Is a starting dose of 0.25mg of Ozempic (semaglutide) administered subcutaneously once weekly a standard regimen?

Ozempic Prescription Verification

Yes, this prescription is correct for initiating Ozempic therapy. The starting dose of 0.25 mg subcutaneously once weekly for 4 weeks is the FDA-approved and guideline-recommended initiation regimen 1.

Prescription Components Analysis

Dose and Frequency

• The 0.25 mg starting dose is appropriate and mandatory for the first 4 weeks of therapy 1, 2
• The FDA label explicitly states this dose is "intended for treatment initiation and is not effective for glycemic control" 1
• Once-weekly subcutaneous administration on the same day each week is correct 3, 1

Duration and Titration Schedule

• The 30-day (4-week) duration for the 0.25 mg dose aligns with FDA recommendations 1
• After completing 4 weeks at 0.25 mg, the dose should be increased to 0.5 mg once weekly 1, 2
• If additional glycemic control is needed after at least 4 weeks on 0.5 mg, the dose may be increased to 1 mg once weekly (maximum approved dose for diabetes) 1

Pen Formulation

• The "2 MG/3ML Solution Pen-injector" is the correct FDA-approved formulation 1
• This pen delivers 1.34 mg/mL concentration and can provide both 0.25 mg and 0.5 mg doses 1

Refills

• Two refills are reasonable for continuing therapy through the titration phase 2

Critical Safety Considerations

Contraindications to Verify

• Absolute contraindications include: personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) 1, 3
• Known hypersensitivity to semaglutide 1

Monitoring Requirements

• Assess for gastrointestinal side effects (nausea, vomiting, diarrhea) which are most common during dose escalation 4, 3
• Monitor for signs of pancreatitis, cholelithiasis, and acute kidney injury 4, 3
• If using with insulin or sulfonylureas, monitor closely for hypoglycemia and consider dose reduction of these agents 4, 3

Administration Instructions

• Inject subcutaneously in abdomen, thigh, or upper arm 1
• Can be given at any time of day, with or without meals 3, 1
• Use a different injection site each week within the same body region 1

Common Pitfalls to Avoid

• Do not skip the 0.25 mg initiation phase - this dose allows GI tolerance to develop and reduces adverse effects 2
• Do not use with other GLP-1 receptor agonists or DPP-4 inhibitors 2
• If more than 5 days pass after a missed dose, skip it and resume the regular schedule rather than doubling up 1
• Counsel patients that the 0.25 mg dose will not provide glycemic control - it is purely for tolerability 1