Ozempic® is used to help control blood sugar in patients with Type 2 diabetes. Learn how to use the medication, its common side effects, special precautions to watch out for, and more.

What is this medication for?

Ozempic^® is used to help control blood sugar in patients with Type 2 diabetes.  Ozempic® reduces food cravings and increases the insulin produced during meals. Ozempic^® also helps to lower the chances of a heart attack, stroke, and death in patients with type 2 diabetes with known heart disease.

This medication does not replace insulin.

How should I take or use this medication?

• Ozempic® is given once a week through injection under the skin. Inject the dose as advised by your doctor.
• The usual starting dose is 0.25 mg once a week for four weeks.
• After four weeks, your doctor will usually increase the dose to 0.5 mg once a week if you can tolerate the medication. 
• After at least four weeks with a dose of 0.5 mg once weekly, your doctor may increase your dose further to 1 mg once a week if your blood sugar is not well-controlled.
• You should use Ozempic® on the same day each week if possible.
• If necessary, you can change the day of your weekly injection of Ozempic®, as long as it has been at least 2 days since your last Ozempic® injection. After selecting a new dosing day, the once-weekly dosing should be continued.
• Do not stop using your medication without checking with your healthcare professional.
• You may use this medication with or without food.

How to select an injection site:

Ozempic® should be injected into the fatty tissue that is between the skin and muscle layer. You can choose to inject to your upper arms, thigh or abdomen. 

You should rotate the injection site every week to prevent your body from forming lipodystrophy (a small lump or dent in the skin that forms when a person repeatedly injects in the same spot).

How to inject Semaglutide:

Read the instruction leaflet or approach your healthcare professional for more details.

Step 1: Prepare your pen with a new needle

1. Before injecting Ozempic®, check the injection pen. 
   1. The solution in the pen should be clear and colorless.
2. Attach a new needle to the Ozempic^® pen.
3. Pull off the outer needle cap and keep it for later.
4. Pull off the inner needle cap and throw it away.

Step 2: First time use for each NEW pen: check the flow

Before your first injection with each new pen, you will need to check the flow of the pen.

You do not need to check the flow of the pen that is already in use.

1. Turn the dose selector to the flow check symbol right past ‘0’. Make sure the flow check symbol lines up with the pointer. 
2. Hold the pen with the needle pointing up. 
3. Press and hold in the dose button until the dose counter returns to ‘0’.
4. A drop of solution should appear at the needle tip.
5. If no drop appears, repeat these steps up to 6 times. If there is still no drop, change the needle and repeat these steps once more. Discard the pen and use a new one if a drop of solution still does not appear.

Step 3: Select your dose

1. Turn the dose selector to your prescribed dose.

Step 4: Inject the dose

1. Wash your hands before and after you use this medication. 
2. Clean the skin before injecting.
3. Lift a skin fold. Insert the needle at 90 degrees, at a right angle to the skin.
4. Make sure that you can see the dose counter. Do not cover it with your fingers.
5. Press and hold down the dose button so the dose counter returns to '0'. 
6. Continue pressing the dose button while keeping the needle in your skin. 
7. Count slowly to 6

Step 5: After the injection

1. Remove the needle from your skin while keeping the dose button pressed. This is to ensure that you get the full dose. 
2. Do not rub or massage the injection site. 
3. Throw the injection needle after each injection. Do not re-use the needles.

What should I do if I forget to take or use this medication?

If you forget to inject Ozempic®, it should be administered as soon as you remember within 5 days after the missed dose. Then inject your next dose as usual on your scheduled day.

If more than 5 days have passed, the missed dose should be skipped, and the next dose should be administered on the regularly scheduled day. 

Do not take two doses to make up for the missed dose. 

What precautions should I take when taking or using this medication?

Inform your healthcare professional if you:

• Are allergic to this medication or any of the other ingredients of this medication
• Have type 1 diabetes mellitus
• On certain diabetes medication such as insulin or sulfonylurea (e.g. glipizide, gliclazide, tolbutamide etc)
• Have history of inflammation to your pancreas
• Have heart, kidney or liver problems
• Have stomach or bowel problems
• Have thyroid cancer or family history of thyroid cancer
• Have history of depression
• Are pregnant, planning to get pregnant or breastfeeding
• You are taking any other medications, including supplements, traditional medications and herbal remedies.

What are some common side effects of this medication?

• Nausea, vomiting, bloating, stomach discomfort
  • Avoid food that is too oily, spicy
  • Eat small portion of food at a time
  • Keep yourself hydrated 
• Diarrhea
  • Keep yourself hydrated
• Bruising or pain at injection site 
  • Rotate injection site for every week 
  • Do not reuse your needles 
• Feeling tired
• Headache
• Runny nose
• Nose or throat irritation
• Symptoms of low sugar including giddiness, cold sweat, hunger, fast heartbeat, trembling, blurred vision, drowsy or confused
  • If you experience any of these low blood sugar symptoms, do the following immediately: 

Step 1: Check your blood sugar with a blood sugar meter (glucometer) if available. 
If your blood sugar level is less than 4 mmol/L, take 15 grams of fast-acting sugar. Examples of 15 grams of fast-acting sugar include:

• 3 glucose tablets or 
• Half a glass of fruit juice (200ml) or 
• Half a can of soft drink or sweetened drink (175ml) or
• 1 can of less sugar soft drink (330ml) or
• 3 teaspoons of sugar, honey or syrup 

Step 2: Monitor yourself for 15 minutes. If you have a glucometer (blood sugar meter), check your blood sugar level again after 15 minutes.

Step 3: If your blood sugar level is still less than 4 mmol/L or you still have symptoms of low blood sugar, you should take another 15 grams of fast-acting sugar as per Step 1. 

If your symptoms do not go away, see a doctor or go to the hospital immediately.

Step 4: If your sugar is 4 mmol/L and above after consuming the fast-acting sugar earlier on, take a slow-acting sugar. Examples include

• Your next meal or
• 1 slice of bread or
• 3 pieces of plain crackers or
• 1 cup of low-fat milk (250ml).

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Very rarely Ozempic® can cause inflammation of the pancreas or gall bladder. This can cause symptoms such as severe pain in the stomach, nausea, vomiting, pale- coloured stools, yellowing of the skin or eye white and fever.

Very rarely Ozempic® may worsen a diabetes-related eye condition (diabetic retinopathy), especially if there is a large and fast improvement in blood sugar. This may cause changes in your eyesight.

There are rare reports of thyroid cancer in animal studies.  Your doctor will usually screen for any history or family history of thyroid cancer before starting on this medication. Symptoms of thyroid cancer can include unusual lumps or swelling in the neck, hoarseness of the voice or difficulty in swallowing.

There are also rare reports of increased suicidal thoughts and self-harm with use of Ozempic®.

 If you experience any of the above symptoms, you should stop your medication and seek medical attention immediately.

What food or medication should I avoid when I take or use this medication?

Avoid eating food that is too oily or spicy as this may increase the chances of getting stomach upset.

How should I store this medication?

Store unused Ozempic® in the refrigerator between 2-8°C. Do not freeze. 

Keep the pen cap on when the pen is not in use to protect it from light. 

After opening, store below 30 °C or in a refrigerator between 2-8°C. Discard 6 weeks after opening.

Keep this medication away from children.

How do I throw away this medication safely?

You may throw this injection away along with the used needles into a metal tin or thick plastic container (eg. detergent bottles). You can also buy a container specially designed to throw sharp items, known as a sharps box, to prevent any injuries due to the needles.  

Disclaimer

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Oct 2024