Ozempic (semaglutide) is a brand-name injectable medication that belongs to a group of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists.
Ozempic is approved by the Food and Drug Administration (FDA) to:
- Help manage blood sugar levels in adults with type 2 diabetes, along with exercise and a healthy diet
- Reduce the risk of heart and blood vessel complications, such as heart attack and stroke, in adults with type 2 diabetes and heart disease
It comes in prefilled pens that allow you to inject the medication under your skin.
The recommended starting dose of Ozempic is 0.25 milligrams (mg) once weekly. This low dose will help your body get used to the medication. After four weeks, the dose is typically increased to 0.5 mg once weekly, the maintenance dosage.
This article will review how to take Ozempic safely, including commonly recommended dosages, adjusting dosages for special circ*mstances, and what to do if you miss a dose.
:max_bytes(150000):strip_icc()/VWH-GettyImages-1807239973-944cddb21ce647c594217130457b8f00.jpg "A Guide to Your Ozempic Dosage (1)")
Recommended Ozempic Dosages
Ozempic comes as a liquid that you inject under your skin. Healthcare providers typically prescribe a low starting dose. Then, they gradually increase the dosage based on how your body responds to Ozempic.
The recommended starting dose of Ozempic is 0.25 mg injected under the skin once every four weeks. This dose is not enough to effectively manage your blood sugar levels. It's used to help your body get used to digestion-related side effects, such as nausea and stomach pain while starting Ozempic. After this time, these side effects are likely to subside.
After four weeks, your healthcare provider will increase your dosage to 0.5 mg once per week. This is the recommended maintenance dose.
How to Use Ozempic
Ozempic comes in prefilled pens to inject the medication under your skin.
Inject your Ozempic dose once per week on the same day each week, with or without food. You can use Ozempic at any time during the day.
Ozempic can be injected into the abdomen, thigh, or back of the upper arm. You can inject the medication into the same or different parts of your body. If you inject each dose of Ozempic into the same part of your body, be sure to rotate the spot where you inject.
If you also use insulin with Ozempic, you may inject both medications into the same body part. However, neither injection should be given next to the other.
You should not mix insulin and Ozempic in the same syringe. Both injections should be given separately.
Your Ozempic pen may deliver more than one strength of the medication. In this case, you may need to select your dose before injecting it.
Before your first dose, your healthcare provider will likely show you how to use your Ozempic pen. They'll go over how to select the correct dose in your pen.
If you have more questions about using your Ozempic pen, talk with your pharmacist or other healthcare provider.
How Does Ozempic Work?
Dosage Forms and Strengths
Ozempic is available as three different prefilled pens. Each strength is color-coded as follows:
- The red pen contains 0.25 mg and 0.5 mg doses
- The blue pen contains 1 mg doses
- The yellow pen contains 2 mg doses
Each red pen can deliver four 0.25 mg starting doses and two 0.5 mg maintenance doses. Your healthcare provider will likely prescribe this strength as your first pen.
The red pen can also deliver four 0.5 mg doses, so you may use this pen for your maintenance dose.
Each blue pen delivers four 1 mg doses, and the yellow pen contains four 2 mg doses. Your healthcare provider may prescribe either of these pens if your dosage needs to be increased.
The table below summarizes the dosages and strengths of each Ozempic pen.
| Total Pen Strength | Dose Per Injection | Doses Per Pen |
| 2 mg of semaglutide per 3 milliliters (mL) of liquid (2 mg/3 mL or 0.68 mg/mL) | 0.25 mg or 0.5 mg | Four 0.25 mg starting doses and two 0.5 mg maintenance doses or Four 0.5 mg doses |
| 4 mg/ 3 mL or 1.34 mg/mL | 1 mg | Four 1 mg doses |
| 8 mg/3 mL or 2.68 mg/mL | 2 mg | Four 2 mg doses |
Dosage Adjustments
Before you begin Ozempic treatment, your healthcare provider will likely discuss healthy blood sugar level goals with you.
They'll check your blood sugar levels four weeks after beginning your 0.5 mg maintenance dose. They may also recommend regularly monitoring your blood sugar level at home. You'll do this using a glucometer or a continuous glucose monitoring device.
If Ozempic is not effectively lowering your blood sugar, your healthcare provider may increase your dosage to 1 mg once per week.
If, after four more weeks, your blood sugar levels are still too high, they may further increase your dosage to 2 mg once per week,
The maximum dose of Ozempic is 2 mg per week.
Dosage Adjustments for Other Medications for Diabetes
Your healthcare provider may prescribe Ozempic with other medications to help manage your blood sugar levels, such as Glucotrol XL (glipizide) or insulin.
