinson's disease experience, including tremulousness and drooling Hyperprolactinaemia (rare for those treated with clozapine, quetiapine and aripiprazole), which can cause: Galactorrhoea, the unusual secretion of breast milk. Gynaecomastia, abnormal growth of breast tissue Sexual dysfunction (in both sexes) Osteoporosis Orthostatic hypotension Weight gain (particularly prominent with clozapine, olanzapine, quetiapine and zotepine, can be counteracted by starting the drug with metformin) Antipsychotic medication-induced weight gain (AIWG) is a difficult-to-manage condition. In a meta-analysis analyzing data from 9 studies having more than 40,000 patients with AIWG, use of semaglutide was on an average was associated with 7.37kg weight loss with a good reduction in waist circumference. The occurrence of psychiatric adverse events was lower in semaglutide users.
The United States Food and Drug Administration and the European Medicines Agency have approved weight loss medications for adults with either a body-mass index (BMI) of at least 30, or a body-mass index of at least 27 with at least one weight-related comorbidity. This patient population is considered to have sufficiently high baseline health risks to justify the use of anti-obesity medication. The American Academy of Pediatrics had not previously supported the use of weight loss medication in adolescents but issued new guidelines in 2023, which recommend considering the use of weight loss medication in some overweight children aged 12 or older. The European Medicines Agency has approved semaglutide for children aged 12 or older who have a BMI in the 95 percentile for their age and a weight of at least 60 kilograms (130 lb). However, GLP-1 agonists may not be cost effective in this population.
Sources: en.wikipedia.org
The US Food and Drug Administration (FDA) approves anti-obesity medications as an adjunctive therapy to diet and exercise for people for whom lifestyle changes do not result in sufficient weight loss. In the United States, semaglutide (Wegovy) is approved by the FDA for chronic weight management. The FDA guidelines say that a therapy may be approved if it results in weight loss that is statistically significant greater than placebo and generally at least five percent of body weight over six months that comes predominantly from fat mass. Some other prescription weight loss medications are stimulants, which are recommended only for short-term use, and thus are of limited usefulness for patients who may need to reduce weight over months or years. As of 2022, there is no pathway for approval for drugs that reduce fat mass without 5 percent overall weight loss, even if they significantly improve metabolic health; neither is there one for drugs that help patients maintain weight loss although this can be more challenging than losing weight. As of 2022, no medication has been discovered that would equal the effectiveness of bariatric surgery for long-term weight loss and improved health outcomes.
Amylin analogues can both reduce energy intake and increase expenditure and can usefully be combined with leptin analogues for synergistic effect. The dual amylin and calcitonin receptor agonist cagrilintide, in combination with semaglutide, was more effective than semaglutide alone in promoting weight loss in clinical trials. Glucagon receptor agonists both reduce energy intake and increase energy expenditure in humans. They can cause hyperglycemia so it is recommended to combine them with a hypoglycemic drug, such as a GLP-1 or GIP receptor agonist.
Amylin analogues can both reduce energy intake and increase expenditure and can usefully be combined with leptin analogues for synergistic effect. The dual amylin and calcitonin receptor agonist cagrilintide, in combination with semaglutide, was more effective than semaglutide alone in promoting weight loss in clinical trials. Glucagon receptor agonists both reduce energy intake and increase energy expenditure in humans. They can cause hyperglycemia so it is recommended to combine them with a hypoglycemic drug, such as a GLP-1 or GIP receptor agonist.
Sources: en.wikipedia.org
Native GLP-1 is a short-lived peptide cleared within one to two minutes by dipeptidyl peptidase-4 and related enzymes. Semaglutide keeps the receptor-binding backbone but adds substitutions and a lipid chain. These changes block the main cleavage site and allow reversible albumin binding, extending the half-life to roughly 165 hours.
Albumin is the most abundant protein in plasma and carries molecules that bear fatty-acid chains. Binding shields the peptide from renal filtration and from peptidases, keeping a circulating reservoir. Slow release from this reservoir produces sustained receptor occupancy and supports infrequent dosing.
The insulinotropic effect is glucose-dependent, meaning secretion increases mainly when glucose is elevated. This property is often described as lowering the chance of hypoglycaemia when the compound is used alone. Other glucose-lowering agents used at the same time can still cause low blood glucose.
冻融过程中冰晶形成与局部浓度升高会促使肽链发生界面吸附和聚集。聚集不仅降低有效含量，还会改变可见异物与不溶性微粒的计数结果。将溶液分装为单次使用的小体积等份可减少循环次数。