When to Reinject Semaglutide After a Missing a Dose
If you miss a dose of subcutaneous semaglutide, administer it as soon as possible within 5 days of the missed dose; if more than 5 days have passed, skip the missed dose and resume your regular weekly schedule. 1
Specific Timing Guidelines for Subcutaneous Semaglutide
Within 5 Days of Missed Dose
- Administer the missed dose immediately when you remember, as long as it is within 5 days of when it was due 1
- After taking the missed dose, resume your regular once-weekly dosing schedule 1
More Than 5 Days After Missed Dose
- Skip the missed dose entirely if more than 5 days have elapsed 1
- Administer the next dose on your regularly scheduled day 1
- Do not double up or take extra doses to compensate 1
Multiple Consecutive Missed Doses
1-2 Consecutive Missed Doses
- Resume at the same dose if you previously tolerated the medication well 2, 3
- Clinical judgment should guide dosing decisions, particularly considering your history of gastrointestinal side effects 2, 3
- If you experienced significant nausea, vomiting, or other GI symptoms previously, consider lowering the next dose 2
3 or More Consecutive Missed Doses
- Restart the titration schedule from a lower dose to minimize gastrointestinal adverse effects 2, 3
- This approach helps prevent the severe nausea and vomiting that can occur when restarting at higher doses after prolonged interruption 2, 3
- The standard titration begins at 0.25 mg weekly for 4 weeks, then increases to 0.5 mg weekly 1
Important Clinical Considerations
Impact on Glycemic Control
- Missing multiple doses may compromise blood glucose control and weight management benefits 3
- Monitor blood glucose more frequently when resuming treatment, especially if you are also taking insulin or insulin secretagogues 2
Gastrointestinal Side Effects
- Nausea, vomiting, diarrhea, and abdominal pain are dose-dependent and most common when initiating or escalating doses 3
- Slow dose titration after missed doses helps minimize these adverse effects 3
Special Perioperative Considerations
- Semaglutide has a half-life of approximately 7 days (168 hours), meaning it remains in your system for an extended period 4
- If you have upcoming surgery, be aware that semaglutide delays gastric emptying, which may increase aspiration risk during anesthesia 4, 2
- The American Society of Anesthesiologists recommends stopping weekly injections one week before elective procedures 4
Common Pitfalls to Avoid
- Never share your semaglutide pen with another person, even if the needle is changed, due to risk of blood-borne pathogen transmission 1
- Do not attempt to "catch up" by taking multiple doses at once 1
- Avoid restarting at your previous high dose after missing 3 or more consecutive doses without medical guidance 2, 3