Ozempic (semaglutide) is a brand-name medication containing the drug semaglutide. It is available only as a brand-name medication and is not currently available in a generic form. It is administered via a self-injection pen. Ozempic is used to treat type 2 diabetes and to lower the risk of a heart attack, stroke, or death in people who also have heart disease. The medicine is also used to lower the risk of kidney function decline, kidney failure, or death from cardiovascular disease in people with both type 2 diabetes and chronic kidney disease.
How Ozempic Works
Ozempic mimics a natural hormone called GLP-1, which is released when we eat to help balance blood sugar and make us feel full after meals. Ozempic works to improve blood sugar in 3 different ways. Ozempic works to stimulate your pancreas to release more insulin after you eat, prevents your liver from releasing stored sugars, and slows down the movement of food through your body.
Dosage and Administration
Ozempic should be taken once a week, on the same day every week, at any time of the day. Ozempic may be taken with or without food. You may inject under the skin of your stomach/abdomen, thigh, or upper arm. Be sure to change the injection site after each weekly injection, and do not use the same site for each injection. After injecting Ozempic exactly as instructed, some people may experience some bleeding at the injection site. Press on the area lightly with a gauze pad or cotton ball.
Starting Dosage
The recommended starting dosage for Ozempic is the same regardless of which condition you’re using it to treat. The following dosage initiation schedule helps to reduce the risk of digestive side effects from Ozempic:
- 0.25 mg of Ozempic once per week for 4 weeks
- Increase the dose to 0.5 mg of Ozempic once per week for 4 weeks
Dosage for Type 2 Diabetes
When you first start using Ozempic, you’ll likely follow the starting dosage schedule. After at least 4 weeks at the 0.5-mg dose, your doctor will check your blood sugar levels. If your blood sugar levels are well-managed, you’ll continue to inject 0.5 mg once weekly. If you need to lower your blood sugar levels even more, your doctor may increase your dosage to 1 or 2 mg once weekly. The maximum recommended dosage of Ozempic is 2 mg once weekly.
Read also: Transformations with Ozempic
You should administer your Ozempic injection on the same day each week. However, you can give the injection at any time of day, with or without meals. If needed, you can change the day you give your injection. If you do, you must have taken your last dose at least 48 hours before the new day you plan to administer the injection.
Dosage for Preventing Kidney Disease Progression
You’ll likely begin treatment with the typical starting dose for Ozempic: weekly injections of 0.25 mg once for 4 weeks, then weekly injections 0.5 mg for 4 weeks. After at least 4 weeks at the 0.5-mg dose, your doctor will likely increase your dosage to 1 mg per week. This is the recommended maintenance dosage of Ozempic for people with type 2 diabetes and kidney disease.
What if You Miss a Dose?
If you miss a dose, take it as soon as you remember, as long as it’s within 5 days of the date of the missed dose. Then take your next dose on its regular schedule. But if more than 5 days have passed, or if the date of your next scheduled dose is only 1 or 2 days away, don’t take the missed dose. Instead, just take the next dose on its scheduled day.
How Long Do You Take Ozempic?
Ozempic is typically used long term. You’ll likely receive Ozempic for as long as you and your doctor agree that it’s safe and effective for your condition.
Drug Forms and Strengths
Ozempic comes as a pen that you use to self-inject the medication. The strengths and doses dispensed by each pen are described in the following table:
Read also: Ozempic Meal Plan
When you first start Ozempic treatment, you’ll likely use the 2 mg/3 mL pen. If you need a higher dose of Ozempic to help manage your blood sugar levels, your doctor might prescribe a higher strength. Each Ozempic pen comes with several needles. You’ll use a new needle each time you give yourself an injection. You can use Ozempic pens multiple times, but you should never share a pen with another person.
How is Ozempic Supplied (Dosage Forms)?
Ozempic is available in the following dosage forms that are injected under the skin.
- 0.25 mg or 0.5 mg solution for injection, pre-filled pens
- 1 mg solution for injection, pre-filled pens
- 2 mg solution for injection, pre-filled pens (not currently marketed)
How Should I Store Ozempic?
