#21

That’s good to know! I did try on Indiamart first and got varying quotes. And then I read the news that it only got launched in India last week lol

Fortunately, I was able to get access to Rybelsus 3mg here in Finland. Listening to US-based podcasts, I assumed Ozempic would be much more expensive.

Later I looked up the prices and realized that all doses of Rybelsus and Ozempic are priced similarly here, and Ozempic would have given me some more control w.r.t dosing strategies.

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#22

I haven’t used it yet. I tried to get a prescription from my primary care doctor for weight loss, but he wasn’t going to issue one because I’m not diabetic. I know of one friend who started Ozempic and Metformin last July and lost around 60 pounds, and my cousin who has diabetes started Ozempic 3 months ago, and she lost at 30 pounds but experienced much nausea the first month on it. I convinced a relative to issue me a prescription for Trulicity that’s covered by my insurance and had it filled, but I haven’t started it yet.

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#23

Let us know how it goes. It seems that this drug class is really good.

#24

Btw, found a short older discussion about protocols combining sema and rapa on twitter:

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#25

(Liraglutide and rapamycin interaction)

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#26

I have been using semaglutide (compounded version) for patients for over 8 months with phenomenal results. Some of the patients use metformin as well as a continuous glucose monitor to know which carbs to avoid. They are on a Mediterranean diet with an avoidance of seed oils. Those who elect to use rapamycin are started on 6 mg once a week. In addition, after the weight is lost I use a combination of different peptides like CJC 1295 with ipamorelin or BPC 157/TB4 to help tone their bodies. After completing methylation epigenetic true age tests the patients have decreased their pace of aging and are younger than their biological or calendar age. I have found that the weekly semaglutide is more effective than the oral medication and only a small insulin syringe is used.

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#27

What is meant by compounded version?

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#28

I have a few questions…

i) What are differences you’ve observed in those who choose to take rapamycin and those who don’t? Does the rapa group lose more weight for example?
ii) Are there some unique side effects in those who take rapa + sema compared to those who take rapa alone?
iii) When you say weekly semaglutide is more effective what do you mean? Better glucose control, or fewer side effects?
iv) Do you have a different semaglutide protocol or is it the standard 0.25 a week for a month, then 0.5 a week for a month and so on till the maintenance dose of 1mg is reached?

Usage of semaglutide with rapamycin
#29

compounding pharmacies make a generic version with vitamin B12 in the US since the dosage is different from the commercial version and the B12 is added to help with occasional nausea

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#30

I’m curious about the peptides. I use BPC157 and TB500 to help with periodic joint injuries from Brazilian jiu jitsu (which is inherently hard on joints), but I wasn’t aware of any systemic health benefits. Can I ask what you mean by “tone their bodies?”

#31

Tony Robbins book reminded me about peptides (Bpc 157 can help both with musculoskeletal injuries and heal leaky gut) and FYI: Reliable peptide suppliers can be used to get semaglutide cheaper than prices mentioned above (though you’ll have to be comfortable reconstituting it from powder-pretty easy).

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#32

Just got some Rybelsus from Oddways in India - came through to New Zealand no problems

#33

What was the pricing, and how many tablets did you buy?

And please post your results with it and dosing.

#34

… semaglutide causes an average of 18–20% loss of body weight when paired with diet and lifestyle advice. In other words, a person who walks into his office weighing 250 pounds and chooses semaglutide can expect to shed about 48 pounds.

Semaglutide is just the leading edge of a wave of new obesity therapies in development that reflect our deepening understanding of the human body and that promise to fundamentally change the lives of people with obesity.

…

Semaglutide may sound too much like a free lunch, and it is indeed far from free in a financial sense. Ryan estimates that Wegovy will cost about $1,300 per month in the US, although it will probably cost about a quarter of that in other countries. In the US, many people won’t have immediate access to it due to insurance coverage and other limitations, and it remains to be seen how accessible it will be in other countries. [3]

Compounding this problem is the fact that US insurance companies usually require doctors to submit burdensome “prior authorization” paperwork to justify the prescription of weight loss drugs. “The result is that most doctors don’t fool with it,” explains Ryan. “It tends to be the obesity medicine specialists,” which most people with obesity never see.

#35

From Oddway International:
Rybelsus 3mg : USD 55 per pack
Rybelsus 7mg: USD 75 per pack
(10 pills per pack)
Received order 20 days from payment.
Have tried the 3mg for the last two days - so early days.
Appetite seems to be reduced, and feeling noticeably ‘fuller’ earlier in the meal.

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#36

So, total cost per month is going to be in the range of:

$160+ per month at 3mg/day
$225+ per month at 7mg/day

Seems worth a try for people who may have struggled to lose that last bit of weight that doesn’t go away despite diet and exercise modifications.

For oral dosage form (tablets):

  • Adults—At first, 3 milligrams (mg) once a day for 30 days. Your doctor may adjust your dose as needed. However, the dose is usually not more than 14 mg once a day.

https://www.mayoclinic.org/drugs-supplements/semaglutide-oral-route/proper-use/drg-20492085

#37

Given the long half-life of 7 days, 7mg every other day would be somewhat equivalent to 3mg daily, and would cut down the monthly cost.

3 Likes
#38

Wow - that is a long half-life. I wonder what the dose/response rate is for this drug in terms of weight loss… probably individual, at some level.

Full Package insert here for Semaglutide / Rybelsus

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#39

Referring back to Alex’s original twitter post, it seems like single weekly dose of a GLP-1 drug like semaglutide might be a way to get to the optimal body fat level / lean body mass measure to where you want it for lowest all cause mortality rates.

While the cost of daily dose semaglutide is not insignificant:

Total cost per month is going to be in the range of from the above source mentioned:
$160+ per month at 3mg/day
$225+ per month at 7mg/day

The monthly cost of a weekly 7mg dose would only be:
$30 per month at 7mg/once per week

This might be interesting to test, but if I did test this idea, I’d do regular weekly or every two week blood tests to track key blood measures.

Given all the research on caloric restriction, it seems likely that the risk of excess weight seems to far exceed any potential risk of low weight, specifically when it comes to excess fat:

Below is the Age-adjusted All Cause Mortality Rates for Men (“fully adjusted” calculation on the right side image).

AgeAdjustedAllCauseMortalityFat
AgeAdjustedAllCauseMortalityFat1256×750 70 KB

Source:

Full Paper Available for PDF Download here:

http://sci-hub.wf/10.7326/M15-1181

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#40

Another new drug targeting GLP-1, for weight loss:

It may be difficult to afford long-term

One of the biggest questions about tirzepatide right now is if it will be affordable and accessible to patients who need it over time.

Typically, the high cost of weight loss drugs can be a deterrent to patients. Semaglutide, for instance, has been listed at a price of $1,349 for a month’s supply for obesity treatment.

A majority of insurance plans don’t cover weight loss medications, and those that do require extensive paperwork, according to Isaacs.

“It’s a huge burden to prove patients qualify for the drug,” he said.

Currently, tirzepatide is gaining popularity as a weight loss prescription because of a discount which makes the drug available at $25 for one to three months supply, according to the manufacturer’s website.

The catch with weight loss medications like tirzepatide and semaglutide is that patients have to continue taking the medication to maintain the weight loss.

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