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Health Guide / GLP-1

Injection sites for Ozempic: where and how to inject Ozempic

felix gussoneAmelia willson

Reviewed by Felix Gussone, MD, written by Amelia Willson

Last updated: Jul 26, 2022
5 min read

table of contents

  1. What is Ozempic?
  2. Where is the best injection site for Ozempic?
  3. How do you administer an Ozempic injection?
  4. Ozempic injection site reactions
  5. When to see a healthcare provider

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. 

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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
  • Lightheadedness
  • Sweating
  • Mood changes
  • Shakiness
  • Confusion
  • 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).

Disclaimer

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.

References

  1. 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/ 
  2. 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/
  3. 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 
  4. 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
  5. Medline Plus. (2021). Semaglutide injection. American Society of Health-System Pharmacists, Inc. Retrieved from https://medlineplus.gov/druginfo/meds/a618008.html 
  6. 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/
  7. 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
Felix Gussone, MD

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.

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Important Safety Information for Ozempic®

Important Safety Information for Ozempic (semaglutide) injection

Warning: Risk of Thyroid C-Cell Tumors

  • In studies with mice and rats, semaglutide (the active ingredient in Ozempic and Wegovy) caused thyroid tumors, including thyroid cancer. It is not known if Ozempic will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Do not use Ozempic if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

What is the FDA-approved use of Ozempic?

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that is used:

  • with diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
  • to reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus and established cardiovascular disease.

Limitations of Use:

  • Ozempic has not been studied in patients with a history of pancreatitis.
  • Ozempic is not for treatment of type 1 diabetes mellitus.

Your Ro-affiliated provider may recommend the use of Ozempic as treatment for chronic weight management (obesity or overweight).

Who should not use Ozempic?

Do not use Ozempic if:

  • You or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • You have a known allergic reaction to semaglutide (the active ingredient in Wegovy or Ozempic). 

How should Ozempic be administered? 

You can take Ozempic with or without food. The pre-filled injector pen is self-administered as a subcutaneous injection in the stomach, thigh, or upper arm once a week on the same day every week. Your Ro-affiliated provider will guide you on a treatment regimen that may include an increase in dose every four weeks. 

You should not change your dosing regimen or stop taking Ozempic as prescribed without discussing with your provider first.  

What should I tell my Ro-affiliated provider before using Ozempic?

  • Ozempic has certain drug interactions. It’s important to tell your Ro-affiliated provider all of the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements. 

Some medications to watch out for include:

  • Medications used to treat type 1 or type 2 diabetes, including insulin or sulfonylureas (such as Amaryl or Glucotrol XL)
  • Ozempic causes a delay in gastric emptying so it has the potential to impact the absorption of medications that are taken by mouth at the same time. Your provider can guide you on how to schedule your medications.
  • Other GLP-1 medications, including Wegovy, Saxenda, Victoza, Byetta, or Bydureon
  • If you’re using other products for weight loss, including dietary supplements

It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a past history of:

  • Type 1 or type 2 diabetes
  • Thyroid cancer
  • Pancreatitis
  • Kidney disease
  • Diabetic retinopathy
  • Depression
  • Suicidal thoughts or behavior

Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. 

  • If you are pregnant: Ozempic should not be used during pregnancy. Based on animal studies, there may be potential risks to an unborn baby from exposure to Ozempic during pregnancy. There is no benefit to weight loss during pregnancy and it may cause harm to the unborn baby. 
  • If you are a female or male of reproductive potential: Discontinue Ozempic at least 2 months before a planned pregnancy since the drug can stay in the bloodstream for a long time.
  • If you are breastfeeding: Ozempic was found in the milk of lactating rats. Tell your Ro-affiliated provider if you are breastfeeding before you start Ozempic.

Pregnancy registry: There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to semaglutide (the active ingredient in Ozempic and Ozempic) during pregnancy. Pregnant women exposed to semaglutide and healthcare providers are encouraged to contact Novo Nordisk at 1-800-727-6500.

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I or a caregiver should monitor for when taking Ozempic? 

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects can occur with Ozempic. You or a caregiver should carefully monitor for these side effects, especially in the beginning of treatment and with dose changes.

  • Thyroid C-Cell Tumors: In mice and rats, semaglutide (the active ingredient in Ozempic and Ozempic) caused an increase in thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is unknown whether Ozempic causes thyroid C-cell tumors in humans. There were cases of MTC reported in patients who took liraglutide (the active ingredient in Victoza and Saxenda) after the drug was put on the market. Ozempic is contraindicated in patients with a family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Inflammation of Pancreas (Acute Pancreatitis): Monitor for signs of acute pancreatitis, including severe abdominal pain that does not go away, sometimes radiating to the back, with or without vomiting.
  • Diabetic Retinopathy Complications in Patients with Type 2 Diabetes: If you have type 2 diabetes, tell your provider right away if you experience changes in vision.
  • Never Share a Pen: Pen-sharing poses a risk of infection. 
  • Low Blood Sugar (hypoglycemia): Ozempic lowers blood glucose. It can cause too low blood sugar in patients with type 2 diabetes who also take another glucose control medication. Monitor your blood sugar and watch out for signs of too low blood sugar such as dizziness, blurred vision, mood changes, sweating, or fast heartbeat.
  • Acute Kidney Injury: In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse. It is important for you to drink plenty of water to help reduce your chance of dehydration.
  • Serious Allergic Reactions: Stop using Ozempic right away if you experience symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, severe rash or itching, very rapid heartbeat, problems breathing or swallowing, or fainting or feeling dizzy.
  • Acute Gallbladder Disease: Ozempic may cause gallbladder problems, including gallstones. Some gallbladder problems require surgery. Tell your provider right away if you have pain in your upper stomach, yellowing of skin or eyes (jaundice), fever, or clay-colored stools.
  • Increase in Heart Rate: Tell your provider right away if you have a racing heartbeat while at rest. 
  • Suicidal Behavior and Ideation: You should pay attention to any mental health changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.

What are the most common side effects of Ozempic?

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Constipation

You are encouraged to report negative side effects of prescription products:

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.