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M., Sesso, H

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It is important to recognize that sexual dysfunction is common in individuals with obesity and type 2 diabetesthe very populations for whom semaglutide is prescribed

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Injectable GLP-1s: Nearly 100% bioavailability Consistent, predictable absorption Doses of 1-2.4mg weekly for semaglutide FDA-Approved Oral Tablets: 0.4-1% bioavailability Requires 7-25mg doses to achieve similar effects Must be taken with specific timing and fasting requirements Compounded ODT Formulations: Theoretical bioavailability advantage over swallowed tablets Sublingual/buccal delivery bypasses stomach acid and first-pass metabolism However, research on peptide delivery shows challenges: peptides may be degraded by salivary enzymes, have poor permeability due to large molecular size, and face continuous wash-away from saliva No clinical trials have established actual bioavailability or effectiveness for compounded GLP-1 ODTs These formulations are not FDA-approved and haven't undergone rigorous testing The theoretical advantage of ODT formulations is that by dissolving in the mouth rather than the stomach, they could achieve better absorption than swallowed tablets while maintaining the convenience of a daily, needle-free option