Ozempic (Semaglutide)

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Ozempic (Semaglutide)

What is Ozempic (Semaglutide)?

Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) medication that is primarily used to treat type 2 diabetes by boosting a patient’s natural insulin production and balancing blood glucose levels.

How is Ozempic Used?

Ozempic is a liquid medication that comes in prefilled doses in a disposable autoinjector pen to be injected under a patient’s skin.

Patients will give themselves the injections according to the dosing schedule provided by their prescribing physician. Ozempic injections are done in the skin on the patient’s abdomen, upper arm, or thigh. The injection site should be rotated each time the medication is administered, and patients should be sure to install a new needle for every use to avoid infection or other health concerns.

Storage

New and unused Ozempic autoinjector pens should be stored in the refrigerator at a temperature in the range of 36°F to 45°F. Once the pen has been opened and used, it should be stored either in the refrigerator in the temperature range of 36°F to 46°F or in a room temperature setting ranging between 59°F to 86°F.

Keep this medication out of the reach of children at all times.

After opening, prefilled Ozempic pens will expire in 56 days. Patients are requested to mark this date in a place they will remember to ensure that they properly dispose of their expired Ozempic pens at the correct time.

Do not share your Ozempic pen with another person.

Do not use your Ozempic pen if the medication contained within the pen appears cloudy or discolored.

Uses

Ozempic is prescribed for adult individuals diagnosed with type 2 diabetes to help manage their blood glucose levels.

Additionally, Ozempic may also be prescribed for patients with certain health risks, such as those with diabetes or heart disease, as this medication may lower a patient’s chances of having a stroke or experiencing a heart attack.

How Does Ozempic Work?

Ozempic works alongside patients making changes to their lifestyles, diets, and exercise habits by causing an increase in insulin production. This medication also reduces the rate at which the stomach empties, allowing for nutrients to be released more slowly and thereby preventing spikes in blood sugar after consuming a meal. Additionally, this GLP-1 RA medication inhibits the liver from releasing an excessive amount of sugar into the bloodstream, further preventing difficulties with managing one’s blood glucose levels.

Dosage

Although a doctor will determine the correct dosage of Ozempic for your particular health situation, this medication is available in the following strengths:

  • 2 mg/1.5 mL (0.25 mg or 0.5 mg dose per injection)
  • 4 mg/3 mL (1 mg dose per injection)
  • 8 mg/3 mL (2 mg dose per injection)

Each autoinjector pen contains multiple doses of Ozempic, and your doctor should advise you on proper use as well as when you should dispose of the pen and begin using a new pen.

This medication is typically injected once per week. Patients should strive to inject this medication at the same time on the same day of each week.

Often, doctors prescribe Ozempic at a lower dose for the first four weeks of use before determining if an increase of the dosage for treatment is advisable. For most patients, the dosage is increased after the first month. This increase is determined by the patient’s usual blood sugar levels as well as any additional health concerns or conditions that may apply.

Overdose

Overdosing on Ozempic typically results in symptoms such as low blood sugar, nausea, and vomiting. If you suspect that you have overdosed on this medication, call your doctor or local Poison Control Center. Seek out emergency medical help if you are experiencing any symptoms that are severe.

Due to Ozempic’s ability to lower a patient’s blood glucose levels as well as remain in a person’s system for about a week, individuals who have managed to overdose or administer too much of the medication too soon after a previous dose may struggle with hypoglycemia while the medicine remains active for nearly seven days.

Side Effects

Taking Ozempic may result in side effects for some individuals.

The most common side effects of taking Ozempic are as follows:

  • abdominal pain
  • constipation
  • diarrhea
  • nausea
  • vomiting

Some of the following side effects may occur and require immediate medical attention if a patient experiences one or more of these while taking Ozempic:

  • anxiety
  • a lump in the neck
  • blurred vision
  • breathing difficulties
  • chills
  • clammy skin
  • confusion
  • coughing
  • decreased urination
  • empty or dark visual areas
  • fatigue
  • “floaters” (strings or spots present in one’s visual field)
  • hunger
  • impatience
  • irritability
  • itching
  • lightheadedness
  • nausea
  • nervousness
  • rapid heart rate
  • rash
  • shaking
  • shock
  • sweating
  • swelling in the feet, ankles, or legs
  • trouble swallowing
  • upper abdominal pain
  • vision changes that fluctuate
  • vision loss
  • vomiting

Please contact your doctor for further information if you experience any side effects and have any concerns.

Warnings & Precautions

Ozempic is not a medication that should be used by any individuals who have had pancreatitis nor is it suitable for use in type 1 diabetes or for diabetic ketoacidosis.

Children

It has not been determined if this medication is effective or safe for use in children under the age of 18 years old.

