Semaglutide and liraglutide come in a prefilled injection pen. You (or someone in your household) will administer the injection of semaglutide or liraglutide under the skin of your stomach, thigh, or arm once a week.

Be sure to read the instructions that come with the pen before taking your first dose.

Ozempic-branded semaglutide comes in a “dial-a-dose” pen. Each pen contains multiple doses, and you’ll turn a dial to select the prescribed dose.

You’ll need to attach a new needle per the instructions below each time you administer a dose—after which the needle should be disposed of safely (like in a sharps container purchased from your local pharmacy, or a heavy-duty plastic container with a screw-on lid).

How to store your medication

Before you use an injection pen for the first time, it should be stored in the refrigerator between 36–46º F.

After a pen is first used, it may be kept outside the refrigerator between 59–86º F for up to 56 days.

When to take your dose

You’ll use one pen each week.

Take your Ozempic-branded semaglutide on the same day each week (for example, every Monday), with or without food.

Steps

Wash your hands before handling your medication.

Preparing the medication

1. First, make sure the pen indicates the correct medication that you were prescribed and that the expiration date has not passed.

2. Next, pull the cap of the pen straight off.

3. Inspect the medication—it should look clear and colorless, with no debris or particles in it. If it’s not, don’t use the medication. In that instance, contact your pharmacy and your Ro-affiliated provider for further guidance, since you may need a new pen.

4. If the medication looks clear, colorless, and particle-free, you can attach a new needle.

5. Take a new needle and tear off the paper tab. Do not take the cap off the needle just yet.

6. Holding the pen in one hand, take the capped needle between the thumb and forefinger of your other hand. Push the needle straight onto the pen. Turn clockwise until the needle is on tight.

7. Pull off the outer needle cap. Do not throw the outer cap away.

8. Pull off the inner needle cap. You can throw the inner cap away.

Always use a new needle for each injection. Do not reuse a needle. Do not share needles with other people. Do not use a bent or damaged needle.

Check the Ozempic flow with each new pen

You should check the Ozempic flow each time you use a new pen. If you’ve previously used a pen, you should proceed to the “Select your dose” steps below.

To check the flow:

1. Turn the dose selector until the dose counter shows the flow check symbol.

2. Hold the pen with the needle pointing up toward the sky.

3. Press and hold in the dose button until the dose counter shows The 0 must line up with the dose pointer.

4. A drop of Ozempic will appear at the needle tip.

• If no drop appears, repeat Steps 1–3 up to six times. If this does not cause a drop to appear, replace the needle and repeat Steps 1–3 once more. If a drop of Ozempic still does not appear, contact your pharmacy or Ro-affiliated provider.

Select your dose

Turn the dose selector until the dose counter shows your dose.

• If you have an Ozempic 2 mg pen, you can only select doses of 0.25 mg or 0.5 mg. Follow the dosing instructions from your Ro-affiliated provider to select the correct dose.

• If you have an Ozempic 4 mg pen, you can only select doses of 2 mg.

Administering the injection

1. Choose an injection site in either your stomach, thigh, or upper arm. You can use the same part of your body each week, but don’t inject it into the exact same spot in that body part each time.

2. First, use an alcohol wipe to clean the injection site you’ve chosen.

3. Insert the needle by pressing the pen firmly against your skin. Make sure you can see the dose counter.

4. Hold the button down until the dose counter turns to 0.

5. After the dose counter turns to 0, wait six seconds.

6. Remove the needle from your skin.

After administering the dose

• Carefully remove the needle from the pen.

• Dispose of the needle in a sharps container (your local pharmacy may be able to provide one) or a heavy-duty plastic container with a screw-on lid. Do not throw the needle into your regular trash.

Put the cap back onto your pen.

If your pen contains more medication, then store it in a safe location. If the pen contains no more medication, dispose of it in your sharps container or heavy-duty plastic container.

GLP-1s are prescription medications that are clinically-tested, stimulant-free, and non-habit forming. These medications work by mimicking the functions of a naturally occurring hormone in your body to slow down how fast your stomach empties after you eat and act on your brain to make you less hungry. This helps you feel fuller, causing less food intake without uncomfortable hunger. These medications are meant to be used with a reduced calorie diet and regular physical activity.

Side effects to the injection: Patients occasionally note irritation of the skin or small raised areas near or at the injection site. By ensuring that the area of injection is cleaned with an alcohol swab prior to injection and injecting at a perpendicular angle to the skin, you can decrease the chance of these reactions occurring. These usually go away on their own within 4-8 weeks.

Side effects to the medication: The side effects of GLP-1s are generally limited to gastrointestinal complaints, with the most common being nausea and diarrhea. Other side effects included vomiting, constipation, and abdominal pain, dyspepsia (or upset stomach), abdominal distension, and reflux. Non-gastrointestinal side effects included headache, fatigue, and dizziness.

In patients with type 2 diabetes, there were also reports of low blood sugar.

Less common were serious side effects including inflammation of the pancreas (pancreatitis), gallbladder inflammation and stones, kidney injury, increases in heart rate, and complications related to diabetic retinopathy in patients with type 2 diabetes.

Changes in mood have been reported with GLP-1s and you should report these to your Ro-affiliated provider. We will also monitor this while you are on therapy with us.

