Ozempic dosing guide: how much should you take?

Ozempic (semaglutide), a drug originally approved to treat type 2 diabetes and to reduce the risk of cardiovascular events, has found huge popularity as an off-label weight loss drug. Though it’s not a silver bullet, many people have been able to use it to lose weight when they combine it with lifestyle improvements. 

Ozempic dosing questions are common, which is understandable as the maximum dose could be different for everyone. We’ll explain what the typical Ozempic dosing schedule is, how it’s scaled up, when a person’s dose might change, and what to do if you miss a dose or take too much.

The right Ozempic (semaglutide) dose depends on a number of things, including your health status, the condition you’re taking Ozempic for, and more. In general, higher isn’t necessarily better (more on that below).

Ozempic comes in a prefilled injection pen that contains multiple doses of semaglutide, and is injected into areas like the abdomen, thigh, or upper arm, once per week. It’s injected just under the skin (called a subcutaneous injection).

The FDA has approved four different doses of Ozempic to control blood sugar for people with type 2 diabetes: 0.25 mg, 0.5 mg, 1.0 mg, and 2.0 mg. The lowest dose of Ozempic is 0.25 mg once a week and the maximum dose is 2.0 mg once a week. The dosing schedule for other medications with semaglutide as the active ingredient, such as Wegovy, is different. 

For everyone, the starting dose of Ozempic is generally 0.25 mg injected weekly. From there, if it’s appropriate, your healthcare provider will gradually increase your dose month by month until you reach the one that’s ideal for you — that means that you’re seeing the desired effect from the drug and can tolerate any side effects you may experience.

To find the right Ozempic dosage, providers will guide patients along a once-weekly dosing schedule that typically looks like this:

Ozempic dosing schedule

You’ll stay in close contact with your provider to check in about how you’re tolerating the drug, whether you’re experiencing any side effects, your blood glucose control, and the rate of any weight loss. This will help guide your provider in deciding whether it’s appropriate to adjust your dose. 

In general, it’s best to take the lowest effective dose. That means that if you achieve your desired blood sugar level control and/or weight loss with 1 mg Ozempic, there’s no need to increase it to 2 mg. That’s good news in terms of reducing Ozempic side effects. Staying at a lower dose can help to minimize gastrointestinal discomfort, the most common side effect of semaglutide.

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Pre-existing medical conditions can sometimes impact a person’s dose of medications, but that’s typically not the case for Ozempic. While there are few situations where age or medical treatment could change your Ozempic dose, having medical conditions won’t actually affect it.

For example, certain health issues, like kidney (renal) or liver impairment, can sometimes mean that dosages of certain medications have to be adjusted. This is because the kidney and liver are responsible for processing medications, and it’s possible to overtax them. However, while the kidneys process semaglutide in the body, you typically won’t need to adjust your Ozempic dose. However, if you have existing kidney problems and experience common Ozempic side effects like diarrhea and vomiting, your healthcare provider might monitor kidney function while you’re going up with your Ozempic dose.

If you already take certain prescription drugs for diabetes, your Ozempic dosage or the dose of the other medications might need to be adjusted. These diabetes medications—including insulin and sulfonylureas —help to manage diabetes by lowering your blood sugar. If you begin taking Ozempic (which also lowers blood sugar), it’s possible that your blood sugar levels could dip dangerously low. This doesn’t mean that you can’t take Ozempic if this applies to you—just that you’ll need to be monitored a little more closely to make sure your dose is appropriate.

Missing a dose of Ozempic isn’t the end of the world, but you should take a missed dose as soon as you remember. You can do it at any point over the course of five days from the missed dose. However, if more than five days have passed since you were supposed to take your dose, just skip the missed dose and take your next dose at the normally scheduled time. From there, you can just resume your normal weekly dosing schedule.

The reason for this is that you don’t want to take two doses of Ozempic too close to each other. Doing so can put too much Ozempic in your system, putting you at higher risk of side effects as well as a dangerous drop in your blood sugar levels.

It can be hard to remember to take medication at the same time every week, especially if you don’t keep to a strict schedule. A few tricks can help you to stay on track:

• Set a weekly alarm or calendar reminder on your phone  

• Use a dedicated medication reminder app

• Time your Ozempic dose with other weekly activities you may participate in (for example, religious services, a sporting event, or a regularly scheduled work meeting)

Ozempic comes in a format that’s designed to be simple and straightforward to use. It comes in a prefilled injector pen with a simple dial that you can turn to select your prescribed dose before giving yourself the injection. This helps to make it easy for you to inject the right amount. 

However, everyone makes mistakes, and it’s possible to turn the dial to the wrong dose and accidentally give yourself a larger amount of Ozempic than has been prescribed.  

If this happens, call your provider immediately. A couple of things could occur, but the most risky one is hypoglycemia, or low blood sugar (glucose). The other is exacerbated gastrointestinal discomforts like nausea, vomiting, diarrhea, abdominal pain, or constipation.

Hypoglycemia is common in people with type 1 diabetes who need to take insulin to control their blood glucose levels. Even though less common, people with type 2 diabetes who take too much semaglutide can also develop hypoglycemia, especially if they’re already taking other diabetes medications, like insulin. 

This is because one of the ways Ozempic works is by reducing blood sugar. Taking too much may bring sugar levels too far down for too long. This can be relatively simple to treat but is vital to treat before it lasts too long. 

Fortunately, blood sugar can be easily checked with a small device called a glucometer. You should also monitor for symptoms of hypoglycemia, including:

• Feeling cold and clammy

• Feeling weak, sleepy, or dizzy

• Headache

• Confusion

• Nausea and vomiting

• Shaking

• Blurry vision

You can treat hypoglycemia by eating or drinking sugar (carbohydrates) and monitoring your symptoms. Some providers call this the “15-15” rule: consume 15-20 grams of carbohydrates and wait 15 minutes to see if symptoms improve and blood sugar rises. If not, repeat the process again. If your symptoms are severe and aren’t improving, seek medical advice immediately. The ideal carbs for this treatment are quick, sugary, and swiftly absorbed by the body. Examples include cake frosting, soda (not diet), fruit juice, jelly, and honey.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

September 21, 2023

Written by

Nancy LaChance, BSN, RN

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

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