Management of Missed Doses of Oral Semaglutide

Clinical Judgment and Dosing Adjustments

For patients who have missed more than 2 consecutive doses, clinical judgment is required to determine subsequent dosing, considering factors such as previous tolerance and gastrointestinal side effects 1, 2, 3
Resume at the same dose if the patient has previously tolerated the medication well, but consider lowering the next dose if the patient had previously experienced significant gastrointestinal side effects 1, 2, 3
Consider restarting the titration schedule from a lower dose for 3 or more consecutive missed doses to minimize the risk of gastrointestinal adverse effects 1, 2, 3

For patients on oral semaglutide who are scheduled for surgical procedures, be aware of the potential for delayed gastric emptying, which may increase aspiration risk, according to the American Society of Anesthesiologists 4, 5, 6, 7
For patients with diabetes who miss doses, monitor blood glucose more frequently when resuming treatment, especially if also taking insulin or insulin secretagogues, as recommended by the American Diabetes Association 8, 9