Before using Ozempic, store in the refrigerator between 36 F to 46 F (2 C to 8 C). Unused Ozempic can be stored until the expiration date. Once you start using Ozempic, store at room temperature between 59 F to 86 F (15 C to 30 C) in a place that is not exposed to direct sunlight or in the refrigerator between 36 F to 46 F (2 C to 8 C) for up to 56 days. Keep the cap on the pen when you are not using Ozempic. If you are storing Ozempic in the refrigerator, do not store the medicine next to the cooling element in the refrigerator. Do not use Ozempic if it has been frozen.
Ozempic for Weight Loss
Ozempic can decrease appetite. As a result, many people with diabetes who receive the drug lose weight. That said, Ozempic is not FDA approved for weight management. However, doctors may sometimes prescribe this drug off-label for weight management. Off-label drug use means prescribing a drug for a purpose other than what it’s been approved for by the FDA.
Wegovy, another brand name for semaglutide, may also cause damage to the retina, suicidal ideation, gallstones, pancreatitis, and acute kidney damage.
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The Food and Drug Administration (FDA) approved Wegovy, a brand name for semaglutide, for weight loss in adults who have high cholesterol, type 2 diabetes, or high blood pressure.
Some people with eating disorders or patterns of disordered eating may misuse semaglutide (and other weight loss medications) for weight management since this medication can reduce appetite and caloric intake. However, this can be risky, especially for those with anorexia nervosa who may already significantly restrict their food intake-it could increase the likelihood of undernutrition and its many dangerous consequences.
Ozempic Face
“Ozempic face” is a term coined to describe the cosmetic effects of weight loss drugs. The issue is not limited just to those using Ozempic. It refers to the side effects of the rapid weight loss produced by any of the GLP-1 medications. Losing fat from the face quickly can have a pronounced effect on appearance. The faster you lose weight, and the more you lose, the more likely you are to notice facial changes. People using GLP-1 drugs report seeing cosmetic changes to their faces, such as:
- Hollowed, sunken look, especially around the cheeks and eyes
- More visible lines and wrinkles
- Sagging, loose skin
- Thinning lips
Side Effects of Ozempic
Ozempic can cause mild or serious side effects. It is very important to carefully follow any instructions from your health care team.
More Common Side Effects
The most common side effects of Ozempic can include:
- Nausea
- Headache
- Vomiting
- Diarrhea
- Stomach pain
- Upset stomach
- Constipation
- Flatulence (passing gas)
These side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.
Serious Side Effects
Serious side effects from Ozempic aren’t common, but they can occur. Call your doctor 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:
- Pancreatitis (inflammation of the pancreas). Symptoms can include:
- Pain in your back and abdomen
- Nausea
- Vomiting
- Unintended weight loss
- Fever
- Swollen abdomen
- Hypoglycemia (low blood sugar). Symptoms can include:
- Drowsiness
- Headache
- Weakness
- Hunger
- Irritability and confusion
- Sweating
- Feeling jittery
- Fast heartbeat
- Diabetic retinopathy (diabetes-related eye problems). Symptoms can include:
- Blurred vision
- Vision loss
- Seeing dark spots
- Poor night vision
- Acute kidney injury due to dehydration. Symptoms can include:
- Reduced urination
- Confusion
- Fatigue
- Gallbladder disease. Symptoms can include:
- Gallstones, which can cause pain in your abdomen, nausea, vomiting, and fever
- Cholecystitis (inflammation in your gallbladder)
- Thyroid cancer. Ozempic has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA.