Medication Absorption

Due to the nature of Ozempic’s function in slowing digestion in patients taking the medication, Ozempic may possibly affect the absorption of other medications a patient may be taking since many medications are digested and absorbed through the stomach. Before beginning Ozempic, be sure to tell your doctor about any current supplements or medications you may be taking that may be impacted by this.

Alcohol Use

Alcohol may affect a patient’s blood glucose levels, meaning alcohol consumption runs the risk of negatively interacting with Ozempic when the two are consumed together. It is recommended that patients taking Ozempic only consume alcohol in moderation and avoid doing so after exercising as well as on an empty stomach as both of these factors can contribute to the individual experiencing hypoglycemia (low blood glucose levels).

Pregnancy

Patients who are pregnant or may become pregnant should discuss the use of this medication with their doctor. Ozempic is not safe to use during pregnancy due to the harm that may be caused to a patient’s unborn child. Additionally, it is recommended that its use be discontinued at least two months before a patient plans on becoming pregnant. For individuals who take Ozempic and may become pregnant, it is strongly recommended to use appropriate protection to prevent pregnancy while taking this medication. In animal studies, Ozempic was shown to cause structural abnormalities as well as early pregnancy losses regardless of dosage.

Breastfeeding

Although there is very little likelihood that taking Ozempic while breastfeeding could impact the health of an infant or be absorbed whatsoever, it is still recommended to proceed with caution, especially if a mother is taking Ozempic and feeding a preterm infant or newborn.

Diabetic Retinopathy

Patients with diabetic retinopathy should be cautious when using Ozempic as rapidly improved control of one’s blood glucose levels has been linked to a transient worsening of retinopathy associated with diabetes. Individuals with this condition should notify their doctor before taking Ozempic that they have diabetic retinopathy, and these individuals should be monitored closely for any worsening of the condition.

Additional Medical Conditions

If you have any of the following medical conditions, exercise caution when taking Ozempic, and discuss your medical history with your doctor before beginning this medication:

  • pancreatitis
  • hypoglycemia
  • thyroid cancer
  • renal impairment
  • suicidal ideation or behavior

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with Ozempic. Discuss any concerns you may have with your doctor or a trusted pharmacist.

Drugs That Should Not Be Used with Ozempic

The following medications should never be used alongside Ozempic:

  • bexarotene
  • gatifloxacin

Using bexarotene when taking Ozempic may result in an increased risk of inflammation of the pancreas (pancreatitis). The use of gatifloxacin may impact a patient’s blood glucose levels which will be further affected by the use of Ozempic. If you take either of these medications, consult with your doctor before beginning treatment with Ozempic.

Other Drugs That May Interact with Ozempic

The following medications and herbal supplements are also indicated to cause interactions when used alongside Ozempic:

