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Medication Overview
The Centers for Disease control and Prevention (CDC) reports that roughly 42 percent of adults in the US are considered obese. Obesity can cause a slew of health complications, including high blood pressure, heart disease, type 2 diabetes, cancer, sleep apnea, and more.
All of these effects can negatively impact one’s quality of life, overall health, and survival. Given the extent of obesity and its consequences, there is an unmet need for effective weight loss drugs. In recent years, Ozempic, also known by its generic name semaglutide, has gained traction for its efficacy in inducing weight loss. Ozempic is a weekly injection that helps lower blood sugar by helping the pancreas make more insulin. While it is not approved for weight loss, a physician may prescribe it for weight loss.
Ozempic (Semaglutide Injection)Medical Indications
Ozempic was originally approved by the Food and Drug Administration (FDA) in 2017 for the treatment of adults with type 2 diabetes in combination with diet and exercise. Type 2 diabetes is a chronic condition characterized by inadequate insulin production or decreased insulin sensitivity, resulting in abnormal blood sugar levels once weekly injections of Ozempic (Semaglutide Injection) are both safe and effective in lowering blood sugar levels by assisting the pancreas in creating more insulin.
In 2021, the FDA approved Wegovy for management of obesity. Wegovy and Ozempic both contain the same drug semaglutide; however, they differ in terms of their dose. Wegovy has a higher dose of semaglutide than Ozempic. Although Wegovy is indicated for weight loss, it is oftentimes not covered by health insurance. Thus, many people will opt for Ozempic (Semaglutide Injection) to achieve their weight loss goals.
Dosage and Administration for Ozempic (Semaglutide Injection)
The dosage and administration of Ozempic (Semaglutide Injection) are based on its labeled indication for type 2 diabetes. Ozempic is provided as an injection in a 2 mg/1.5 mL strength. It comes as a single-use pen that can deliver either 0.25, 0.5, or 1 mg per injection.
To begin treatment, the recommended starting dose is 0.25 mg once weekly. After four weeks, you can increase the dose to 0.5 mg once weekly. After an additional four weeks, your provider can assess if you need further blood sugar control. If so, the dose can be further increased to 1 mg once weekly.
Potential Side Effects of Ozempic (Semaglutide Injection)
Ozempic (Semaglutide Injection) works by prolonging gastric emptying, which is the process in which your stomach contents move throughout the digestive tract. Because of this, Ozempic tends to cause gastrointestinal (GI) related side effects, including nausea, vomiting, diarrhea, stomach pain, and constipation. These side effects are more frequent when your dose is increased. In clinical trials, roughly three to four percent of individuals stopped treatment because of these side effects. Other mild side effects that occur less frequently are indigestion, gas, reflux, burping, and gastritis (2).
If you experience uncomfortable side effects, discuss these with your healthcare provider. You may need a lower dose if you are unable to tolerate these symptoms. Additionally, Ozempic (Semaglutide Injection) can cause more serious adverse events. These are described in the next section.
Precautions and Contraindications
There are several warnings and precautions associated with Ozempic therapy. They are as follows:
- Pancreatitis. Pancreatitis is characterized by inflammation, including swelling and redness, in the pancreas. If you have pancreatitis, you may have nausea, vomiting, or stomach pain radiating to the back.
- Allergy. If you experience any signs of allergy, stop Ozempic right away and seek medical attention.
- Renal failure. Due to the GI side effects, some individuals may experience dehydration because of vomiting and diarrhea. Dehydration is particularly concerning with regard to kidney function, which may lead to kidney failure. Thus, make sure to drink plenty of fluids if you experience GI effects with Ozempic.
- Complications of diabetic retinopathy. Diabetic retinopathy is an eye disorder leading to vision problems and blindness in those with diabetes. Signs of this complication include vision changes.
- Macrovascular outcomes. Currently, the risk of macrovascular events with Ozempic is unknown.
- Thyroid C-cell tumors. In animal models in rodents, semaglutide has been known to cause thyroid C-cell tumors. Although the risk in humans is unknown, monitor for signs of thyroid tumors such as shortness of breath, hoarseness, a lump in the neck, and trouble swallowing.
- Sharing of pens. You should never share your Ozempic pens with other people, even if you have changed the needle. Sharing pens increases your risk of getting infected with blood-borne pathogens.
- Low blood sugar. Ozempic is made to help lower blood sugar levels. Thus, when taken with other blood sugar-lowering medications like insulin, severely low blood sugar levels can occur. If you are on both Ozempic and insulin, you may require a lower dose of insulin.
What If I Experience a Reaction to Ozempic (Semaglutide Injection)?
