Frequently asked questions about Ozempic® (semaglutide) injection
About Ozempic®
Ozempic® (pronounced Oh-ZEM-pick) is a once-weekly injection indicated
- For adults with type 2 diabetes, along with diet and exercise to improve glycemic control
- For adults with T2D and established CVD, to reduce risk of MACE (CV death, nonfatal MI, or nonfatal stroke)
- For adults with T2D and CKD, to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death1
CKD=chronic kidney disease; CV=cardiovascular; CVD=cardiovascular disease; eGFR=estimated glomerular filtration rate; MACE=major adverse cardiovascular event; MI=myocardial infarction; T2D=type 2 diabetes.
Ozempic® lowers fasting and postprandial blood glucose by stimulating insulin secretion in a glucose-dependent manner.1
Ozempic® causes a minor delay in gastric emptying, thereby reducing the rate at which glucose appears in circulation postprandially.1
Ozempic® is not indicated for weight loss.
While the primary endpoint in the majority of Ozempic® clinical trials was mean change in A1C, mean change in body weight was generally evaluated as a confirmatory secondary endpoint. Review A1C and weight results from the Ozempic® studies for additional information and see the Prescribing Information.
Basal insulin can be used along with once-weekly Ozempic® and titrated as needed.1 Review the A1C reductions of Ozempic® in combination with basal insulin.
Patients receiving Ozempic® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia.
The most common adverse reactions, reported in ≥5% of patients treated with Ozempic® are nausea, vomiting, diarrhea, abdominal pain, and constipation.1
See how to prescribe a 1-month or 3-month supply of Ozempic® in your EHR system here.
Taking Ozempic®
Ozempic® is available in the following doses:
- A 0.25 mg starting dose and a maintenance dose of 0.5 mg, both available in a red-label pen1
- A maintenance dose of 1 mg available in a blue-label pen
- A maximum maintenance dose of 2 mg available in a yellow-label pen
- For patients with T2D and CKD, initiate Ozempic® with a dosage of 0.25 mg once weekly for 4 weeks. After 4 weeks on the 0.25 mg, increase the dosage to 0.5 mg once weekly. Increase to the maintenance dosage, 1 mg once weekly, after at least 4 weeks on the 0.5 mg dosage.
The 0.25 mg dose is intended for treatment initiation and is not effective for glycemic control.
CKD=chronic kidney disease; T2D=type 2 diabetes.
Instructions for using the pen can be found here.
Ozempic® should be administered by a patient once weekly on the same day each week, at any time of the day, with or without meals.
The day of weekly administration can be changed if necessary as long as the time between 2 doses is at least 2 days (>48 hours).
If a patient misses a dose, they should administer Ozempic® as soon as possible within 5 days after the missed dose. If more than 5 days have passed, the patient should skip the missed dose, and administer the next dose on the regularly scheduled day. In each case, patients can then resume their regular once-weekly dosing schedule.
Administer Ozempic® once weekly on the same day each week, at any time of the day, with or without meals.
The Ozempic® injection is supplied as a clear, colorless solution in a prefilled, disposable, single-patient-use pen in the following packaging configurations1:
Red-label pen:
- Contains 2 mg of semaglutide in a 3 mL (0.68 mg/mL) pen
- Delivers doses of 0.25 mg or 0.5 mg per injection
- Includes 6 NovoFine® Plus needles
- NDC: 0169-4181-13
Blue-label pen:
- Contains 4 mg of semaglutide in a 3 mL (1.34 mg/mL) pen
- Delivers doses of 1 mg per injection
- Includes 4 NovoFine® Plus needles
- NDC: 0169-4130-13
Yellow-label pen:
- Contains 8 mg of semaglutide in a 3 mL (2.68 mg/mL) pen
- Delivers doses of 2 mg per injection
- Includes 4 NovoFine® Plus needles
- NDC: 0169-4772-12
Prior to first use (until expiration date): Ozempic® should be refrigerated at 36°F to 46°F (2°C to 8°C).
After first use (up to 56 days): Ozempic® should be stored at room temperature 59°F to 86°F (15°C to 30°C) or refrigerated at 36°F to 46°F (2°C to 8°C).
Do not store in the freezer or directly adjacent to the refrigerator cooling element. Do not freeze Ozempic® and do not use Ozempic® if it has been frozen.
Keep the pen cap on when not in use. Ozempic® should be protected from excessive heat and sunlight.
