Ozempic: Indications, Use & Side Effects

Ozempic is a medication that contains semaglutide, and is FDA-approved for use in diabetics to manage blood sugar levels and/or reduce the risk for cardiovascular disease. It is used in place of metformin or in combination with other medications to lower blood sugar.

Ozempic acts to lower blood sugar levels by stimulating insulin secretion and inhibiting the release of glucagon.

Ozempic is an injectable medication that requires a prescription from a licensed medical professional. It is sold in pharmacies and drugstores in the form of an injector pen. 

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Typical uses

Ozempic is indicated for the treatment of type 2 diabetes that is not controlled by diet and exercise alone. Benefits of Ozempic may include:

  • Improved blood sugar control;
  • Lowered risk of cardiovascular disease, like heart attack and stroke.

Ozempic is usually indicated for use in patients that cannot tolerate or have contraindications to the use of metformin, or in combination with other diabetes medications.

Ozempic should be used under a doctor's supervision and in combination with a healthy diet and regular exercise. 

Mechanism of action

Ozempic is the brand name for semaglutide, a peptide substance that lowers blood sugar levels in people with type 2 diabetes. It is also sold under the brand names Rybelsus and Wegovy. Semaglutide promotes the secretion (production and release) of insulin and inhibits (prevents) the release of glucagon when blood sugar is high.

Weight loss

While Ozempic is not indicated for weight loss, some people with diabetes who are treated with Ozempic can experience weight loss as a side effect of this medication.

Ozempic slows down digestion, causing decreased appetite and suppressing cravings for fatty foods. These effects can reduce caloric intake (the number of calories being consumed), leading to weight loss.

However, Ozempic should NOT be used for weight loss, as it has not yet been authorized by the FDA for this purpose. 

Wegovy is the only brand of semaglutide approved by the FDA for weight loss.

How to use

Ozempic is a subcutaneous injection (given under the skin) administered once weekly to the belly, thigh, or upper arm. 

The recommended dose for adults is:

Week of treatment Dose and dosing instructions
Month 1 (weeks 1 to 4) 0.25 mg of Ozempic given once a week in a single dose.
Month 2 (weeks 5 to 8) 0.5 mg of Ozempic given once a week in a single dose.
Month 3 (week 9 and beyond) 1 mg of Ozempic given once a week in a single dose if necessary for additional glycemic control.

Ozempic injections should be given on the same day each week, at any time of day, with or without a meal. 

Dosing changes should only be made in consultation with a doctor and involve evaluation of an individual's response to treatment, including blood glucose levels and the presences of any side effects.

Missed doses

In the case of a missed dose, it is recommended to administer the missed dose as soon as you remember, up to five days following the missed dose. 

If it has been greater than five days since the missed dose it is recommended to skip that dose and continue with the next weekly dose as scheduled. 

How to administer

Correctly administering Ozempic requires the following steps:

  1. Remove the cap from the injector pen;
  2. Attach a new needle by screwing it firmly onto the top of the injector pen;
  3. Remove both the outer and inner needle caps;
  4. Turn the top of the pen to select the correct dose (as prescribed by your doctor);
  5. Insert the needle under the skin of your thigh, belly, or upper arm at a 90º angle;
  6. Press down on the button until the dose counter reaches 0;
  7. With the button still held down, slowly count to six;
  8. Remove the needle from your skin and release the button;
  9. Replace the outer needle cap and remove the needle;
  10. Put the cap back on the injector pen.

After administering Ozempic, the used needle should be discarded in a sharps container and brought to a pharmacy or other supervised collection site for disposal. Speak to your pharmacist about where you can safely dispose of your used needles.

Care instructions

It is important to follow instructions for correct storage of Ozempic in order to maintain the effectiveness of the medication. 

Prior to first use, Ozempic pens should be stored in the refrigerator, at temperatures between 36º to 46ºF (2º a 8ºC). Avoid storing them on the refrigerator door, as frequent opening and closing of the refrigerator can cause fluctuations in temperature.

After first use, Ozempic pens should be stored either in the refrigerator or in a cool, dark place at temperatures less than 86ºF (30ºC).

Ozempic pens are good for six weeks after being opened, and should be discarded after this time.

Do not freeze Ozempic pens and do not use if the liquid in the pen is frozen.

Side effects

The most common side effects of Ozempic are nausea, vomiting, headache, and diarrhea. 

Ozempic may also cause indigestion, stomach pain, acid reflux or heartburn, constipation, burping, dizziness, sleepiness, loss of appetite, weight loss, gas and bloating, gallstones, and an increase in pancreatic enzymes.

Ozempic can also cause hypoglycemia in people with diabetes who do or do not use medications containing sulfonylureas or insulin.

Less common side effects include changes in taste, accelerated heartbeat, pancreatitis, retinopathy, gastroparesis, bowel obstruction, and a localized reaction at the injection site, including bruising, pain, itchiness, and irritation.

Ozempic face

"Ozempic face" is a term used in popular culture to refer to the sagging and aging appearance of the facial skin that can occur due to loss of facial fat following rapid weight loss. 

Rebound effect

Ozempic can cause a rebound effect, in which a person gains back all the weight lost (or even more) after stopping treatment.

This rebound effect happens more often in people who change their dose or stop taking Ozempic without consulting a doctor.

Contraindications for use

Ozempic cannot be used in children or adolescents less than 18 years of age, people with type 1 diabetes, or those with diabetic ketoacidosis. 

People who are pregnant or breastfeeding should not use Ozempic, as it is still unknown how this medication affects the fetus and whether it passes through the breast milk. 

It is important to talk to a doctor about any herbal supplements you are taking, as well as medications like warfarin or other anticoagulants, before taking Ozempic. People who are planning to undergo surgery with anesthesia should also talk to their doctor before taking Ozempic.

In addition, people with a personal or family history of medullary thyroid cancer and those presenting with multiple endocrine neoplasia type 2 should also talk to their doctor before taking Ozempic.

Frequently asked questions

Common questions regarding Ozempic include:

1. What is "natural Ozempic"?

"Natural Ozempic" is a popular term used on social media to refer to possible natural alternatives to Ozempic, such as berberine, that can have the same effect as Ozempic.

When advised by a doctor, berberine can be used as a complementary therapy in the treatment of diabetes, helping to control blood sugar levels.

2. Does Ozempic require a prescription?

Yes, a prescription is required for the use of Ozempic, as it is an injectable medication that is contraindicated in certain situations and can cause serious side effects.

4. What is compounded Ozempic?

Compounded Ozempic is a version of the original product produced in compounding pharmacies. 

Novo Nordisk, the maker of Ozempic, has stated that they have not supplied any compounding pharmacy or other manufacturer with semaglutide or authorized the manufacturing of compounded semaglutide, which is not authorized or regulated by the FDA.

Because compounded Ozempic is not regulated, the efficacy, safety, and quality of this product is not guaranteed, posing potential health risks.

5. Does Ozempic cause depression?

There is no evidence at this time that Ozempic or other medications containing semaglutide cause depression.

However, it is always important to talk to your doctor if you develop new or worsening depression, thoughts of suicide, or any changes in your mood or behavior.

6. What are "Ozempic breasts"?

"Ozempic breasts" is a term referring to sagging of the breasts that can occur as a side effect of Ozempic. 

Sagging of the breasts can result from rapid weight loss that can also lead to fat loss in the breasts, reducing their volume and firmness.