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 1.7 mg weekly every 4 weeks, with a maximum dose of 2.4 mg weekly for weight management and glycemic control, as recommended by the most recent guidelines 1.
Dosing Considerations
When prescribing Ozempic, it is essential to consider the following:
- The dose should be increased gradually to minimize gastrointestinal side effects, as recommended by the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1.
- The medication should be injected subcutaneously in the abdomen, thigh, or upper arm on the same day each week.
- The time of day and injection site can vary, but it is crucial to maintain a consistent schedule.
- If more than two consecutive doses are missed, clinical judgment is required to decide on subsequent dosing, and restarting the titration schedule should be considered if three or more consecutive doses are missed 1.
Administration and Storage
- Ozempic should be stored in the refrigerator before first use and can be kept at room temperature for up to 56 days after opening.
- The medication should be administered subcutaneously, and patients should be instructed on proper injection techniques.
Mechanism of Action and Efficacy
- Ozempic works by mimicking the hormone GLP-1, which helps regulate blood sugar by increasing insulin secretion when blood sugar is high, slowing gastric emptying, and reducing appetite, making it effective for both diabetes management and weight loss.
- The recommended dosing for Ozempic is supported by the Mayo Clinic Proceedings, which provides a comprehensive guide for the management of diabetic kidney disease and recommends gradual dose titration for GLP-1 receptor agonists, including semaglutide 1.
From the FDA Drug Label
Instructions for Use – 0.25 mg or 0.5 doses • 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.
The dosing for Ozempic is 0.25 mg or 0.5 mg.
- The pen delivers doses of 0.25 mg or 0.5 mg. 2
From the Research
Dosing Ozempic
- Ozempic, also known as semaglutide, is a glucagon-like peptide-1 receptor agonist used to treat type 2 diabetes.
- The dosing of Ozempic is typically initiated at 0.5 mg once weekly, with the option to increase to 1.0 mg once weekly after at least 4 weeks [ 3 ].
- Studies have shown that switching from other glucagon-like peptide-1 receptor agonists, such as liraglutide or dulaglutide, to semaglutide can improve glycemic control and weight loss [ 3, 4,5 ].
- The effectiveness of semaglutide in improving kidney outcomes has also been demonstrated, with significant reductions in albuminuria and slowing of estimated glomerular filtration rate decline [ 6 ].
- A systematic review and meta-analysis of randomized trials found that long-acting glucagon-like peptide-1 receptor agonists, including semaglutide, reduced the incidence of major adverse cardiovascular events, hospitalization for heart failure, and kidney events [ 7 ].
Key Findings
- Semaglutide 1.0 mg significantly lowered albuminuria by 33% compared to placebo [ 6 ].
- Semaglutide slowed the decline of estimated glomerular filtration rate by 0.87 mL/min/1.73 m2/y compared to placebo [ 6 ].
- Switching from liraglutide or dulaglutide to semaglutide improved glycemic control, with a significant reduction in HbA1c levels [ 3, 4,5 ].
- Semaglutide also improved treatment satisfaction and reduced body weight in patients with type 2 diabetes [ 4, 5 ].