  • acetazolamide
  • acetohexamide
  • albuterol
  • alclometasone topical
  • aloe vera
  • alpelisib
  • amcinonide topical
  • amprenavir
  • aripiprazole
  • asenapine
  • asparaginase erwinia chrysanthemi
  • asparaginase Escherichia coli
  • atazanavir
  • bendroflumethiazide
  • benzphetamine
  • betamethasone
  • betamethasone (topical)
  • bortezomib
  • brentuximab
  • brexpiprazole
  • brigatinib
  • bumetadine
  • calaspargase pegol
  • cariprazine
  • ceritinib
  • chlorothiazide
  • chlorotrianisene
  • chlorpromazine
  • chlorpropamide
  • chlorthalidone
  • chromic chloride hexahydrate
  • chromium picolinate
  • clobetasol topical
  • clocortolone topical
  • conixacin
  • ciprofloxacin
  • clarithromycin
  • clozapine
  • conjugated estrogens
  • conjugated estrogens (topical)
  • copanlisib
  • corticorelin
  • corticotropin
  • cortisone
  • cosyntropin
  • daclatasvir
  • danazol
  • darunavir
  • deflazacort
  • delafloxacin
  • desonide (topical)
  • desoximetasone (topical)
  • dexamethasone (topical)
  • dexamethasone
  • dexamethasone (ophthalmic)
  • dexfenfluramine
  • diazoxide
  • dichlorphenamide
  • dienestrol topical
  • diethylproprion
  • diethylstilbestrol
  • diflorasone (topical)
  • dobutamine
  • dopamine
  • drospirenone
  • enfortumab vedotin
  • enoxacin
  • ephedrine
  • epinephrine
  • esterifiedid estrogens
  • estradiol
  • estradiol (topical)
  • estramustine
  • estrone
  • estropipate
  • estropipate (topical)
  • ethacrynic acid
  • ethanol
  • ethinyl estradiol
  • etonogestrel
  • everolimus
  • fenfluramine
  • fludrocortisone
  • fluocinolone (topical)
  • fluocinonide (topical)
  • flurandrenolide (topical)
  • fluticasone (topical)
  • fluphenazine
  • formoterol
  • fosamprenavir
  • fosphenytoin
  • furosemide
  • gemifloxacin
  • ginseng
  • glimepiride
  • glipizide
  • glyburide
  • goserelin
  • grepafloxacin
  • halcinonide (topical)
  • halobetasol (topical)
  • histrelin
  • hydrochlorothiazide
  • hydrocortisone
  • hydrocortisone (topical)
  • hydroflumethiazide
  • hydroxyprogesterone
  • iloperidone
  • indacaterol
  • indapamide
  • indinavir
  • insulin
  • insulin aspart
  • insulin aspart protamine
  • insulin degludec
  • insulin detemir
  • insulin glargine
  • insulin glulisine
  • insulin inhalation, rapid acting
  • insulin isophane
  • insulin lispro
  • insulin lispro protamine
  • insulin regular
  • insulin zinc
  • insulin zinc (extended)
  • isoniazid
  • isoproterenol
  • lanreotide
  • leuprolide
  • levofloxacin
  • levonorgestrel
  • levothyroxine
  • liothyronine
  • liotrix
  • lithium
  • lomefloxacin
  • lonapegsomatropin
  • lorcaserin
  • lumateperone
  • lurasidone
  • ma huang
  • mazindol
  • medroxyprogesterone
  • megestrol
  • mephentermine
  • mesoridazine
  • metaproterenol
  • metaraminol
  • methamphetamine
  • methazolamide
  • methdilazine
  • methotrimeprazine
  • methoxamine
  • methyclothiazaide
  • methylprednisolone
  • methylprednisolone (topical)
  • metolazone
  • midostaurin
  • mometasone (topical)
  • moxifloxacin
  • nalidixic acid
  • nateglinide
  • nelfinavir
  • niacin
  • niacinamide
  • norepinephrine
  • norethindrone
  • norfloxacin
  • norgestrel
  • octeotide
  • ofloxacin
  • olanzapine
  • olodaterol
  • omacetaxine
  • orlistat
  • paliperidone
  • pasireotide
  • pegaspargase
  • pegvisomant
  • pentamidine
  • perphenazine
  • phendimetrazine
  • phentermine
  • phenylephrine
  • phenylpropanolamine
  • phenytoin
  • polythiazide
  • prednicarbate (topical)
  • prednisolone
  • prednisone
  • prochlorperazine
  • progesterone
  • progesterone (topical)
  • promazine
  • promethazine
  • propiomazine
  • pseudoephedrine
  • quetiapine
  • quinestrol
  • repaglinide
  • risperidone
  • ritodrine
  • ritonavir
  • salmeterol
  • saquinavir
  • sermorelin
  • sibutramine
  • simeprevir
  • sirolimus
  • sirolimus protein-bound
  • sofosbuvir
  • somapacitan-beco
  • somatrem
  • somatropin
  • sparfloxacin
  • sucralfate
  • tacrolimus
  • tagraxofusp
  • temsirolimus
  • teprotumumab
  • terbutaline
  • tesamorelin
  • thiethylperazine
  • thioridazine
  • thyroid desiccated
  • thyrotropin alpha
  • tipranavir
  • tolazamide
  • tolbutamide
  • torsemide
  • triamcinolone
  • triamcinolone (topical)
  • triamcinolone (ophthalmic)
  • trichlormethiazide
  • trifluoperazine
  • triflupromazine
  • trimeprazine
  • triptorelin
  • trovafloxacin
  • turmeric
  • vorinostat
  • ziprasidone

Alternative Medications

For patients who are unable to take Ozempic or experience significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed.

GLP-1 Agonists (glucagon-like peptide-1 receptor agonists):

  • Adlyxin (lixisenatide)
  • Bydureon, Byetta (exenatide)
  • Trulicity (dulaglutide)
  • Victoza (liraglutide)

SGLT2 Inhibitors (sodium-glucose co-transporter 2 inhibitors):

  • Farxiga (dapagliflozin)
  • Invokana (canagliflozin)
  • Jardiance (empagliflozin)
  • Steglatro (ertugliflozin)

DPP-4 Inhibitors (dipeptidyl peptidase-4 inhibitors):

  • Januvia (sitagliptin)
  • Nesina (alogliptin)
  • Onglyza (saxagliptin)
  • Tradjenta (linagliptin)

Alpha-Glucosidase Inhibitors:

  • Glyset (miglitol)
  • Precose (acarbose)

Biguanide medication:

  • Metformin (otherwise listed as Glucophage, Riomet, and Glumetza)

Sulfonylureas:

  • Amaryl (glimepiride)
  • chlorpropamide
  • Diabeta, Glynase Prestabs (glyburide)
  • Glucotrol (glipizide)

Thiazolidinedione medications:

  • Actos (pioglitazone)
  • Avandia (rosiglitazone)

FREQUENTLY ASKED QUESTIONS

Some patients may require long-term use of this medication if recommended by their doctor. Discuss any concerns about long-term use or potential side effects associated with prolonged use of this medication with your physician.

