Simeglutide is a new type of potent hypoglycemic drug, which, in addition to its good hypoglycemic effect, also has the effects of weight loss, lowering blood pressure and improving blood lipids, making it one of the world's best-selling hypoglycemic drugs. Currently, the only one on the market in China is the  simeglutide injection (pre-filled injection pen), which is used similarly to insulin and needs to be injected subcutaneously, but it is not a substitute for insulin. The indication approved by the State Food and Drug Administration of China is for glycaemic control in adult patients with type 2 diabetes mellitus and reduction of the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adult patients with type 2 diabetes mellitus with concomitant cardiovascular disease, with no approval for the indication of simple obesity. Although simeglutide is used once a week, it needs to be injected under the skin, and there are instructions on how to use and store it, so for novices who are using the drug for the first time, you need to pay attention to these details in order to use the drug in a safe and effective way.

reparation of materials before injection

1.Preparation of materials for skin sterilization

Before injecting simeglutide, you will need to sterilise the skin at the injection site, at which point you will need to have 75% alcohol, sterilised cotton swabs, or alcohol pads available in advance.

2.Injection Needle Preparation

Hospital pharmacies usually only provide medicines, not needles, so you will need to buy them from a pharmacy or online. The needle used for the simeglutide Injection Pen is the same as the disposable needle used for insulin injections, and can be purchased in 4 mm, 5 mm or 6 mm, with the numbers representing the length of the needle. Needles are consumables and need to be replaced frequently, so try to buy more than one box at a time.

Preparation for blood glucose monitoring

Diabetics are advised to buy a glucose meter for easy monitoring of blood sugar. When you first start injecting simethicone, you will need to monitor your blood glucose frequently and keep a blood glucose record as a basis for your doctor to adjust the dosage of your medication. It is recommended that you buy a glucose meter from a pharmacy, where the pharmacy staff will personally guide you through the operation of the meter, or you can buy it online.

Injection site

Simeglutide is injected subcutaneously, with common injection sites including the abdomen, outer thighs and upper arms. Note that the area within 5 cm from the navel is strictly prohibited for injection, you need to inject in the area beyond 5 cm from the navel, and each time you need to rotate the injection site to reduce the risk of allergic reactions at the injection site, such as rashes, erythema, etc., and repeated injections of the same site will result in the hyperplasia of subcutaneous fat in the area, producing hard knots, which will slow down the absorption of the drug or make it unstable.

Injection volume

To reduce the incidence of side effects, it is recommended to start with a small dose of 0.25 mg once a week and gradually increase the dose per injection as directed by the physician; a single injection of more than 1 mg is not usually recommended.

Injection time

Subcutaneous injections are given once a week and can be given at any time during 1 day, eliminating the need to administer the drug based on mealtimes. If necessary, the day of weekly dosing can be changed, as long as the two doses are separated by at least 2 days (>48 hours). After choosing a new dosing schedule, the dose should continue to be given once a week.

Medication omission

If a missed dose occurs, it should be administered as soon as possible within 5 days of the missed dose. If the missed dose has been given for more than 5 days, the missed dose should be skipped and the patient should receive the next dose on the normal scheduled dosing day. In each case, the patient should return to the regular weekly dosing schedule.

Drug storage

1.Before first use: store in a refrigerator (2°C~8°C) away from frozen originals for 36 months.

2. After first use: store in an environment below 30°C or refrigerate in the fridge (2°C~8°C) for up to 6 weeks.

3.Do not freeze this product and do not use after freezing. Cover the cap of the pen when not in use to protect it from light. Remove the needle after each injection and when storing the product to prevent needle obstruction, contamination, infection, solution leakage and inaccurate administration.

Possible adverse reactions

1. Common: Gastrointestinal reaction at the initial stage of drug administration, some patients may experience gastrointestinal discomfort such as nausea, vomiting, diarrhoea, etc. These are normal reactions to drug administration, and most of them are transient and mild reactions. With the passage of time, the frequency and degree of these symptoms will be reduced and can be tolerated. It is recommended to take a small dose initially and gradually increase the dose to the normal dose according to the tolerance situation, eat small meals and a light diet.

 2. Uncommon: hypoglycaemic reactions, increased heart rate, etc. Low risk of hypoglycaemia when used as a single agent, common in the combined application of sulphonylureas or basal insulin, taking precautions to avoid hypoglycaemia when driving and using the machine; may increase the patient's heart rate to varying degrees during the use of the drug, but will not lead to cardiac arrhythmia, if the symptoms are obvious, the application of medication for controlling the ventricular rate of the heart can be symptomatic treatment.

Which patients should not use

1. hypoglycaemic patient；

 2. In pregnant women, the product should be discontinued for at least 2 months prior to planned pregnancy due to the long half-life;

3. Lactating women 

4. Not recommended for children under 18；

5. A history of combined pancreatitis should be used with caution; if the diagnosis of acute pancreatitis is confirmed, the drug should be discontinued immediately;

6. It cannot be used to treat type 1 diabetes or diabetic ketoacidosis;

7. Patients with a previous or family history of medullary thyroid cancer;

8. patients with type 2 multiple endocrine neoplasia syndrome.

The information is from the Internet and is for reference only.