Ozempic® patient support
Eligible patients pay as little as $25 for a 1‑month, 2‑month, or 3‑month prescription.a
Patients can get the Ozempic® Savings Card by texting BEGIN to 21848 or registering on OzempicSavings.com.b
The Ozempic® 2-month and 3-month savings offers are intended to help patients minimize gaps in therapy.
aApplies to eligible commercially insured patients with coverage for Ozempic®. Maximum savings of $100 for a 1-month supply, $200 for a 2-month supply, and $300 for a 3-month supply. Month is defined as 28 days. Offer is good for up to 48 months. Eligibility and restrictions apply.
bMessage and data rates may apply. Check with your mobile service provider. See Terms and Conditions of Use at Ozempic.com/terms.
Patients can connect with a Diabetes Health Coach who can help answer questions about their prescription, diet, and exercise. They can call 1‑866‑696‑4090, Monday through Friday, 9:00 am to 6:00 pm ET or visit OzempicSupport.com to get started. The Diabetes Health Coach is available by phone, text, or email on a schedule that’s convenient for your patients.
Patients can also watch My Type 2 Transformation, a video series where a team of experts helps two adults learn how to manage their type 2 diabetes.
Yes! Patients can download a digital patient starter kit at OzempicQuickResources.com. The kit includes information on:
- Taking and storing Ozempic®
- Using the Ozempic® Pen
- Side effects
- Savings and support programs
More ways to help your patients with T2D
Check your patients' coverage and view savings offer
See details »
Ozempic® is available in 3 pens for more A1C control
Find out more »
Important Safety Information for Ozempic® (semaglutide) injection
WARNING: RISK OF THYROID C-CELL TUMORS
- In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Ozempic® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined
- Ozempic® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Ozempic® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Ozempic®
Indications and Usage
Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg is indicated:
- as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes
- to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes and established CV disease
- to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease
Important Safety Information cont.
Contraindications
- Ozempic® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic®
Warnings and Precautions
- Risk of Thyroid C-Cell Tumors: Patients should be further evaluated if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging
- Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists, including semaglutide. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic® and initiate appropriate management
- Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy - Never Share an Ozempic® Pen Between Patients: Ozempic® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens
- Hypoglycemia: Patients receiving Ozempic® in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia
- Acute Kidney Injury Due to Volume Depletion: There have been postmarketing reports of acute kidney injury, in some cases requiring hemodialysis, in patients treated with semaglutide. The majority of reported events occurred in patients who experienced gastrointestinal reactions leading to dehydration such as nausea, vomiting, or diarrhea. Monitor renal function in patients reporting adverse reactions to Ozempic® that could lead to volume depletion, especially during dosage initiation and escalation
- Severe Gastrointestinal Adverse Reactions: Use of Ozempic® has been associated with gastrointestinal adverse reactions, sometimes severe. In Ozempic® clinical trials, severe gastrointestinal adverse reactions were reported more frequently among patients receiving Ozempic® (0.5 mg 0.4%, 1 mg 0.8%) than placebo (0%). Ozempic® is not recommended in patients with severe gastroparesis
- Hypersensitivity: Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported in patients treated with Ozempic®. If hypersensitivity reactions occur, discontinue use of Ozempic®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist
- Acute Gallbladder Disease: Acute events of gallbladder disease such as cholelithiasis or cholecystitis have been reported in GLP-1 receptor agonist trials and postmarketing. In placebo-controlled trials, cholelithiasis was reported in 1.5% and 0.4% of patients treated with Ozempic® 0.5 mg and 1 mg, respectively, and not reported in placebo-treated patients. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated
- Pulmonary Aspiration During General Anesthesia or Deep Sedation: Ozempic® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Ozempic®
Adverse Reactions
- The most common adverse reactions, reported in ≥5% of patients treated with Ozempic® are nausea, vomiting, diarrhea, abdominal pain, and constipation
Drug Interactions
- When initiating Ozempic®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia
- Ozempic® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised
Use in Specific Populations
- There are limited data with semaglutide use in pregnant women to inform a drug-associated risk for adverse developmental outcomes. Discontinue Ozempic® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide
Please click here for Ozempic® Prescribing Information, including Boxed Warning.
References:
- Ozempic® [package insert]. Plainsboro, NJ: Novo Nordisk Inc.
- Pratley RE, Aroda VR, Lingvay I, et al, on behalf of the SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018;6(4):275-286.