Ozempic (Semaglutide) - Subcutaneous

Warning:

In nonhuman animal studies, semaglutide was shown to cause thyroid C-cell tumors in rodents. However, it is unknown whether this risk applies to humans. Still, semaglutide should not be used in people with a personal or family history of medullary thyroid carcinoma or in people with multiple endocrine neoplasia syndrome type 2.

What Is Ozempic?

Ozempic (semaglutide) is a prescription drug used along with diet and exercise to manage blood sugar in people with type 2 diabetes. It is also used to lower the risk of major cardiovascular events, such as stroke or heart attack, in adults with type 2 diabetes and heart disease.

Ozempic is not insulin. It works by helping the pancreas release insulin when blood sugar levels are high and preventing the liver from making and releasing too much sugar. Ozempic also slows food movement through the stomach, reducing appetite and resulting in weight loss. Ozempic is in a drug class known as glucagon-like peptide 1 (GLP-1) receptor agonists.

Ozempic is available as a subcutaneous injection, meaning it is injected under the skin.

Drug Facts

Generic Name: Semaglutide

Brand Name(s): Ozempic, Wegovy

Drug Availability: Prescription

Administration Route: Subcutaneous

Therapeutic Classification: Antidiabetic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Semaglutide

Dosage Form(s): Solution

What Is Ozempic Used For?

The Food and Drug Administration (FDA) approved Ozempic to:

  • Improve blood sugar control in adults with type 2 diabetes (in combination with diet and exercise)
  • Lower the risk of major cardiovascular events, such as heart attack or stroke, in adults with type 2 diabetes who also have heart disease

Ozempic does not treat type 1 diabetes. It has not been studied in people with pancreatitis (inflammation of the pancreas).

Ozempic (Semaglutide) Drug Information - A person with hands on their hips and their pancreas showing

Verywell / Dennis Madamba

How to Take Ozempic

Before starting Ozempic, read the patient information leaflet with your prescription and ask your healthcare provider or pharmacist any questions.

Make sure to take this medication as directed. People generally start with the lowest dose, which gradually increases as instructed by their healthcare provider. However, you should not change your dose of Ozempic without talking to a healthcare provider.

Ozempic is a subcutaneous injection. This means that it is injected under the skin of the thigh, upper arm, or stomach. People typically inject their dose once a week on the same day each week. A healthcare provider will show you where to inject your dose. 

When using Ozempic, remember to:

  • Check the solution in the pen before injecting. If the solution is cloudy, has particles in it, or has changed colors, contact your pharmacist for a replacement pen.
  • Rotate injection sites. Try not to inject into the same area twice in a row.
  • Inject under the skin of the thigh, upper arm, or stomach.

The ingredient in Ozempic, semaglutide, is also available in tablet form under the brand name Rybelsus and as another injection form under the brand name Wegovy. Do not use different kinds of semaglutide at the same time. 

Ask your healthcare provider how often you should check your blood sugar. If your blood sugar gets too low, you may feel shaky, hungry, or dizzy. Your healthcare provider will tell you how to treat low blood sugar, usually with a small amount of apple juice or fast-acting glucose tablets. Some people also use prescription glucagon in an injection or nasal spray to treat severe low blood sugar emergencies. 

Storage

Keep Ozempic in the original packaging in the refrigerator, protected from light. Do not use an expired or frozen pen. 

You can reuse the pen several times with a new needle for each administration. Never reuse the injection needle. After using the pen, remove the needle and place the used needle in a sharps container for proper disposal. Sharps disposal containers are generally available through pharmacies, medical supply companies, and healthcare providers. According to the FDA, if a sharps disposal container is not available, you can use a household container that meets the following requirements:

  • Made of heavy-duty plastic
  • Has a tight-fitting, puncture-resistant lid
  • Able to stand upright and stable
  • Leak-resistant
  • Properly labeled to warn of hazardous waste

Once finished with the pen, put the cap back on and put it back in the refrigerator or at room temperature. Keep it away from heat or light. Throw the pen away 56 days after the first use or if less than 0.25 milligrams (mg) is left (as shown on the dose counter).

Keep Ozempic away from children and pets. Never share an Ozempic pen with anyone else, even if you change the needle.

Off-Label Uses

Healthcare providers may prescribe Ozempic for off-label uses, meaning for conditions not specifically indicated by the FDA. Semaglutide is also sometimes prescribed to help people manage their weight in combination with diet and exercise.

How Long Does Ozempic Take to Work?

After the first dose, it takes one to three days for Ozempic to reach its highest levels in the body. However, Ozempic does not reduce blood sugar at its starting dose. You may need to assess your blood sugar levels after eight total weeks of treatment. If the dose at this time isn’t working, a healthcare provider may increase your weekly dose again.

