In addition to traditional injections, some individuals prefer rapid-dissolving sublingual tablets. This method involves placing the medication under the tongue, where it dissolves and is absorbed directly.

Potential advantages of sublingual delivery may include:

• No need to swallow tablets or use water

• Discreet and travel-friendly format

• May allow for quicker absorption compared to some traditional tablets

Sublingual delivery is especially helpful for individuals who prefer a needle-free, fast-acting, and easy-to-use format.

1. Fewer and Milder Side Effects

   • Smaller daily doses result in less nausea, bloating, diarrhea, and vomiting, compared to the peaks of weekly injections.
     
     

2. Steady, Consistent Drug Levels

   • Daily dosing maintains stable semaglutide levels, reducing the ups-and-downs associated with weekly injections.

   • Promotes consistent appetite suppression, energy balance, and blood sugar control.
     
     

3. Patient Convenience and Compliance

   • Needle-free dosing reduces patient discomfort, fear of injections, and increases adherence.

   • Simple, fast administration under the tongue daily.
     
     

4. Easier Dose Adjustments

   • Allows incremental, personalized adjustments to achieve optimal effectiveness and minimize side effects.

   • Reduces the risk of abrupt side effects from larger, weekly doses.
     
     

5. Rapid Onset and Patient Satisfaction

   • Faster sublingual absorption can lead to quicker therapeutic effects.

   • Improved patient comfort and convenience enhance overall satisfaction.

Challenges of Weekly SQ Injection

• Higher Side-Effect Profile: Larger weekly dose spikes increase risk of significant GI discomfort.

• Fluctuating Drug Levels: Peaks and troughs can lead to uneven appetite control and variable symptom relief.

• Injection Discomfort: Pain, bruising, and injection-related anxiety or reluctance.

• Reduced Flexibility: Adjustments to weekly injections are less precise and can take longer to stabilize.

Conclusion:

Daily sublingual wafer dosing (microdosing) is likely better for most patients because it provides stable, effective dosing with fewer side effects, greater convenience, and enhanced adherence.

• Licensed U.S. providers

• Physical location in Kingsport, TN for in-person visits

• HIPAA-compliant virtual consults from the comfort of home

• Wellness-based plans tailored to you

• A non-invasive, routine-based solution to support weight loss

• Daily oral delivery options (if prescribed)

• No refrigeration or injections required

• Take a short online assessment

• Book an in-person visit or virtual consult with a licensed provider

• Get a care plan designed around your needs

• If appropriate, prescriptions are sent to a pharmacy of your choice

• Ongoing support with easy follow-ups and flexible options

No. You can start a free assessment 24 hours a day, 7 days a week. 

You’ll start your online visit by answering questions about your medical history, symptoms, and lifestyle. Your initial visit will be either face-to-face or1:1 real-time video conference with one of our healthcare prescribers. Follow-up visits may include face-to-face, telephone, video and/or secure online messaging. 

Subito Health does not accept insurance and is cash-pay only. Our team will provide a superbill to submit to your plan. You can also use FSA/HSA funds to cover appointments and many supplements.

At Subito Health, we are passionate about providing high-quality, accessible, and personalized healthcare to women. All of our network physicians and nurse practitioners on the Subito Health platform undergo an extensive background check and license verification process, as well as training on the Subito Health platform. 

Chambless R. Johnston, III, MD

NPI# 1790972628

Pamela Earles, NP

NPI# 1487061313

1. Reduced Side Effects with Lower, Frequent Doses

• Lau, D. C., Erichsen, L., Francisco, A. M., Satylganova, A., & le Roux, C. W. (2022). Gastrointestinal side effects and tolerability of glucagon-like peptide-1 receptor agonists: A systematic review and meta-analysis. Diabetes, Obesity & Metabolism, 24(6), 931-946.
  https://doi.org/10.1111/dom.14644

2. Stability and Consistency in Therapeutic Levels

• Nauck, M. A., Quast, D. R., Wefers, J., Meier, J. J. (2021). GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art. Molecular Metabolism, 46, 101102.
  https://doi.org/10.1016/j.molmet.2020.101102

3. Sublingual Delivery: Faster Absorption and Improved Bioavailability

• Narang, N., & Sharma, J. (2011). Sublingual mucosa as a route for systemic drug delivery. International Journal of Pharmacy and Pharmaceutical Sciences, 3(Suppl 2), 18-22.
  https://innovareacademics.in/journal/ijpps/Vol3Suppl2/1357.pdf

• Madhav, N. V., Shakya, A. K., Shakya, P., & Singh, K. (2009). Orotransmucosal drug delivery systems: A review. Journal of Controlled Release, 140(1), 2-11.
  https://doi.org/10.1016/j.jconrel.2009.07.016

4. Increased Patient Adherence with Sublingual Route

• Jin, J., Sklar, G. E., Min Sen Oh, V., & Chuen Li, S. (2008). Factors affecting therapeutic compliance: A review from the patient's perspective. Therapeutics and Clinical Risk Management, 4(1), 269-286.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503662/

• Spain, C. V., Wright, J. J., & Hahn, R. M. (2022). Patient preference for oral and sublingual therapies over injectable treatments: A systematic review. Patient Preference and Adherence, 16, 153-162.
  https://doi.org/10.2147/PPA.S348283

5. Benefits of Flexible and Precise Dose Adjustment

• Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., et al. (2015). Management of hyperglycemia in type 2 diabetes, 2015: A patient-centered approach. Diabetes Care, 38(1), 140-149.
  https://doi.org/10.2337/dc14-2441

6. Side Effects and Tolerability Issues of Weekly Dosing

• Wilding, J. P. H., Batterham, R. L., Calanna, S., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.
  https://doi.org/10.1056/NEJMoa2032183

7. Peaks and Troughs in Drug Concentration with Weekly Injections

• Kapitza, C., Nosek, L., Jensen, L., & Hartvig, H. (2017). A randomized, double-blind, placebo-controlled trial to assess pharmacokinetics, safety, and tolerability of single and multiple once-weekly doses of semaglutide in healthy subjects. Clinical Pharmacokinetics, 56(7), 781-791.
  https://doi.org/10.1007/s40262-016-0479-5