If you experience symptoms of any of the above adverse events, contact your doctor or get medical attention right away. In addition to these adverse events, there are certain individuals and conditions that prevent you from taking Ozempic (Semaglutide Injection). These contraindications include:
- History of medullary thyroid carcinoma (MTC). If you or your family has had medullary thyroid carcinoma (MTC), you should not take Ozempic.
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). If you have MEN 2, you cannot take Ozempic.
- Allergy. If you are allergic to semaglutide or any of Ozempic’s components, Ozempic is contraindicated.
- Pregnancy. Ozempic may pose a risk to the fetus. Thus, if you plan to get pregnant or are currently pregnant, be sure to let your healthcare provider know.
Interactions with Ozempic (Semaglutide Injection)
Ozempic can interact with other drugs and medications. These include:
- Insulin and insulin secretagogues (e.g., sulfonylurea). As aforementioned, taking both Ozempic and another medication that lowers blood sugar poses the risk of hypoglycemia (low blood sugar). If you are taking both these types of medications, you may need your dose adjusted.
- Oral medications. Ozempic prolongs the emptying of the digestive contents. In doing so, it may affect how your oral medications are absorbed and, thus how effective they are. Therefore, you and your provider should be cautious when taking oral medications along with Ozempic (Semaglutide Injection).
Ozempic (Semaglutide Injection) Effectiveness and Expectations
In a clinical trial, 388 participants with type 2 diabetes received either placebo, Ozempic 0.5 mg, or Ozempic 1 mg for 30 weeks. At the end of treatment, HbA1c levels were significantly reduced in the Ozempic groups versus placebo. Only 28 percent of placebo patients achieved an HbA1c of less than 7 percent. Meanwhile, 73 percent of individuals on Ozempic 0.5 mg and 70 percent of individuals on Ozempic 1 mg achieved this milestone. Thus, Ozempic can be incredibly effective in maintaining blood sugar levels in diabetic patients.
Semaglutide can be very effective for weight loss. One study evaluated how efficacious semaglutide 2.4 mg (the dose for Wegovy) was in overweight and obese individuals for 68 weeks. On average, participants lost 14.9 percent of their baseline weight. Additionally, more semaglutide-treated patients achieved weight losses of greater than 5, 10, and 15 percent versus placebo-treated patients. Participants lost an average of 15.3 kg by the end of the 68 weeks. While the results were very promising, semaglutide was also associated with nausea and diarrhea that resolved over time.
Additional Research
Another study aimed to determine if these results from clinical trials could be mimicked in an additional study. To do so, 175 overweight or obese patients were enrolled and received either 1.6 or 2.4 mg of semaglutide weekly. By month three, participants lost an average of 6.7 kg, equivalent to 10.9 percent of body weight from baseline. By month six, participants lost an average of 12.3 kg, equivalent to 10.9 percent of body weight from baselines. These findings suggest that semaglutide associated weight loss is comparable to those presented in clinical trials.
It is important to keep in mind that the weight loss studies evaluated Wegovy doses (1.7 and 2.4 mg), which are higher than the Ozempic (Semaglutide Injection) doses. Therefore, at the Ozempic dose, semaglutide might be less efficacious. Regardless, many people still have success in shedding the pounds with Ozempic.
Long-Term Use and Monitoring of Ozempic (Semaglutide Injection)
If taking Ozempic (Semaglutide Injection) for diabetes, it is important to periodically monitor your blood sugar levels and get HbA1c testing done. This will evaluate how well Ozempic is working in managing your blood sugar levels.
Alternatives and Complementary Therapies
To achieve the best results with Ozempic for both diabetes and weight loss, you should supplement your lifestyle with proper diet and regular exercise. These can help to improve your overall health, manage your diabetes, and lose weight.
Frequently Asked Questions (FAQs) About Ozempic (Semaglutide Injection)
Is it possible to get Ozempic right now?
The manufacturer of Ozempic (Semaglutide Injection) has experienced supply chain issues, meaning that some pharmacies might not have it in stock. You may have to call around to different pharmacies to see if they have it available. If you have trouble accessing Ozempic, speak with your provider about other options, specifically if you are taking it to manage your diabetes (5).
How much does it cost to get Ozempic?
In the US, certain patients with private or commercial insurance can access Ozempic for as low as $25 dollars for a one, two, or three-month supply of Ozempic for the first two years. However, exact coverage and cost will vary depending on the insurance.
How do I store Ozempic?
Before your first use of Ozempic (Semaglutide Injection), keep it in the refrigerator between 36- and 46-degrees Fahrenheit. After first use, you can keep it in the refrigerator or at room temperature for up to 56 days.
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