What Are the Side Effects of Ozempic?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Ozempic are stomach problems such as:

Other side effects include: 

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Mood changes or suicidal thoughts
  • Thyroid C-cell tumor (this has only been seen in nonhuman animal studies)
  • Risk of medullary thyroid cancer: Symptoms may include swelling/a lump in the neck, trouble swallowing or breathing, and hoarseness.
  • Hypersensitivity reaction or anaphylaxis: Symptoms can include hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
  • Angioedema (swelling beneath the skin) 
  • Kidney problems: Symptoms may include swelling, decreased urination, fatigue, and shortness of breath.
  • Inflamed pancreas: Symptoms include severe stomach pain and nausea with or without vomiting.
  • Gallbladder inflammation and gallstones: Symptoms include upper stomach pain, fever, and yellowing of the skin or whites of eyes.
  • Fainting or feeling like you may pass out

Long-Term Side Effects

In some cases, long-term side effects may occur. Some possible long-term side effects may include:

  • Appendicitis
  • Constipation
  • Dehydration 
  • Gallstones/gallbladder inflammation
  • GERD
  • Hair loss
  • Inflammation of the pancreas
  • Kidney failure
  • Orthostatic hypotension (feeling dizzy when going from a lying down or sitting position to standing up) 
  • Retinopathy (eye complications) 
  • Thyroid cancer

Report symptoms to your healthcare provider or seek emergency attention if needed. Call your healthcare provider right away if you have signs of a thyroid tumor, including: 

  • Swelling or a lump in the neck
  • Difficulty swallowing
  • Hoarseness
  • Shortness of breath

Report Side Effects

Ozempic may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Ozempic Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For type 2 diabetes and lowering the risk of heart attack or stroke:
    • For injection dosage form (Ozempic® solution):
      • Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose as needed. However, the dose is usually not more than 1 mg once a week.
      • Children—Use and dose must be determined by your doctor.
  • For weight management:
    • For injection dosage form (Wegovy™ solution):
      • Adults—At first, 0.25 milligrams (mg) injected under the skin once a week for 4 weeks. Your doctor may increase your dose every 4 weeks. However the dose is usually not more than 2.4 mg once a week.
      • Children—Use and dose must be determined by your doctor.

Modifications

In some cases, it is necessary to modify, or adjust, treatment with Ozempic. Some individuals may need to use caution when taking this medication.

Pregnancy

There is limited data on Ozempic use during pregnancy.

Nonhuman animal studies showed that semaglutide exposure might potentially harm fetuses. However, these studies are not an alternative to studies in humans and do not necessarily translate to human use. 

If you are pregnant or planning to become pregnant, consult your healthcare provider for medical advice. You may need to stop taking Ozempic at least two months before you want to become pregnant. People of childbearing age should use effective birth control while taking Ozempic and at least two months after the last dose.

Breastfeeding

Consult your healthcare provider before using Ozempic if you are nursing. It is not known if Ozempic passes into breast milk.

Age

Some adults 65 or older are more sensitive to Ozempic. In some cases, starting at a lower dose and increasing it slowly can benefit older adults.

Missed Dose

If you miss a dose of Ozempic, administer it as soon as you can within five days after the missed dose. Then, resume the regular once-weekly schedule. If more than five days have passed, skip the missed dose and resume your dose on the regularly scheduled day of your dose.

Overdose: What Happens If I Take Too Much Ozempic?

Overdosing on Ozempic can cause nausea, vomiting, or low blood sugar (hypoglycemia). Based on your symptoms, you may receive support treatment.

What Happens If I Overdose on Ozempic?

If you think you or someone else may have overdosed on Ozempic, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Ozempic, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. Do not use this medicine for at least 2 months before you plan to become pregnant.

It is very important to carefully follow any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are using semaglutide unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, diabetic patients may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur during pregnancy in patients with diabetes.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

This medicine may increase the risk of having thyroid tumors. Tell your doctor right away if you have a lump or swelling in your neck or throat, trouble swallowing or breathing, or if your voice gets hoarse.

Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

Check with your doctor right away if you have gaseous stomach pain, recurrent fever, stomach fullness, or yellow eyes or skin. These may be symptoms of a gallbladder problem (eg, cholelithiasis).

This medicine may cause diabetic retinopathy. Check with your doctor if you have blurred vision or any other changes in vision.

This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use semaglutide with other medicines, including insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.

  • Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
  • If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms including seizures or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family should also know how to use it.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

This medicine may cause acute kidney injury. Check with your doctor right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may increase your heart rate while you are at rest. Check with your doctor right away if you have fast or pounding heart beat.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

  • Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, or unusual thirst.
  • If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, including feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Ozempic?

Ozempic is not appropriate for everyone.

You should not take Ozempic if you:

  • Are allergic to semaglutide or any of the inactive ingredients in Ozempic
  • Are allergic to any drugs in the GLP-1 receptor agonist class of medicines
  • Have a history or family history of medullary thyroid carcinoma
  • Have multiple endocrine neoplasia syndrome type 2 
  • Have type 1 diabetes

Ozempic may be prescribed with caution in some people if your healthcare provider determines it is safe. The following circumstances may require you to use extra caution when taking Ozempic:

  • Kidney problems
  • Taking medications that can harm the kidneys
  • Dehydration
  • Risk or history of pancreas problems 
  • Diabetic retinopathy 
  • Females (sex assigned at birth) of childbearing age

What Other Medications Interact With Ozempic?

