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They are metabolised and eliminated through different pathways: semaglutide is broken down by proteolytic enzymes (similar to endogenous proteins) and does not rely on cytochrome P450 liver enzymes, whilst topiramate is partially metabolised hepatically but largely excreted unchanged in urine

doi: 10.1016/j.urology.2005.04.012

Patients: A total of 397 adult patients with T2D inadequately controlled on basal insulin with or without metformin were randomized to once-weekly Ozempic injection 0.5 mg (n=132), Ozempic injection 1 mg (n=131), or placebo (n=133)