If you are within five days of your previous dose and miss a dose of this medication, you are safe to take the missed dose as soon as you remember. If more than five days have passed since your last dose, you should simply skip the missed dose and wait to take your medication until the next scheduled time. If you have skipped a dose or otherwise needed to postpone taking Ozempic, be sure to regularly check your blood glucose levels to ensure that you keep within the safe range on those readings. If your blood glucose levels become irregular or problematic, contact your doctor.

Ozempic begins working soon after being injected. Patients taking Ozempic may require several weeks before fully adjusting to the medication and receiving the full health benefits of its use. Discuss any concerns with your doctor, and your dose may be adjusted as needed.

If patients taking Ozempic stop taking the medication abruptly, their blood glucose levels may increase. The severity of hyperglycemia will depend upon the individual’s diet, lifestyle, overall health, and reaction to the medication. Patients should never stop taking Ozempic without first talking to their doctor.

When first taking Ozempic, some patients struggle with nausea and stomach upset caused by the medication working and slowing down the emptying process of the stomach (which assists in regulating blood glucose levels). However, this typically passes, and patients adjust within a few weeks after beginning the medication. It is recommended that patients struggling with digestive discomfort when first beginning to take Ozempic, eat multiple smaller meals throughout the day to decrease the burden of digestion until their stomach adjusts to the new changes.

Determine the type of injection you plan to use, and insert the needle carefully into your skin. You will then need to press down on the dose button for the injection to begin. Keep holding the button down until the pointer and “0 mg” are aligned together. While holding the button down, count to 7 to be entirely sure that the medication has had enough time to be properly injected and you’ve received your full dose.

The time of day for taking Ozempic is irrelevant. It should simply just be done on the same day of each week. Ozempic is also unaffected by food consumption, so patients can inject the medication regardless of whether they’ve eaten or not.

Although the elimination half-life of the medication is about the span of a week, it could take nearly five weeks after stopping Ozempic for it to fully be cleared from your system.

Ozempic may be injected under the skin on your upper arm, your thigh, or your stomach. Patients taking Ozempic should not inject in the same area for each dose and should rotate between the three recommended injection sites to have good absorption. This medication should be injected only under the skin (subcutaneously) and should not be injected into a vein or muscle.

No. Ozempic is not a form of insulin. It is also not suitable as a substitute for insulin since it relies on the patient’s preexisting insulin production to function as intended. This is why Ozempic cannot be used in patients who have type 1 diabetes and do not produce insulin and can also not be used in individuals with pancreatitis. (The pancreas is the organ that produces insulin in the body.)

Side effects typically occur during the first few weeks of taking Ozempic and are usually not very problematic. After this adjustment period, most patients report a decrease or complete cessation of the initial side effects they experienced when beginning the medication. If you are experiencing serious side effects or ones that last longer than the first few weeks of use of this medication, speak to your doctor.

Most individuals taking Ozempic notice weight loss after beginning this medication due to the balance of their insulin levels. In very few cases, some patients taking this medication experienced mild weight gain.

This is a common side effect of taking Ozempic and should be discussed with your doctor. Patients with pre-existing heart conditions should discuss this part of their health history with their physician before beginning treatment with Ozempic.

Some patients taking Ozempic experience more significant side effects of digestive distress when first beginning this medication due to the slowing of the emptying of one’s stomach. This typically passes after the first few weeks of use. Speak with your doctor if problematic digestive symptoms persist and do not improve.

Generally, patients will have their prescribed dosage increased over time until they reach a suitable maintenance dose. However, this will depend upon the results of the medication in the patient as well as their overall health, their tolerance for any side effects that may be caused by Ozempic, and how well their blood glucose levels have been managed during treatment.

Ozempic has not been approved for weight loss, but it is currently being used for some individuals off-label to assist in reducing a patient’s weight. It is particularly effective in those who actually do have type 2 diabetes and need assistance in managing their insulin production. Increased levels of insulin contribute to weight gain in many individuals, so reducing those levels will naturally allow a person to begin losing weight when this occurs alongside an improved diet and regular exercise.

No. Ozempic may only be prescribed by a licensed physician.