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Cutting or crushing the tablet would: Disrupt the specialized coating and formulation designed for gastric absorption Potentially alter the pharmacokinetic profile, leading to unpredictable drug levels Reduce bioavailability, as oral semaglutide already has low absorption (approximately 1% bioavailability per FDA labeling) Create inconsistent dosing between the two halves Expose the patient to medication that may not be absorbed effectively The American Diabetes Association guidelines emphasize that medications should be taken as prescribed and formulated unless specifically indicated otherwise by the manufacturer

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It may be adjusted by the doctor as necessary, and you can then transition to a maintenance dose

However, GLP-1RAs effects on calcium channel modulation are multifunctional

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Unlike tolerance to stimulant medications, GLP-1 tolerance doesn't indicate failure