The first UK patients to receive the newly available Wegovy weight loss pill have reported experiencing significant side effects, including nausea, diarrhoea and fatigue, during their first month on the daily tablet.
Louise Atkinson switched to the daily semaglutide tablet after losing two stone on Mounjaro injections over 18 months. Her weight dropped from 13 stone 5 pounds to 11 stone 5 pounds on the injections.
UK pharmacies began shipping the Wegovy pills on July 7. Manufacturer Novo Nordisk has supplied 1.5mg doses for beginners and 4mg doses for patients moving from low dose injections.
The tablets cost about 100 pounds for a one month supply of the lowest dose through private online pharmacies, compared to 150 pounds for Mounjaro. The medication is not expected to be available through the National Health Service for months, pending approval by the National Institute for Health and Care Excellence.
Atkinson received her 4mg pills from private provider SheMed alongside medication for diarrhoea, bloating, constipation and heartburn.
The active ingredient, semaglutide, is identical to the Wegovy injection but requires patients to take it after an eight hour fast with a maximum of 120ml of water. Patients must then wait 30 minutes before consuming anything else to allow the pill's special coating to protect the peptides from stomach acids before entering the bloodstream. Observers believe the pills could revolutionise the market by appealing to patients who fear needles.
Initial side effects
Atkinson experienced stress dreams about accidentally eating on her second night, and baked biscuits to manage severe sugar cravings. She said she missed the morning tea her husband, Jon, usually brought her in bed.
By her fourth day on the medication, Atkinson experienced a wave of nausea, which she said made it difficult to eat lunch with her husband.
Rachael Joy, chief clinical officer at SheMed, said the medication accumulates in the body over time. Joy said semaglutide has a half life of about seven days, meaning daily tablets gradually increase the amount in the blood until it reaches a steady state after four to five weeks.
Joy said peak blood concentrations are reached an hour after taking the tablet, before gradually falling over the rest of the day.
Atkinson's stomach pain disrupted her sleep by the end of her first week. During her second week, after drinking wine one evening, she developed an itchy rash on her neck and shoulders alongside diarrhoea and gastrointestinal discomfort.
Other users on Facebook support groups reported similar symptoms, complaining of sickness, headaches and fatigue.
Atkinson considered switching back to the Mounjaro injection, which she could safely do 24 hours after taking her last pill. She decided to continue with Wegovy, noting the expense of Mounjaro was difficult to justify for maintaining weight rather than losing it.
Weight fluctuations
Atkinson's weight rose to 11 stone 6 pounds in her second week after she twisted her knee playing padel, reducing her daily step count.
In her third week, her weight returned to 11 stone 5 pounds. She used antihistamines to clear her rash and ate prunes and a fibre drink to manage constipation.
Atkinson said she experienced afternoon fatigue, but her food cravings and nausea subsided.
By her fourth week, her weight dropped to 11 stone 4 pounds, breaking a 12 month plateau. Her side effects disappeared entirely, and she was able to manage the daily pill routine without drinking alcohol during a weekend trip away.
Atkinson said she planned to drop to the 1.5mg starter dose once she reaches a body mass index of 25. Her starting BMI was 27. She said she hopes the daily pill will eventually replace the blood pressure tablet and statin she previously took, and noted she is saving money on food, wine and taxis.
Studies show more than 70 per cent of users are affected by gastric side effects from semaglutide medications. Clinical data indicates the Wegovy pill produces an average body weight loss of 17 per cent, compared to 20 per cent for the Wegovy injection and 22.5 per cent for Mounjaro.
Joy said serious complications such as pancreatitis and gallbladder disease are uncommon and usually linked to rapid weight loss, meaning they are less likely on the oral medication.
Addressing the recent death of a 73 year old woman from Norfolk from a bowel perforation, Joy said the complication is so rare it is not listed as a recognised side effect of GLP-1 medicines.
Larger 9mg and 25mg doses of the Wegovy pill are now available. A new GLP-1 pill, Foundayo, is expected to be approved for the UK market later this year.
