Self-Injectable Weight Loss Treatment

The Self-Injectable Weight Loss Treatment that we can provide prescriptions for (where medically appropriate) is a once-daily medication that can help with weight loss.

It is prescribed as one part of a weight management plan that includes increased physical activity and a reduced calorie diet.

It comes in a pre-filled pen so that you can self-inject it at home.

This medication belongs to a group of medications called Glucagon-Like-Peptide (GLP-1) agonists.

Your body produces a hormone called Glucagon-Like-Peptide (GLP-1), which is released from the gut in response to food. This plays an important role in regulating blood glucose levels, slowing the emptying of your stomach and suppressing your appetite.

These medications are synthetic versions of this hormone. They can be used in the management of diabetes, and to aid weight loss and maintenance.

Please note the dosing regimes and the licensed products available for each medical condition, are different.

They act on part of the brain that controls appetite, causing you to feel more satisfied after you eat and fuller for longer. Therefore, you eat less.

The effect of this medication is only apparent when you are using it. When you stop using it , appetite regulation returns to the pre-treatment pattern. Most people will start to eat more again and regain weight.
In some cases, patients will regain more weight than they lost (they will weigh more than before treatment started). For this reason, medication often needs to be continued life long, or until another suitable treatment is arranged.

It is very important to be aware of this before agreeing to commence this treatment as part of your weight management plan.

This medication is a once-daily injection – you will have to self-administer the injections. We will provide training for this to ensure you are safe and comfortable with the self-injection technique.

This medication is injected under the skin every day via a short needle into the tissue just below the skin . This is called a subcutaneous injection.

The best places to inject are

• Your upper arms
• The front of your thighs
• Your abdomen (stomach)

You should inject a different place each day.

This treatment comes in a pre-filled pen with a measurement gauge so you can set and check the dose to be administered. You will need to connect a new, clean needle each time you use it, and dispose of each needle into a sharps box after every injection.You should never reuse needles, and never share needles or medication with anyone.

It should be given at the same time every day. It doesn’t matter if you take it with or without food. You should choose a time that suits you and works for your daily routine.

The dose of treatment will change over the first 4 weeks. You will start off on a low dose and gradually increase to the target treatment dose. This is to minimise any potential side effects, particularly nausea. 

If you do experience side effects, do not increase the dose as planned. This can be done more gradually to allow the side effects to settle. If you do increase the dose, the side effects are likely to become more troublesome and potentially very serious. We can provide you with advice on how to manage this if necessary.

When you reach the maximum dose, you will remain on this dose ongoing as maintenance treatment. 

It is important that you DO NOT use more than the maximum dose each day. This will increase the possibility of potentially serious side effects but will not have any effect on weight loss. 

Some people do not reach the max dose, as they have side effects, but you can still lose weight. 

We will provide detailed information on medication doses if your request is approved.

It will start to work immediately, but it can take up to 2 weeks before you notice any weight loss.

This will vary from person to person, and will depend on what dose of medication you are using. You can expect to lose 0.5-1kg per week when you reach the target treatment dose (week 5 ).

It is normal for your weight (and weight loss) to fluctuate from week to week.

You may not reach a ‘normal’ BMI (25 or less). That is OK! It is important to be aware of this and set a realistic mind-set. The focus of weight management should be health gain, and not the numbers on your scales.

Approximately 20% of patients do not respond to this particular  treatment, even if they make the required lifestyle changes. 

Once you have been using the target treatment dose every day for 12 weeks, you will need to get a verified weight measurement from a healthcare professional (such as your pharmacist) . 

If you have not lost at least 5% of your initial body weight you will be advised to stop using this treatment as you have not responded. This is not a failure on your part, the treatment is just not effective for you. 

This is usually after 16 weeks of treatment (4 weeks to reach the target dose and then 12 weeks using this dose daily). It may take longer in some patients if they have to increase the dose more slowly to cope with side effects.

This medication should not be used if you are actively trying to conceive. It should be stopped at least one month before trying to get pregnant, or starting IVF treatment.

Ideally, you should use a reliable form of contraception when using this medication. If you do become pregnant when using this treatment , you should stop it immediately.

It should not be used if you are pregnant or breastfeeding. If you are not breastfeeding and you have recently had a baby, we advise that you wait at least 3 months before using this treatment .

As with all medications, there is a possibility that you may experience some side effects (not everyone will experience these).

The most common side effects are related to gastric disturbance and include:

• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Stomach pain/ cramps

These symptoms are the most problematic and approximately 65% of all patients report some (not all!) of these symptoms. They are usually mild and settle with time, hence the gradual increase in dose over 4 weeks. Some people can take a little longer to settle on this medication than others. We can provide you with useful hints and tips on how to manage these and when to seek advice.

Other side effects include:

• Localised reaction at injection sites
  • Bruising, pain, redness, itch
• Difficulty sleeping (usually within the first 3 months of treatment)
• Altered sense of taste
• Dizziness
• Fatigue (tiredness)
• Headaches
• Increased heat rate (palpitations)
• Gallbladder problems such as gallstones
• Low blood sugar (hypoglycaemia)

If you are concerned that you are developing these side effects, we advise that you stop the medication and seek medical advice.

Potentially serious side effects are uncommon but include:

• Severe allergic reactions (anaphylaxis)
  • Seek URGENT medical advice if you experience lip/ tongue swelling, breathing problems, rapid heart rate.
• Pancreatitis (inflammation of the pancreas)
  • This is a serious, potentially life-threatening condition
  • Seek URGENT medical advice if you develop nausea/ vomiting AND severe persistent pain in your upper tummy (this may move through to your back).

For full details of the potential side effects of this treatment , please ensure that you read the patient information leaflet that comes with your medication before you start to use it.

• Pre-filled injectable treatment pens:
• If you are starting treatment: 18 pens
• Repeat prescription: 30 pens 
• A sharps box
• Needles for the pre-filled pens

Please note: the price of this medication can vary between pharmacies. This should be checked directly with your chosen pharmacy.