What is the dosing for Semaglutide (Ozempic)?

From the Guidelines

Ozempic (semaglutide) dosing should be initiated at 0.25 mg subcutaneously once weekly for the first 4 weeks, then increased to 0.5 mg once weekly, and further increased to 1 mg once weekly if needed, as recommended in the Mayo Clinic Proceedings study 1. The dosing regimen for Ozempic is designed to minimize gastrointestinal side effects and optimize glycemic control.

• The initial dose of 0.25 mg once weekly is not therapeutic but helps reduce side effects.
• After 4 weeks, the dose can be increased to 0.5 mg once weekly.
• If additional glycemic control is needed, the dose can be further increased to 1 mg once weekly after at least 4 weeks on the 0.5 mg dose. Key considerations for Ozempic administration include:
• Injecting the medication subcutaneously in the abdomen, thigh, or upper arm.
• Rotating the injection site to minimize local reactions.
• Administering the medication on the same day each week, with or without meals.
• If a dose is missed, it should be administered as soon as possible within 5 days; if more than 5 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day, as indicated in the study 1. Ozempic works by mimicking GLP-1, a hormone that regulates blood sugar and appetite, making it effective for both diabetes management and weight loss, with common side effects including nausea, vomiting, diarrhea, and constipation, which typically improve over time, as noted in the study 1.

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 dosing options for Ozempic are:

• 0.25 mg
• 0.5 mg
• 1 mg 2 2

From the Research

Ozempic Dosing

• The recommended dosing for Ozempic (semaglutide) is 0.5 or 1.0 mg once weekly, administered via subcutaneous injection 3, 4.
• The dose of semaglutide can be administered without regard to meals, and it has a half-life of 7 days, reaching steady state in 4-5 weeks 4.
• No dose adjustments are necessary for semaglutide, but it may delay gastric emptying and impact the absorption of oral medications 4.
• Semaglutide is available in prefilled pens for subcutaneous injection and is reimbursed in Belgium for patients with type 2 diabetes who have failed antidiabetic therapy, including metformin, with an HbA1c level above 7.5% or 58 mmol/mol 3.
• Oral semaglutide has also been approved for the treatment of type 2 diabetes, with a systematic review and meta-analysis showing its efficacy and safety in reducing HbA1c, body weight, and fasting plasma glucose 5.

Administration and Pharmacokinetics

• Semaglutide can be administered subcutaneously once weekly, with a dose of 0.5 or 1.0 mg 3, 4.
• The pharmacokinetics of semaglutide have been evaluated in several studies, with a half-life of 7 days and steady state reached in 4-5 weeks 4.
• Semaglutide has been shown to have a favorable safety profile, with few drug interactions and no increased risk of hypoglycemia when used as monotherapy 4, 6.

Clinical Evidence and Role in Therapy

• Semaglutide has been compared with placebo, sitagliptin, exenatide extended release, and insulin glargine in clinical trials, showing its efficacy in reducing HbA1c and body weight 4.
• A systematic review and meta-analysis of oral semaglutide found it to be effective in reducing HbA1c, body weight, and fasting plasma glucose, with a favorable safety profile 5.
• Semaglutide has been approved for the treatment of type 2 diabetes, with potential benefits for patients who require weight loss and have a low risk of hypoglycemia 4, 6.