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If you have diabetes and struggle to keep your blood sugar levels under control, you’re not alone.
Roughly 1 in 10 Americans have diabetes. If you’re being treated for type 2 diabetes but still have high blood sugar levels, your healthcare provider might suggest a medication called Ozempic (CDC, 2020).
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What is Ozempic?
Ozempic (semaglutide) is a prescription medication that you inject once a week. It’s used in adults with type 2 diabetes mellitus when first-line treatments like metformin and lifestyle changes aren’t effectively lowering glucose (blood sugar) levels (Collins, 2021).
Semaglutide, the active ingredient in Ozempic, is classified as a glucagon-like peptide-1 (GLP-1) receptor agonist. This drug class works by mimicking the effects of GLP-1, a naturally occurring hormone that regulates blood sugar and appetite. While Ozempic isn’t considered a weight loss drug, it may help you shed some pounds (FDA, 2021; Collins, 2021).
The U.S. Food and Drug Administration (FDA) has approved Ozempic for lowering blood sugar levels in adults with type 2 diabetes, along with a healthy diet and regular exercise. It’s also prescribed to diabetes patients who also have cardiovascular disease to reduce the chances of major problems like a heart attack or stroke.
Healthcare providers may prescribe Ozempic off-label to help people achieve and maintain their weight loss goals, even if they don’t have diabetes or heart disease (Collins, 2021). But if you have obesity or are overweight, losing it is one of the best ways to prevent high blood pressure (hypertension), high cholesterol, and type 2 diabetes (Garvey, 2016).
Ozempic works best when it’s integrated as a part of a healthy lifestyle. Your healthcare provider or a registered dietitian can work with you to figure out a meal plan. If you’re having trouble getting enough exercise, a qualified fitness trainer can create a safe and effective fitness routine with you.
Rybelsus vs. Ozempic: differences and similarities
Ozempic side effects and risks
Common side effects of Ozempic include (FDA, 2021):
- Abdominal pain
- Pain or swelling at injection site
Rarely, serious side effects have been reported with Ozempic, such as:
- Increased risk of medullary thyroid carcinoma (MTC), a type of thyroid tumor
- Pancreatitis (inflammation of the pancreas)
- Hypoglycemia (low blood sugar)
- Kidney problems
- Diabetic retinopathy, a vision problem
- Serious allergic reactions
Ozempic carries a boxed warning (the strongest type of warning from the FDA) because thyroid tumors were observed when the drug was studied in rodents. It isn’t known for sure whether this risk applies to humans. Seek medical advice if you experience any of the serious symptoms above.
The typical starting dosage of Ozempic is 0.25 mg once weekly. After four weeks, your dose may increase to 0.5 mg per week. Following another four weeks, your healthcare provider may up you to the maximum dose of 1 mg weekly. While being treated with Ozempic, your blood glucose and body weight will be regularly monitored.
Ozempic comes in boxes with needles and 1–2 injection pens prefilled with a clear liquid solution. Each pen has multiple doses; the number of doses per pen depends on your dose of Ozempic). Attach a new needle to the pen before each dose. Never share your Ozempic pen with anyone else, even with a new needle (FDA, 2021).
After a healthcare professional teaches you how to first use Ozempic, you’ll inject one dose under the skin (subcutaneously) of your thigh or abdomen once weekly. Or if someone else gives your injection, the upper arm is another option.
Be sure to read the medication guide that comes with Ozempic for full details on how to store the pens in the refrigerator and how to dispose of them safely.
Diabetes treatments: insulin, metformin, diet, and more
Before prescribing Ozempic, a healthcare provider will go over your medical history. This medication may not be safe for everyone, especially if you have any of the following conditions or risk factors (FDA, 2021):
- Multiple endocrine neoplasia syndrome type 2
- Family history of thyroid cancer
- Are pregnant, planning a pregnancy, or breastfeeding
- Allergies to Ozempic, semaglutide, or other GLP-1s (like Byetta, Bydureon, Saxenda, Trulicity, and Victoza)
Since Ozempic wasn’t studied during clinical trials in people with type 1 diabetes, a history of pancreatitis, or a stomach-emptying problem called gastroparesis, we’re not 100% sure how or if it affects these conditions.
Ozempic drug interactions
Two main types of drug interactions can occur with Ozempic. Ozempic can slow down the rate at which your stomach empties into the intestines. This might slow down the absorption of certain oral medicines.
But, according to drug interaction studies, this shouldn’t cause major problems for most drugs. One potential exception is the blood thinner drug warfarin. Closer monitoring may be needed if you take warfarin and Ozempic (FDA, 2021).
If you take certain diabetes medications, adding Ozempic may cause your blood sugar to drop too low. As a precaution, your healthcare provider may recommend more frequent monitoring of your blood sugar. They may also change your dosage if you take any of the following:
- Insulin: Lantus, Levemir, Humulin, or others
- Sulfonylureas: Glimepiride (Amaryl), glipizide (Glucotrol), or glyburide (Diabeta)
- Meglitinides: Nateglinide or repaglinide
Your healthcare provider will go over how to check your blood sugar and what to do if it becomes too low. Other drug interactions are possible, so be sure to tell your doctor about everything you take including over-the-counter and prescription drugs, as well as vitamins, herbs, and other supplements.
What are GLP-1 receptor agonists, and how do they work?
Ozempic is a brand name drug. There’s currently no generic version. A pill form of semaglutide is available as the brand Rybelsus, an oral tablet that’s taken once daily (Collins, 2021; FDA, n.d.).
Brand-name medications are pretty expensive out of pocket: the average cash price of Ozempic is around $1,000 per month. You may have insurance coverage or you be able to take advantage of coupons or savings programs from the drug’s manufacturer, Novo Nordisk, if you’re eligible.
- Center for Disease Control and Prevention (CDC). (2020). A snapshot: diabetes in the United States. Retrieved on Feb. 18, 2022 from https://www.cdc.gov/diabetes/library/socialmedia/infographics/diabetes.html
- Collins, L. & Costello, R. A. (2021). Glucagon-like peptide-1 receptor agonists. [Updated June 25, 2021]. In: StatPearls [Internet]. Retrieved on Feb. 18, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK551568/
- Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., et al. (2016). American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocrine Practice, 22(3), 1–203. doi:10.4158/EP161365.GL Retrieved from https://www.endocrinepractice.org/action/showPdf?pii=S1530-891X%2820%2944630-0
- U.S. Food and Drug Administration (FDA). (n.d.). [email protected]: FDA-approved drugs. Retrieved on Feb. 9, 2022 from https://www.accessdata.fda.gov/scripts/cder/daf/
- U.S. Food and Drug Administration (FDA). (2021). Ozempic (semaglutide) injection, for subcutaneous use. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/209637s008lbl.pdf