How and where to inject semaglutide

The three places to inject

Both Medication Guides describe the injection in the same words, down to the warning at the end:

The OZEMPIC Medication Guide says the same of OZEMPIC. The Instructions for Use that come with each device are more specific about where in each area:

Some skin is off limits wherever it is. The WEGOVY pen instructions put it plainly:

Neither label ranks the three areas. The WEGOVY label says you can switch between them freely: “The time of day and the injection site can be changed without the need for a dosage modification.” If one area is giving you trouble with the pen, its instructions suggest “a more firm injection site, such as upper leg, or upper arm”, or standing up to inject into the lower stomach.¹

Rotating sites: same area, new spot

Both labels want the spot to move every week, and the pen instructions spell out what that allows:^1,2

Read together, the rule is simple. You can keep to your stomach, or your thigh, week after week, as long as each injection goes in a different place from the last one.

How to inject WEGOVY with the single-dose pen

On the single-dose pen, “The dose of WEGOVY is already set on your pen”, the needle stays hidden under a cover, and each pen is used once. Its Instructions for Use give five steps:¹

1. Prepare. Wash your hands and check the pen. Don’t use it if it looks used or broken, if the medicine isn’t clear and colorless through the window, or if the expiration date has passed.
2. Choose your injection site and clean it with an alcohol swab or soap and water. Let the skin dry, and don’t touch it again before you inject.
3. Remove the pen cap by pulling it straight off, only when you’re ready to inject.
4. Inject. Push the pen firmly against your skin and keep pressing until the yellow bar in the window has stopped moving. You’ll hear two clicks: the first when the injection starts, the second while it’s still going.
5. Throw the pen away in a sharps disposal container right away, not in the household trash.

The instructions warn more than once against lifting the pen too soon, and they say why:

If the yellow bar doesn’t start moving, press harder. If medicine appeared on your skin or squirted from the needle, the instructions’ answer is for next time: keep the pressure on until the yellow bar stops, then lift the pen slowly.

Some people on 2.4 mg are prescribed WEGOVY FlexTouch instead, a pen that holds four weekly doses. It works like the OZEMPIC pen below: a new needle each time, a flow check before the first dose from a new pen, and the button held down while you count slowly to 6.¹

How to inject OZEMPIC with the pen

The OZEMPIC pen holds several weeks of doses. You attach a new needle each time and dial the dose yourself. Its Instructions for Use give five steps:²

Which pen you have decides how many doses are in it, and the OZEMPIC pen page sets the three of them out with what comes in each carton.

1. Prepare the pen with a new needle. Wash your hands, check the label says OZEMPIC, pull off the pen cap and check the medicine is clear and colorless. Push a new needle straight on and turn it until it’s tight. Pull off the outer needle cap and keep it, then pull off the inner cap and throw it away.
2. Check the flow, with each new pen only. Turn the dose selector to the flow check symbol, hold the pen with the needle pointing up, and press and hold the dose button until the counter shows 0. A drop should appear at the needle tip.
3. Select your dose. Turn the dose selector until the counter shows your dose. Go by the counter, not the clicks.
4. Inject. Wipe the site with an alcohol swab and let it dry. Insert the needle as your healthcare provider showed you, press and hold the dose button until the counter shows 0, and keep it pressed while you count 6 seconds. Then remove the needle.
5. After your injection, take the needle off, put it in a sharps disposal container, and put the pen cap back on.

Two warnings in those instructions are about a dose that never went in:

If you use a prefilled syringe

Both products also come as single-dose prefilled syringes, and those instructions add two things the pens don’t ask for. You pinch and hold a fold of skin at the site for the whole injection, and you put the needle in at an angle:^1,2

You then push the plunger all the way down until it stops. The back of the upper arm is on the list for the syringes only “with help from someone else”.

After the injection

A little blood is ordinary: press lightly with a gauze pad or cotton ball, and the OZEMPIC instructions add “Do not rub the area.” A drop at the needle tip after the injection is normal too. The OZEMPIC instructions say it “does not affect your dose.”^1,2

Reactions at the injection site were uncommon in the trials. In the WEGOVY trials for weight reduction, 1.4% of people on WEGOVY had one, against 1% on placebo; the label lists itching, redness, inflammation, hardening and irritation among them. In OZEMPIC’s placebo-controlled trials the figure was 0.2%. The reactions that were not uncommon are in WEGOVY’s table of everything reported in at least 2% of patients.^1,2

Which day, and what time

Both are once a week, on the same day each week, at any time of day, with or without food. The day can move if you need it to: the OZEMPIC label allows it as long as the two doses are at least 2 days (more than 48 hours) apart, and the WEGOVY Medication Guide says the same about your last dose.^1,2

If the day has already gone by, the two labels part company. If you missed a semaglutide dose quotes both instructions in full. Which dose goes in the pen each week is on the semaglutide dosage chart.

Questions