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Ozempic is a prescription pen that can help people with type 2 diabetes control their blood glucose levels (CADTH, 2019). The three best Ozempic injection sites are on your abdomen, thigh, and upper arm.
What is Ozempic?
The active ingredient in Ozempic (see Important Safety Information) is semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist manufactured by Novo Nordisk. Ozempic is a prescription pen prefilled with injectable medicine that treats type 2 diabetes by controlling blood sugar levels, along with a healthy diet and regular exercise (CADTH, 2019; Chamberlin, 2019). It is designed to be self-injected weekly, with or without meals (DailyMed, 2022).
Ozempic is primarily prescribed to treat type 2 diabetes, and to those who also have cardiovascular disease to reduce the chances of major problems like a heart attack or stroke (Wilding, 2021; Chamberlin, 2019).
Even though not approved to treat obesity, Ozempic is sometimes prescribed off-label to help adults with obesity lose weight by reducing their appetite (O’Neil, 2018; Wilding, 2021). In this case, people may lose weight faster when using metformin or insulin (Chamberlin, 2019).
Where is the best injection site for Ozempic?
The three best injection sites for Ozempic are your abdomen, thigh, and upper arm. With each weekly injection, use a different site from the week before, rotating through all three over the course of three weeks. Do not inject in the same site each week, to avoid irritating the skin (DailyMed, 2022).
Ozempic should be injected subcutaneously (under the skin), not into a muscle or vein.
You can inject Ozempic in the same area of your body you use for insulin, such as your abdomen, but do not mix the two injections and do not inject them right next to each other (DailyMed, 2022).
How do you administer an Ozempic injection?
Ozempic should be self-injected weekly, on the same day of the week. Your healthcare provider can show you how to use your Ozempic pen. Always read the manufacturer’s instructions in their entirety before using your Ozempic pen (DailyMed, 2022).
1. Prepare your hands
- Wash your hands with soap and water, and dry them.
2. Prepare your pen
- Look at the medicine in your pen. It should be clear and colorless. If you notice any particles or cloudiness, do not use the pen.
- Attach a new needle to your pen. This should be done with each injection.
- Remove the outer and inner needle caps.
3. Prepare your dose
- If this is your first time using a new pen, check the Ozempic flow. Otherwise, proceed to the next step.
- Dial the dose selector to the flow check symbol.
- With the needle pointing up, press and hold the dose button until it goes to 0.
- You should see a drop at the tip of the needle.
- If you don’t see a drop, repeat up to six more times until you do. Otherwise, use a new pen or contact Novo Nordisk at (888) 693-6742.
- Dial the dose counter so the desired dose lines up with the dose pointer. Follow the dosing instructions from your provider to select the correct dose.
4. Inject your dose
- Use an alcohol swab to clean the skin where you will inject. Let your skin dry.
- Angle the pen so you can see the dose counter.
- Put the Ozempic needle into your skin at the injection site (stomach, thigh, or upper arm).
- Press the dose button until 0 mg lines up with the dose pointer.
- With the button still pressed and the needle still inserted, count for six seconds to allow a full dose of Ozempic.
- Keeping your thumb on the dose button, remove the needle from your skin.
5. Dispose of your needle and store your pen
- Remove the needle from the pen and throw it away in an FDA-approved sharps disposal container.
- Put the pen cap back on your pen and store it at room temperature, away from light, until your next dose.
Ozempic injection site reactions
Ozempic injection site reactions are relatively rare. In placebo-controlled trials, only 0.2% of the participants using Ozempic experienced injection site reactions. These included discomfort or redness at the injection site (DailyMed, 2022).
When you remove the needle after injecting Ozempic, you may notice some blood at the injection site. Simply press on it with a cotton ball or gauze (DailyMed, 2022).
Other potential Ozempic side effects
Some people may experience nausea, vomiting, and diarrhea when using Ozempic. These side effects are more common when the dose is increased (Chamberlin, 2019). Rarer side effects include abdominal pain or constipation (DailyMed, 2022).
Using Ozempic may increase your risk of gallbladder disorders, gastrointestinal disorders, or hypoglycemia (low blood sugar) (Wilding, 2021; DailyMed, 2022). Ozempic should not be used by children or people who (Chamberlin; 2019; DailyMed, 2022):
- Have pancreatitis
- Have a personal or family history of thyroid cancer
- Have multiple endocrine neoplasia syndrome type 2
- Have diabetic retinopathy (vision loss caused by diabetes)
- Are currently pregnant or breastfeeding
The US Food and Drug Administration (FDA) has issued a “black box” warning for Ozempic, which appears in the insert for the medication. This is the most serious advisory they issue for a medication. Animal studies have found that Ozempic increases the risk of thyroid tumors in humans. While it is not known if it has the same effect in humans, people with a personal or family history of thyroid cancer or who have multiple endocrine neoplasia syndrome type 2 should not use Ozempic (FDA, 2020; DailyMed, 2022).
When to see a healthcare provider
If you have an allergic reaction to Ozempic, you may experience swelling, trouble breathing, rash, dizziness, fainting, or a fast heartbeat. If you believe you are having an allergic reaction, seek medical attention immediately (DailyMed, 2022).
Also, talk to a health care professional if you experience any of the following (DailyMed, 2022):
- Severe stomach pain, with or without vomiting, that persists
- Blurred vision or vision changes
- Mood changes
- Slurred speech
- Rapid heartbeat
Talk to your healthcare provider if you have questions about your Ozempic pen or notice side effects. They can demonstrate how to use the Ozempic pen at the appropriate injection sites. While Ozempic is safe and generally well-tolerated, you should regularly check in with your doctor and let them know if you experience any side effects (DailyMed, 2022).
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
- Canadian Agency for Drugs and Technologies in Health (CADTH). (2019). Clinical Review Report: Semaglutide (Ozempic): (Novo Nordisk Canada Inc.). Canadian Agency for Drugs and Technologies in Health. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31305971/
- Chamberlin, S. & Dabbs, W. (2019). Semaglutide (Ozempic) for type 2 diabetes mellitus. American Family Physician, 100(2), 116–117. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31305048/
- DailyMed. (2022). OZEMPIC-semaglutide injection, solution. National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
- Food and Drug Administration (FDA). (2020). Drug trial snapshot: Ozempic. Food and Drug Administration. Retrieved from https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trial-snapshot-ozempic
- Medline Plus. (2021). Semaglutide injection. American Society of Health-System Pharmacists, Inc. Retrieved from https://medlineplus.gov/druginfo/meds/a618008.html
- O’Neil, P. M., Birkenfeld, A. L., McGowan, B., et al. (2018). Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet (London, England), 392(10148), 637–649. doi:10.1016/S0140-6736(18)31773-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30122305/
- Wilding, J., Batterham, R. L., Calanna, S., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989–1002. doi:10.1056/NEJMoa2032183. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33567185/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.