Ozempic helps to lower your blood sugar levels. Taking this medication with other drugs that also lower your blood sugar may increase your risk for hypoglycemia (very low blood sugar level).
If you take Ozempic with insulin or other drugs for diabetes, your healthcare provider may reduce the dosage of your insulin or other diabetes medications to lower your risk of hypoglycemia.
Comparing Wegovy vs. Ozempic
What Happens If I Take Too Much?
It's important to use Ozempic exactly as your healthcare provider recommends. Ozempic is a long-acting medication that stays in your body for over a week.
Using too much Ozempic can lead to serious side effects, such as hypoglycemia.
Symptoms of hypoglycemia can include:
- Dizziness
- Sweating
- Shaking
- Hunger
- Confusion
- Nervousness
Hypoglycemia symptoms may be mild at first. However, if it's left untreated, hypoglycemia may result in more serious complications, including coma and even death.
If you think you've used too much Ozempic, contact your healthcare provider right away. If it's an emergency, call 911.
If you have symptoms of hypoglycemia, eat or drink 15 grams of carbohydrates, which can quickly raise your blood sugar. Examples include:
- Glucose tablets
- Fruit juice
- Non-diet soda
- Sugary candy
- Honey
If your hypoglycemia symptoms are severe enough to require help from someone else to recover, have them seek emergency medical attention immediately.
Your healthcare provider may prescribe a glucagon injection pen for you to use in case of a hypoglycemia emergency. Glucagon is a hormone that helps quickly raise your blood sugar level.
Because Ozempic stays in your system for a long time, your provider may monitor you closely for signs of hypoglycemia for a few weeks after using too much Ozempic.
What Should I Do If I Miss a Dose?
It's important to use Ozempic regularly as your healthcare provider recommends.
It can take at least four weeks for Ozempic to reach steady levels in your body. Missing a dose of Ozempic may prevent the medication from working as well as it should. This may lead to an increase in your blood sugar level.
If you miss a dose of Ozempic, inject the missed dose as soon as you remember within five days of missing your dose. If it's been longer than five days since you missed your dose, skip the missed dose. Then, inject the next dose on the regularly scheduled day.
Afterward, you can continue with your regular once-per-week schedule. Do not inject two doses together to make up for a missed dose.
Summary
Ozempic is a prescription injection used along with exercise and a healthy diet to manage blood sugar levels in adults with type 2 diabetes. It is also used to reduce the risk of serious heart conditions in adults with type 2 diabetes and heart disease.
Ozempic comes in prefilled pens to inject the medication under your skin. Each pen is color-coded based on the strength of Ozempic it contains.
Dosing starts at 0.25 mg per week. This low dose is intended to help get your body used to the medication. After four weeks, the dose is typically increased to a maintenance dosage of 0.5 mg once per week.
Your healthcare provider will monitor your blood sugar levels during your Ozempic treatment. If Ozempic does not effectively lower your blood sugar, they may increase your dosage gradually every four weeks to a maximum of 2 mg once per week.
If you have questions about using your Ozempic pen, talk with your pharmacist or other healthcare provider.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Husain M, Bain SC, Holst AG, et al. Effects of semaglutide on risk of cardiovascular events across a continuum of cardiovascular risk: combined post hoc analysis of the SUSTAIN and PIONEER trials.Cardiovasc Diabetol. 2020;19(1):156. doi:10.1186/s12933-020-01106-4
Strain WD, Frenkel O, James MA, et al. Effects of semaglutide on stroke subtypes in type 2 diabetes: post hoc analysis of the randomized SUSTAIN 6 and PIONEER 6. Stroke. 2022;53:2749–2757. doi.org/10.1161/STROKEAHA.121.037775
Food and Drug Administration. Ozempic (semaglutide) prescribing information.
Centers for Disease Control and prevention. Manage blood sugar.
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Hall S, Isaacs D, Clements JN. Pharmaco*kinetics and clinical implications of semaglutide: a new glucagon-like peptide (GLP)-1 receptor agonist.Clin Pharmaco*kinet 2018;57:1529-1538. doi:10.1007/s40262-018-0668-z
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Center for Disease Control and Prevention. How to treat hypoglycemia.
:max_bytes(150000):strip_icc()/RSNewProfile-47db4971b465487fb48eef6716d79b12.jpg "A Guide to Your Ozempic Dosage (2)")
By Rosanna Sutherby, PharmD
Rosanna Sutherby, PharmD, is a freelance medical writer and community pharmacist with over 20 years of experience in medication review, counseling, and immunization.
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