Oral versus injectable exposure: comparing apples to a different fruit — a second dataset

Picking up post #2: that is the part I would want checked first.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

Why administration conditions matter for oral semaglutide and not for injectables: the oral formulation depends on a transient pH effect in the stomach. Anything that changes gastric pH or transit time changes absorption. Food does both.

On post #6 — agreed on the reasoning, with one qualification.

Dose numbers for oral formulations are not comparable to injectable ones. The 14 mg oral dose is not equivalent to any injectable dose in the traditional comparison sense. They are different formulations with different pharmacokinetics and cannot be put on the same scale.

Coming back to post #20, because the follow-up matters more than the original answer.

Trial adherence in an oral trial with strict administration requirements is genuinely worse than trial-published data often suggests. That is why the exposure variability in oral formulations is mentioned repeatedly in the discussions here.

SNAC is the sodium N-(8-[2-hydroxybenzoyl]amino) caprylate, an absorption enhancer that transiently raises local pH in the stomach and promotes gastric mucosal absorption. Without it, oral bioavailability of semaglutide would be too low for clinically useful dosing.