Ozempic dosage, forms, and strengths

Ozempic (semaglutide) is an increasingly utilized option for the treatment of Type 2 diabetes mellitus. Like other members of the glucagon-like peptide 1 (GLP-1) receptor agonist class, Ozempic is a popular choice for diabetes therapy based on improving glucose control while not causing weight gain or hypoglycemia (low blood sugar) in the absence of other diabetes medications. Semaglutide can even produce weight loss. It has an indication for chronic weight management, at higher doses than Ozempic, under the brand name Wegovy. Ozempic’s favorable effects on cardiovascular outcomes is another incentive to utilize it. While semaglutide is available as the daily pill Rybelsus, Ozempic is delivered as a subcutaneous (under the skin) injection once a week. The available doses are 0.25 mg, 0.5 mg, and 1 mg injected once a week. The dosing of Ozempic will be covered in detail here.

Ozempic forms and strengths

• Injection pen: 0.25 mg per injection, 0.5 mg per injection, and 1 mg per injection

Ozempic dosage for adults

Ozempic has two indications for use from the Food and Drug Administration (FDA). Primarily, it is indicated for treatment of Type 2 diabetes mellitus, but it also has a seperate indication for cardiovascular event risk reduction in patients with concurrent diabetes and cardiovascular disease. Of note, Ozempic is not to be used for Type 1 diabetes mellitus.

Ozempic dosage for Type 2 diabetes mellitus

Ozempic injections are given via a prefilled pen device. There are two pen varieties. One can deliver either a 0.25 mg or 0.5 mg dose, and the other Ozempic pen can deliver a 1 mg dose. Ozempic is begun with a 0.25 mg injection once a week for four weeks. The dose is then increased to 0.5 mg once a week. After a minimum of another four weeks, dose adjustment can be made to 1 mg once a week if needed for glycemic control.

Ozempic dosage for cardiovascular risk reduction in diabetes

The Ozempic dosing strategy is the same for cardiovascular risk reduction. Likewise, the decision on whether to increase from 0.5 mg to 1 mg is based on the blood glucose control goals. Cardiovascular complications of diabetes include heart attacks from coronary artery disease (heart disease), a macrovascular or large blood vessel complication. Diabetic retinopathy (eye complication) and diabetic nephropathy (kidney complication) are termed microvascular or small vessel complications. Semaglutide has been associated with reduced nephropathy risk but possible increased diabetic retinopathy complications. Additional investigation is needed into the effect of Ozempic on the microvascular complications of diabetes.

Ozempic dosage for children

Ozempic is not indicated for use in children.

Ozempic dosage restrictions

Dosage adjustment in the setting of renal (kidney) or hepatic (liver) impairment is not required. Caution is advised with dialysis based on limited evidence from clinical trials.

How to take Ozempic

Ozempic is taken using a prefilled pen device. On the same day each week, the user attaches a new Novofine needle to the pen, dials the prescribed dose, and injects the medication. If you wish to change the day of the week for dosing, you can do so as long as at least two days have passed since the last dose. Doses can be given any time of day, without regard to meals. Below are other important points for taking Ozempic correctly.

• Never share medicine pens with others under any circumstances. Sharing needles or pens can result in transmission of infection.

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin. It is given into your stomach, thigh, or upper arm.

• Check the liquid in the pen. It should be clear and colorless. Do not use it if it is cloudy, discolored, or has particles in it.

• You will be shown the body areas where this shot can be given. Use a different injection site each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.

• This medicine should come with a medication guide. Ask your pharmacist for a copy if you do not have one.

• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.

• Store your new, unused medicine pen in its original carton in the refrigerator. Do not freeze. You may store the opened medicine pen in the refrigerator or at room temperature for 56 days. Throw away the pen after you use it for 56 days, even if it still has medicine in it.

• Use a new needle and syringe each time you inject your medicine. After the injection, remove the needle, dispose of the used needle in a sharps container, and replace the pen cap on the Ozempic pen.

• If you miss a dose of this medicine, inject Ozempic as soon as possible within five days after the missed dose. If you miss a dose for more than five days, skip the missed dose and go back to your regular weekly dosing schedule.