FDA Warning: Risk of Thyroid Cancer
Ozempic has a boxed warning from the Food and Drug Administration (FDA) about possible risk of thyroid cancer. A boxed warning is the most serious warning from the FDA. In animal studies, Ozempic increased the risk of thyroid tumors. However, it’s not known if Ozempic causes thyroid tumors in humans. Because of the potential risk of thyroid cancer, you should not use Ozempic if you or an immediate family member have ever had a form of cancer called medullary thyroid carcinoma (MTC) or a rare endocrine condition called multiple endocrine neoplasia syndrome type 2. If you’re receiving Ozempic and have symptoms of a thyroid tumor, contact your doctor right away. Symptoms can include:
- A mass or lump in your neck
- Difficulty swallowing
- Difficulty breathing
- A hoarse voice
Other Serious Side Effects
While less common, the most serious side effects of Ozempic are described below, along with what to do if they happen.
- Severe Allergic Reactions. Ozempic may cause allergic reactions, which can be serious. Stop using Ozempic and get help right away if you have any of the following symptoms of a serious allergic reaction:
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
- Pancreatitis. Ozempic may cause inflammation of the pancreas, which is called pancreatitis. Stop using Ozempic and call your healthcare provider right away if you have symptoms of pancreatitis including vomiting or severe pain in the upper part of your belly that travels to your back.
- Low Blood Sugar (Hypoglycemia). Ozempic may cause low blood sugar (hypoglycemia), usually when used with a sulfonylurea (glimepiride, glyburide, glipizide) or insulin, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Stop using Ozempic and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.
- Headache
- Crankiness or anxiety
- Hunger
- Dizziness, or confusion, or drowsiness
- Blurry vision
- Slurred speech
- Sweating
- Feeling jittery or shakiness
- Fast heartbeat
- Weakness
- Thyroid Tumors. Ozempic may cause thyroid tumors, including a type of cancer called medullary thyroid carcinoma (MTC). Stop using Ozempic and call your healthcare provider right away if you have symptoms of medullary thyroid carcinoma including swelling or a lump in the neck, trouble swallowing, shortness of breath, or hoarseness.
- Vision Changes. Ozempic may cause your vision to worsen when you start using the medicine or start a higher dose. Tell your healthcare provider if you develop new vision problems. If you have a condition called diabetic retinopathy, your vision may temporarily worsen when you start Ozempic or a higher dose. Make sure that you keep all appointments to have your vision checked.
- Kidney Damage. Kidney damage can happen when using Ozempic, especially if you have nausea, vomiting, or diarrhea, which can cause dehydration. Try to drink water to avoid dehydration. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.
- Reduced need to pee
- Swelling in your feet, ankles, or legs
- Weakness or unusual tiredness
- Difficulty catching your breath or chest pain/pressure
- Confusion
- Nausea
- Seizures
- Severe Stomach Problems. Ozempic may cause severe stomach problems. Call your healthcare provider right away if you have any of the following symptoms that are severe or will not go away.
- Nausea, vomiting, or constipation
- Feeling bloated or full sooner than usual when eating
- Stomach pain or cramps
- Gallbladder Problems. Using Ozempic can cause gallbladder problems, including cholecystitis and cholelithiasis, which is also known as gallstones. Call your healthcare provider right away if you have any of the following symptoms.
- Fever
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
- Pain in your upper stomach area
- Stool (poop) that is clay-colored
Warnings and Precautions
Who Should Not Use Ozempic?
- Allergies to Ingredients. People who are allergic to any of the following should not use Ozempic.
- Ozempic
- Semaglutide
- Any of the ingredients in the specific product dispensed
- Thyroid Cancer or Endocrine Condition. Ozempic should not be used if you or someone in your family has had medullary thyroid carcinoma (MTC) or if you have a condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
What Should I Know About Ozempic Before Using It?
- Follow the Instructions for Use when using Ozempic for the first time or when you haven’t used it in a while.
- Use Ozempic on the same day each week, at any time of the day.
- If you have nausea, vomiting, or diarrhea, drink plenty of water, so that you do not get dehydrated.
- Use a new needle for each injection.
- Do not use Ozempic unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
- Do not share Ozempic with other people, even if they have the same condition as you and even if the needle has been changed. It may harm them or you.
- Keep Ozempic out of the reach of children. Since this medicine can be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.
