Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience both.
What I actually want to know is which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.
Happy to be told the question itself is wrong.
zoe_NC said:Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…
Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].
Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.
For the pharmacology, the pharmacology explains the clinical differences between these agents.
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
Dr.GastroMayo said:Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%),…
No disagreement with Dr.GastroMayo. One condition attached. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.
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Browse GL Biochemzoe_NC said:Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…
Same pattern here, and in the same order. Posting only so the count is not one.
Clinical perspective, offered as context rather than as advice.
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:
- Tmax: 24-72 hours post-injection
- T½: ~168 hours (7 days) — enables weekly dosing
- Steady state: reached at 4-5 weeks
- Bioavailability (SubQ): ~89%
- Volume of distribution: ~12.5L (primarily plasma)
The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.