What happens if you use expired semaglutide?

If you find yourself holding an expired dose of semaglutide, you might be tempted to use it, especially since the medication isn’t cheap. But what happens if you use expired semaglutide? Using expired semaglutide, including Ozempic, Wegovy, and Rybelsus, can be harmful to your health. It can:

• Cause side effects like immune responses

• Cause infections from contamination

• Be less effective and not work as well (e.g. resulting in uncontrolled blood sugars) 

Here’s what you need to know about expired semaglutide, how to tell if it’s gone bad, and how to dispose of it safely.

Imagine you’re about to inject your semaglutide dose, but you notice the expiration date has passed. Some solid medications like tablets (e.g. Rybelsus) can stay shelf-stable for years as long as they’re properly stored. But injectable medications don’t always work that way.  

Here’s what can happen if you inject expired semaglutide:

1. Increased risk of infection 

Ozempic and Wegovy are manufactured under sterile conditions and are meant to stay sterile until their expiration date, assuming they’re properly stored. 

After they expire, there’s a higher risk of contamination because the preservative might not be as effective over time. This can cause contamination from bacteria or fungal growth, potentially leading to redness, swelling, or abscesses at the injection site. 

2. Loss of effectiveness 

Semaglutide can break down over time, which means it may not work as well for controlling blood sugar and weight loss. A weaker dose might not be as effective at controlling your blood sugar and could prevent you from feeling full as quickly or for as long.

3. Additional side effects

As a medication approved by the US Food and Drug Administration (FDA), semaglutide is ensured to be safe and effective up to its labeled expiration date. After that, semaglutide’s chemical composition can break down, which can cause additional side effects, including allergic reactions. If you experience trouble breathing, swelling, or severe skin reactions after using it, seek immediate medical attention.

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In general, semaglutide expires 24 months (two years) from the manufacture date. This includes Ozempic, Wegovy, and Rybelsus. But this depends on how it’s stored and if the vial has been opened. 

So, when does each brand-name semaglutide expire? Here’s a breakdown: 

Ozempic 

If kept refrigerated (36°F–46°F), unopened Ozempic pens stay good until the expiration date on the package. The manufacturer’s expiration date is two years (24 months) from the date the medication was made.   

Once you open an Ozempic pen, it can be kept at room temperature (59°F–86°F) or in the fridge for up to 56 days. After that,  discard any leftover doses.

Wegovy 

Like Ozempic, Wegovy is good for 24 months from the date of manufacture (if kept in ideal storage conditions). Unopened Wegovy pens should be refrigerated (36°F–46°F) until the expiration date printed on the box and pen. 

If left at room temperature (59°F–86°F), Wegovy should be used within 28 days. After that, discard any unused doses, even if the pen appears fine. 

Since Wegovy pens are single-use (one dose per pen), there’s no “after opening” storage guidance like there is for Ozempic.

Rybelsus 

Rybelsus, the oral tablet form of semaglutide, expires two years from the date of manufacture. You don’t need to refrigerate Rybelsus, and it can be stored at room temperature (68°F–77°F). 

As long as the tablets are stored properly in their original bottle and remain within this timeframe, they should be safe and effective. (In other words, don’t store Rybelsus tablets in a pill organizer or any other pill storage container.) 

Keep the medication in a dry place away from moisture and heat. The tablets can be exposed to temperatures between 59°F–86°F for a short time, such as when you’re traveling.

Compounded semaglutide 

Compounded semaglutide typically stays good for 14–35 days as long as it’s stored properly (i.e. as instructed by the pharmacist and provider) and contains a preservative (e.g. phenol). Refrigeration is usually required.  Compounded semaglutide isn’t approved by the FDA and doesn’t have a standardized expiration date like Ozempic or Wegovy. 

Instead, compounded semaglutide comes with a beyond-use date (BUD), which is the last day the medication is guaranteed safe to use. This BUD comes from the pharmacy that compounded the medication, and the shelf life can vary. To find the BUD for your Rx, check the prescription label or contact the pharmacy directly. 

Some pharmacies may assign a BUD of up to 120 days, but only if they’ve conducted rigorous stability testing, similar to the testing drug manufacturers use for establishing expiration dates. 

Like other GLP-1 receptor agonists, semaglutide must be stored properly to remain safe and effective. Even before the labeled expiration date, exposure to extreme temperatures, direct sunlight, or moisture can cause medications to degrade. 

You should always carefully inspect your semaglutide before you take it — even if it’s within its expiration date.

Injectable semaglutide (Ozempic, Wegovy) should be:

1. Clear and colorless. If your medication looks cloudy, milky, hazy, or colored upon inspection, it could mean the medication has broken down and is no longer safe for use. 

2. Free of particles. Anything floating within the liquid could indicate clumps or crystals, which may be caused by bacteria or the breakdown of chemicals. 

3. Liquid (i.e. not frozen). Frozen or even thawed semaglutide is not safe to use. If you accidentally left your medication in the freezer instead of the refrigerator or a cold car overnight, do not take it. 

Semaglutide tablets (Rybelsus) should be: 

• Whole

• White to yellow in color

• Smooth (not cracked, chipped, or discolored)

Also important: Do not use any semaglutide pens or needles that appear to be damaged. Not sure? It’s always best to err on the side of caution and consult your healthcare provider or pharmacist before injecting. They may be able to provide a new prescription.

Repeat after us: If your semaglutide has expired or you suspect it has gone bad, discard it. But do not simply throw it in the household trash and call it a day. 

Here’s what to do instead:

• Dispose of expired pens and needles in an FDA-cleared container. Another option is to use a puncture-proof, sturdy plastic container with a secure lid (e.g. repurposed laundry detergent container). 

• Dispose of expired tablets by crushing and placing them with an undesirable substance (e.g. coffee grounds, cat litter). Seal the mixture in a plastic bag and then toss it in the household trash.  

• Use a drug take-back program. The US Drug Enforcement Administration (DEA) hosts National Prescription Drug Take-Back Days, during which you can drop off unwanted or expired medications at authorized sites. Your local pharmacy may also have an in-store disposal kiosk. Whichever method you use, be sure to first remove all personal information on the prescription label or use a permanent marker to cover it.     

• Contact your healthcare provider or pharmacist. They can provide guidance on the best next steps to continue your treatment as best as possible. They may even be able to provide a new prescription.

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Medication manufacturers test medications like Ozempic, Wegovy, and Rybelsus for safety, stability, and effectiveness up to the expiration date. Beyond that, there’s no way to be sure. If you’re wondering when semaglutide expires and what may happen if you use expired semaglutide, here’s a recap of what to consider:

• Don’t use expired semaglutide. Expired semaglutide can lose potency and even become unsafe, potentially causing side effects like immune reactions or infections. 

• Semaglutide generally expires two years after the date it’s made — as long as its stored properly. Be sure to check the expiration date on Ozempic, Wegovy, and Rybelsus packaging.

• Injectable semaglutide should be clear, colorless, and free of particles. If not, this may mean the medication has gone bad and should be discarded, even if it’s within the expiration date.  

• Dispose of expired pens and needles in an FDA-cleared sharps container. Semaglutide tablets can be crushed, mixed into substances like coffee grounds, and then sealed in a plastic bag to throw it away in the trash.