What Should I Tell My Healthcare Provider Before Using Ozempic?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss any of the following.
- Slowed Stomach Emptying. Tell your healthcare provider if you have a condition called gastroparesis. Symptoms may include heartburn, nausea, and feeling bloated or full quickly after eating.
- Upcoming Surgery or Procedures. Ozempic slows the movement of food through your digestive system. If you have an upcoming surgery or procedure, tell your healthcare provider that you use Ozempic. Your risk of food getting into your lungs during anesthesia or sedation may be higher.
- Pancreatitis. Tell your healthcare provider if you have ever had pancreatitis. Your healthcare provider may choose another medicine to treat your type 2 diabetes.
- Kidney Problems. Tell your healthcare provider if you have kidney problems, including chronic kidney failure, as this may worsen while using Ozempic.
- Vision Problems. Tell your healthcare provider if you have diabetic retinopathy or have had vision problems related to your diabetes. Your healthcare provider may check your vision while using Ozempic.
- Low Blood Sugar (Hypoglycemia). Talk to your healthcare provider about low blood sugar and how to manage it. Tell your healthcare provider about any medicines you are taking for diabetes.
- Other Medicines and Supplements. Ozempic may interact with other medicines and supplements. Before using Ozempic, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
- Pregnancy. It is not known if or how Ozempic could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. You should stop using Ozempic at least 2 months before you plan to become pregnant. Your healthcare provider will advise you if you should take Ozempic while you are pregnant or trying to get pregnant.
- Breastfeeding. It is not known if Ozempic passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does Ozempic Interact with Foods or Drinks?
It is unknown if drinking alcohol will affect Ozempic, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of Ozempic. It is best to limit the amount of alcohol you drink.
Does Ozempic Interact with Other Medicines (Drug Interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss if you are using insulin or taking another type of medicine for diabetes called a sulfonylurea (glimepiride, glyburide, glipizide). These medicines may increase your risk of low blood sugar (hypoglycemia).
Ozempic works by slowing down the movement of food through your body. Because of this, Ozempic may affect the absorption of some other medicines that you take by mouth. Tell your healthcare provider about all medicines that you take or have recently taken.
Alternatives to Ozempic
Other drugs are available that can help treat type 2 diabetes or lower the risk of serious cardiovascular problems. Some may be better suited for you than others. If you’re interested in finding an alternative to Ozempic, talk with your doctor to learn more about other medications that may work well for you.
Alternatives for Improving Blood Sugar Levels and Lowering Risk of Cardiovascular Problems
- Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) such as:
- Dulaglutide (Trulicity)
- Exenatide (Bydureon BCise, Byetta)
- Liraglutide (Victoza)
- Lixisenatide (Adlyxin)
- Sodium-glucose co-transporter 2 (SGLT2) inhibitors such as:
- Canagliflozin (Invokana)
- Dapagliflozin (Farxiga)
- Empagliflozin (Jardiance)
- Ertugliflozin (Steglatro)
- Metformin (Glumetza, Riomet), which is a biguanide
- Dipeptidyl peptidase-4 (DPP-4) inhibitors such as:
- Alogliptin (Nesina)
- Linagliptin (Tradjenta)
- Saxagliptin (Onglyza)
- Sitagliptin (Januvia)
- Thiazolidinediones such as:
- Pioglitazone (Actos)
- Rosiglitazone (Avandia)
- In addition, the following drugs are alternative options for improving blood sugar levels:
- Alpha-glucosidase inhibitors such as:
- Acarbose
- Miglitol (Glyset)
- Sulfonylureas such as:
- Glimepiride (Amaryl)
- Glipizide (Glucotrol XL)
- Glyburide (Diabeta, Glynase Prestabs)
- Alpha-glucosidase inhibitors such as:
Alternatives for Chronic Kidney Disease with Type 2 Diabetes
Doctors may prescribe the following drugs to help prevent the progression of chronic kidney disease (CKD) with type 2 diabetes:
- Dapagliflozin (Farxiga)
- D…