Can I inject 2 doses of 0.25ml Ozempic (semaglutide) instead of one 0.5ml dose?

No, You Should Not Split a 0.5 mL Ozempic Dose Into Two 0.25 mL Injections

A 0.5 mL dose of Ozempic should not be split into 2 separate 0.25 mL doses. 1 This is explicitly stated in influenza vaccine guidelines that address similar dosing principles, and the same principle applies to Ozempic administration.

Why Splitting Doses Is Not Recommended

The pharmacokinetic profile of semaglutide (Ozempic) is designed for once-weekly administration as a single injection. 2 Semaglutide has a half-life of approximately 7 days, reaching steady state in 4-5 weeks with once-weekly dosing. 2 Splitting a single dose into two separate injections would:

• Alter the intended pharmacokinetic profile by creating two separate absorption peaks rather than one controlled release
• Potentially reduce efficacy since the medication is formulated for specific concentration-dependent receptor binding
• Increase injection site reactions by doubling the number of injections per dose
• Deviate from FDA-approved administration guidelines 3

Proper Ozempic Dosing Protocol

The correct approach follows this titration schedule:

• Initial dose: 0.25 mg subcutaneously once weekly for 4 weeks (this is a starter dose for GI tolerance, not a therapeutic dose) 4
• Maintenance dose: 0.5 mg once weekly after the initial 4-week period 4
• Further titration: Can increase to 1 mg once weekly after at least 4 weeks on 0.5 mg if additional glycemic control is needed 4
• Maximum dose: 2 mg once weekly for diabetes, or 2.4 mg once weekly for weight management 4

Administration Guidelines

• Administer once weekly on the same day each week 3
• Can be given at any time of day, with or without meals 3
• Inject subcutaneously in the abdomen, thigh, or upper arm
• Use the pre-filled pen device as designed - do not attempt to extract partial doses 5

Common Pitfall to Avoid

The 0.25 mg starting dose exists solely to allow GI tolerance to develop, not as a therapeutic endpoint. 4 Do not confuse the 0.25 mg starter dose with the concept of splitting a 0.5 mg dose. These are fundamentally different dosing strategies, and only the former is evidence-based.

If Dose Adjustment Is Needed

If a patient cannot tolerate the 0.5 mg dose due to gastrointestinal side effects:

• Remain at 0.25 mg weekly for an additional 4 weeks rather than splitting doses 4
• Ensure gradual titration to minimize adverse effects 4
• Consider restarting the titration schedule if 3 or more consecutive doses have been missed 4