Ozempic can cause low blood sugar. Taking Ozempic with other drugs that lower blood sugar can increase the risk of hypoglycemia (low blood sugar). A dosage adjustment of the other medication (such as insulin or other medications used for diabetes) may be required.

Other medications that lower blood sugar includes:

Because Ozempic delays gastric emptying, it can affect the absorption of oral medications. Ask your healthcare provider how you should time your other medications when taking Ozempic.

When taken with Ozempic, some drugs can increase the risk of kidney problems. These medications include:

  • Zovirax (acyclovir) 
  • Bumex (bumetanide) 
  • Vistide (cidofovir) 
  • Epaned, Vasotec (enalapril) 
  • Gentamicin 
  • Advil (ibuprofen) 
  • Altace (ramipril) 
  • Spironolactone 

This is not a complete list of drug interactions. Other drug interactions can occur. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter drugs and vitamins or supplements. This ensures that your healthcare provider has the information needed to prescribe Ozempic safely.  

What Medications Are Similar?

Ozempic is in a class of medications called GLP-1 receptor agonists. Ozempic contains the ingredient semaglutide.

Semaglutide is also available as an injection under the brand name Wegovy for weight loss and as an oral GLP-1 receptor agonist to improve blood sugar control in type 2 diabetes as Rybelsus.

Other injectable drugs in the GLP-1 receptor agonist class include:

A variety of oral medications are available to help control blood sugar in adults with type 2 diabetes, including:

People with type 2 diabetes may also need injectable insulin to help control blood sugar levels. There are various types of long-acting and short-acting insulin.

This list is a list of drugs also prescribed for type 2 diabetes. It is NOT a list of drugs recommended to take with Ozempic. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Ozempic used for?

    Ozempic is an injectable medicine used in combination with diet and exercise to improve blood sugar control in adults with type 2 diabetes. Ozempic can also reduce the risk of heart attack and stroke in adults with type 2 diabetes who have heart disease.

  • How does Ozempic work?

    Ozempic is an injectable medication, but it is not insulin. Ozempic helps the pancreas release insulin when blood sugar is high and prevents the liver from making and releasing sugar. Ozempic also slows the movement of food through the stomach, which can aid in weight loss.

  • What drugs should not be taken with Ozempic?

    Some drugs, like insulin or certain oral medications for type 2 diabetes, interact with Ozempic, increasing the risk of low blood sugar. A dosage adjustment may be required. Other drugs in combination with Ozempic can increase the risk of kidney damage. Talk to your healthcare provider before taking Ozempic to ensure it is safe with the other medicines you take.

  • How long does it take for Ozempic to work?

    One dose of Ozempic reaches its highest levels between one and three days. The first four weeks of treatment (at 0.25 milligrams per week) do not lower sugar. After four weeks, the dose is generally increased to 0.5 milligrams weekly. After four weeks of this dose, for a total of eight weeks of Ozempic treatment, blood sugar levels can be analyzed. Sometimes, the dose of 0.5 milligrams weekly is sufficient to control blood sugar. In other cases, the dose needs to be raised to 1 milligram weekly. Your healthcare provider will advise you on a dosing schedule.

  • What are the side effects of Ozempic?

    The most common side effects of Ozempic are stomach problems. These may include nausea, vomiting, diarrhea, constipation, stomach pain, burping, gas, acid reflux, or indigestion. 

    Severe allergic reactions are rare. Seek emergency medical help if you develop hives, difficulty breathing, or swelling around the face, lips, tongue, or throat.

  • How long do I need to take Ozempic?

    Your healthcare provider will advise you on how long to take Ozempic.

How Can I Stay Healthy While Taking Ozempic?

When taking Ozempic, follow your healthcare provider’s instructions for use. Read the patient information leaflet with your prescription and consult your healthcare provider if you have any questions.

If you have never given yourself an injection, it can be scary at first. A healthcare provider, nurse, or pharmacist can show you how to administer Ozempic and provide training materials. Bring a family member or friend for support and training if possible

Give yourself plenty of time to prepare the injection and administer it yourself. Once you have done the first injection, it only gets easier. In a few weeks, you will not even remember that you were once nervous.

Prepare a kit with supplies that you take with you at all times, including the following items:

  • Blood glucose meter and supplies (strips, lancing device, lancets, alcohol wipes)
  • Emergency contact information
  • Glucagon (such as an injection or nasal Baqsimi)
  • Treatments for low blood sugar such as glucose tablets and juice boxes

It is also a good idea to wear a medical alert bracelet or necklace, which alerts emergency responders that you have type 2 diabetes.

Ozempic should be used along with diet and exercise. Talk to your healthcare team about what diet and exercise regimen you should follow. Monitor blood sugar as directed. Before taking Ozempic, discuss all medical conditions and medical history with your healthcare provider and tell them about your medications. This helps ensure that Ozempic will be prescribed safely and that your healthcare provider can monitor you appropriately during treatment.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. MedlinePlus. Semaglutide.

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  5. Smits MM, Van Raalte DH. Safety of semaglutide. Front Endocrinol. 2021. doi:10.3389/fendo.2021.645563

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By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.