• If you use insulin in addition to this medicine, do not mix them into the same syringe. You may give the shots in the same area (including your stomach), but do not give the shots right next to each other.

Ozempic dosage FAQs

How long does it take Ozempic to work?

The glucose-lowering effects of Ozempic are typically evident within a week of the first use. A steady state level of effect from a dose is noted in about four to five weeks. Since the dose is increased from the starting dose of 0.25 mg weekly after four weeks to 0.5mg weekly, the full effect of a typical dose may not be realized for eight weeks. Even then, the dose may need to be increased to 1 mg weekly.

How long does Ozempic stay in your system?

The half-life of Ozempic is seven days, so one week after a dose, the concentration of the drug is only half of what it was initially. To eliminate nearly all the drug from the body, it takes about five weeks.

What happens if I miss a dose of Ozempic?

The missed dose of Ozempic can be taken within five days of when it was scheduled. If more than five days have passed since its due date, skip the missed Ozempic dose and take the next dose on the day of the week when it is due.

How long can you take Ozempic?

Ozempic can be taken indefinitely. Glucose control goals guide dosing and duration decisions. Over the long term, it is worthwhile to be aware of thyroid tumor signs like neck mass, hoarseness, dysphagia (trouble swallowing), or dyspnea (trouble breathing). The FDA has a black box warning on GLP-1 agonists like Ozempic alerting patients and healthcare professionals of the finding of an increased incidence of thyroid C-cell tumors in rodents given GLP-1 agonists, although the relevance of this finding to humans is unknown. Accordingly, anyone with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome Type 2 (MEN 2) should not take Ozempic or other GLP-1 agonists.

How do I stop taking Ozempic?

If the treating healthcare provider recommends stopping Ozempic, the drug can be stopped without tapering it. No withdrawal symptoms should be expected. If you experience side effects of Ozempic or do not believe it is the right medication for you, always ask your healthcare provider for medical advice before discontinuing any medication.

What is the maximum dosage for Ozempic?

The maximum dosage for Ozempic is 1 mg injected once a week. The other dosage forms of semaglutide, Wegovy and Rybelsus, have different doses.

Can you overdose on Ozempic?

An overdose of Ozempic can be hazardous. Vomiting and low blood sugar levels are potential adverse reactions. Emergency medical attention and a call to the Poison Help line at 1-800-222-1222 are warranted.

What interacts with Ozempic?

Ozempic is contraindicated when cidofovir, an antiviral medication, is used, due to heightened potential side effects from cidofovir. 

Otherwise, there are numerous medications that could interact with Ozempic and may require additional caution or monitoring. For example, combining Ozempic with other antidiabetic medications, such as metformin, sulfonylureas, or insulin, could result in more hypoglycemia. 

The drug could also increase the risk of renal impairment when used with other medications that have a potential risk of adverse renal effects. 

Finally, of note, Ozempic slows gastric emptying, which helps users to feel full quicker at mealtimes, but this effect can alter the absorption of some drugs. It is essential that you review your list of prescription drugs, over-the-counter medications, and supplements with your healthcare professional before starting and while taking Ozempic.

What happens when you mix Ozempic and alcohol?

Alcohol use can adversely affect blood glucose levels, so it can be problematic in Type 2 diabetes mellitus, with or without Ozempic use. Another potential reason to limit or avoid alcohol is pancreatitis, inflammation of the pancreas which can be caused by alcohol. There have been reports of pancreatitis cases in association with GLP-1 receptor agonists, although no causal link has been identified.

Is it safe to take Ozempic during pregnancy?

There is insufficient data from clinical studies on using Ozempic during pregnancy or breastfeeding. Alternative medications for diabetes are typically recommended rather than GLP-1 agonists.

Related resources for Ozempic dosages:

• Adult dosing, Epocrates

• Drug interactions, Epocrates

• Pregnancy/lactation, Epocrates

• Pharmacology, Epocrates

• Ozempic patient education, Epocrates

• Prescribing information, Novo Nordisk