From the Guidelines
Ozempic (semaglutide) should be initiated at a dose of 0.25 mg once weekly for the first 4 weeks, followed by a gradual increase to 0.5 mg, 1.0 mg, and potentially up to 2.4 mg weekly, as needed and tolerated, to minimize gastrointestinal side effects and optimize glycemic control 1.
Key Considerations for Ozempic Dosing
- The initial dose of 0.25 mg once weekly is not therapeutic but serves to reduce gastrointestinal side effects, allowing for better tolerance and adherence to the medication regimen.
- After the initial 4 weeks, the dose can be increased to 0.5 mg once weekly, and further adjustments can be made every 4 weeks based on clinical response and tolerance.
- The maximum dose for glycemic control is typically 1 mg weekly, but for weight management, the dose can be increased up to 2.4 mg weekly, as indicated in the guideline for pharmacological interventions for adults with obesity 1.
Administration and Storage
- Ozempic should be administered subcutaneously in the abdomen, thigh, or upper arm on the same day each week.
- Patients can store unopened pens in the refrigerator and keep opened pens at room temperature for up to 56 days.
Mechanism of Action and Side Effects
- Ozempic works by mimicking GLP-1, a hormone that regulates blood sugar and appetite, making it effective for type 2 diabetes management and, indirectly, weight loss.
- Common side effects include nausea, vomiting, and diarrhea, which typically improve over time.
Clinical Judgment and Dose Adjustment
- Clinical judgment is crucial for adjusting the titration schedule as needed for an individual patient’s response, tolerance, and adverse effects 1.
- If more than 2 consecutive doses are missed, clinical judgment is required to decide on subsequent dosing, considering either resuming at the same dose if well-tolerated or lowering the next dose. Restarting the titration schedule may be necessary if 3 or more consecutive doses are missed.
From the FDA Drug Label
Your pen is a prefilled, single-patient-use, dial-a-dose pen. It contains 2 mg of semaglutide, and you can select doses of 0.25 mg or 0.5 mg. Your pen is a prefilled, single-patient-use, dial-a-dose pen. It contains 4 mg of semaglutide, and you can only select doses of 1 mg
The recommended doses of Ozempic are 0.25 mg or 0.5 mg for the 2 mg pen, and 1 mg for the 4 mg pen 2, 2.
From the Research
Ozempic Dose Information
- The recommended dose of Ozempic (semaglutide) for weight management is 2.4 mg once weekly, as an adjunct to lifestyle intervention 3, 4, 5, 6.
- Studies have shown that semaglutide 2.4 mg is associated with significant weight loss, with mean weight losses of 14.9%-17.4% in individuals with overweight or obesity without type 2 diabetes from baseline to week 68 3, 6.
- In comparison to liraglutide, semaglutide 2.4 mg has been shown to result in significantly greater weight loss at 68 weeks, with a mean weight change of -15.8% vs -6.4% 5.
- The safety profile of semaglutide 2.4 mg is consistent across trials, with primarily gastrointestinal adverse events, such as nausea and diarrhea, being the most common adverse events 3, 4, 5, 6.
Dose Comparison
- A study comparing semaglutide 2.0 mg to 1.0 mg in patients with type 2 diabetes found that the 2.0 mg dose was superior in reducing HbA1c, with additional body weight loss and a similar safety profile 7.
- The STEP clinical trial program has evaluated once-weekly subcutaneous semaglutide 2.4 mg in people with overweight or obesity, and has shown significant weight loss and improvements in cardiometabolic risk factors 6.
Key Findings
- Semaglutide 2.4 mg is a effective treatment for weight management, with significant weight loss and improvements in cardiometabolic risk factors 3, 4, 5, 6.
- The safety profile of semaglutide 2.4 mg is consistent across trials, with primarily gastrointestinal adverse events being the most common adverse events 3, 4, 5, 6.
- Semaglutide 2.4 mg has been shown to be superior to liraglutide in resulting in significant weight loss at 68 weeks 5.