Possible thyroid tumors, including cancer. You should alert your Ro-affiliated provider if you get a lump or swelling in your neck, develop hoarse voice, have trouble swallowing, trouble breathing, or shortness of breath. While it is not certain if Ozempic could cause thyroid tumors or a type of thyroid cancer, Ozempic and medications like it have caused tumors in rodent studies. Additionally, cases of medullary thyroid carcinoma (“MTC”) in patients treated with a different medication in the same class as semaglutide (liraglutide, another GLP-1 receptor agonist), have been reported, but the data in these reports are insufficient to establish or exclude a causal relationship between MTC and GLP-1 receptor agonist use in humans.

Patients with a family history of medullary thyroid carcinoma or patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not take GLP-1s. Additionally anyone that has had a previous serious reaction to the medication should not take it.

All persons, including those who were assigned male at birth and those who were assigned female at birth, who are planning to conceive or conceive with a partner should not take GLP-1s for at least 3 months prior to attempts at conception, including in-vitro fertilization (IVF).

GLP-1s can lower blood glucose and using them with other medications that lower blood glucose such as insulin or sulfonylureas can cause hypoglycemia or significantly low blood sugar. If you are currently taking one of these medications, you should mention these medications to your Ro-affiliated provider as well as consult with your prescribing provider regarding its use along with a GLP-1.

One of the effects of GLP-1s is decreasing the speed of gastric emptying or the speed that material moves through your gastrointestinal tract. Due to this it can change the absorption of medications taken by mouth.

If you are on thyroid medication, specifically levothyroxine, GLP-1s can increase the concentration of the levothyroxine in your blood. Please inform your Ro-affiliated provider that you are taking this medication as well as consult with your prescribing provider regarding its use along with a GLP-1.

Most people who take GLP-1s notice a decrease in hunger, feeling more full for longer or feeling more full after less food. Some patients report side effects such as nausea or diarrhea. At lower doses, however, you may not feel any changes at all. That does not mean the medication is not working—you may start seeing small changes on the scale at low doses—but some people may require higher doses before they notice changes in their appetite. Ultimately, the goal of GLP-1 therapy is weight loss and this may occur without any noticeable differences in how you feel. If you still feel no different and haven’t noticed changes on the scale by the time you’ve been prescribed higher doses of the medication, discuss this with your Ro-affiliated provider.

GLP-1s are just one mechanism of weight management.

All medications, devices, and procedures are just one part of the weight management journey. It is also important to ensure that you are pursuing a healthy diet and engaging in healthy practices such as physical activity, getting enough sleep, and managing stress. Your Ro-affiliated provider and coaching team can help you with these and other changes that are important for weight management.

For Ozempic: Semaglutide was originally a medication developed for the treatment of diabetes. It is still used for the treatment of diabetes, and one form of it is the brand known as Ozempic. One finding from these studies was that patients were losing a significantly greater amount of weight vs. the placebo (inactive) treatment. Though these patients had diabetes, patients who combined the diabetes dosing of semaglutide with diet and exercise modifications had about a 4% to 6% weight loss after 68 weeks in clinical studies.

(A) WARNING: RAPID WEIGHT LOSS MAY CAUSE SERIOUS HEALTH PROBLEMS. RAPID WEIGHT LOSS IS WEIGHT LOSS OF MORE THAN 1 1/2 POUNDS TO 2 POUNDS PER WEEK OR WEIGHT LOSS OF MORE THAN 1 PERCENT OF BODY WEIGHT PER WEEK AFTER THE SECOND WEEK OF PARTICIPATION IN A WEIGHT-LOSS PROGRAM.

(B) CONSULT YOUR PERSONAL PHYSICIAN BEFORE STARTING ANY WEIGHT-LOSS PROGRAM.

(C) ONLY PERMANENT LIFESTYLE CHANGES, SUCH AS MAKING HEALTHFUL FOOD CHOICES AND INCREASING PHYSICAL ACTIVITY, PROMOTE LONG-TERM WEIGHT LOSS.

(D) QUALIFICATIONS OF THIS PROVIDER ARE AVAILABLE UPON REQUEST.

(E) YOU HAVE A RIGHT TO:

1. ASK QUESTIONS ABOUT THE POTENTIAL HEALTH RISKS OF THIS PROGRAM AND ITS NUTRITIONAL CONTENT, PSYCHOLOGICAL SUPPORT, AND EDUCATIONAL COMPONENTS.

2. RECEIVE AN ITEMIZED STATEMENT OF THE ACTUAL OR ESTIMATED PRICE OF THE WEIGHT-LOSS PROGRAM, INCLUDING EXTRA PRODUCTS, SERVICES, SUPPLEMENTS, EXAMINATIONS, AND LABORATORY TESTS.

3. KNOW THE ACTUAL OR ESTIMATED DURATION OF THE PROGRAM.

4. KNOW THE NAME, ADDRESS, AND QUALIFICATIONS OF THE DIETITIAN OR NUTRITIONIST WHO HAS REVIEWED AND APPROVED THE WEIGHT-LOSS PROGRAM ACCORDING TO s. 468.505(1)(j), FLORIDA STATUTES.