Ozempic Dosage Guide: Managing Weight Loss and Diabetes

Ozempic (semaglutide) is available by prescription in 0.25 mg, 0.5 mg, 1 mg or 2 mg weekly injection dosages. The maximum dose is 2 mg injected into the skin once per week. You must administer the Ozempic dose recommended by your doctor.

Ozempic prefilled injection pens come in three different formats, each delivering a specific dose or set of doses. The first type of Ozempic pen delivers both 0.25 mg or 0.5 mg doses and is designed for patients getting started on Ozempic. Other prefilled pens deliver either 1 mg or 2 mg doses.

To reduce the chance of side effects, health care providers gradually increase your dose over time. Your doctor may increase your dose to 1 mg or 2 mg after several weeks if you require additional blood sugar control.

Adults with Type 2 diabetes take Ozempic once per week to lower blood sugar levels, and they usually begin with a 0.25 mg dose. This lower dose allows your body to become accustomed to the medication. At week five, doctors typically increase the dose to 0.5 mg once a week if you tolerate the medication.

Your doctor may prescribe a higher dose of 1 mg per week or 2 mg per week as appropriate. Follow your health care provider’s instructions to progressively increase your weekly dose until reaching the maintenance dose you will take long term. Never change your dose without instructions from your physician.

Ozempic is only FDA-approved to treat symptoms of Type 2 diabetes. All other uses are off-label uses. If you choose to begin Ozempic dosing for weight loss, follow the schedule provided by your health care provider and understand that Ozempic for weight loss is a secondary effect of the prescription medication and not its intended primary use.

The average Ozempic or compounded semaglutide dose for weight loss starts at 0.25 mg. A medical provider may adjust the dose as needed depending on the individual and the amount of weight loss achieved on the initial dose.

“The optimal dose of semaglutide is the dose that allows the patient to lose 1-2 pounds per week or reduce their body fat while avoiding side effects,” said Antoni Adamrovich, MSN, BA, APRN, FNP-C, chief of medicine and co-owner of weight loss clinic TB2.Health. “If the patient has not been on GLP medications before, they should start at the lowest dose to monitor side effects or how they tolerate it.”

According to Adamrovich, Novo Nordisk indicates to increase a patient’s Ozempic dosage every month. However, in his practice, he feels it makes more sense to continue the same dosage if the patient is still losing 1-2 pounds a week and not having any side effects.

“If the patient is eating a whole, balanced diet and practicing daily activities that increase their heart rate or resistance training but plateaus in weight loss for 3-4 weeks, I will encourage increasing the dosage,” he added.

You can take a missed dose of Ozempic within five days of the originally scheduled dose. Always take your missed dose as soon as possible. If more than five days have passed, skip your missed dose and take your next dose as intended on the next scheduled day.

Don’t stop using Ozempic suddenly, as this can increase your blood sugar levels. If you have questions about how to handle a missed dose, contact your doctor for advice.

It’s possible to overdose by taking too much Ozempic or other semaglutide drugs. Doing so can cause Ozempic side effects such as nausea vomiting, bloating, abdominal pain or low blood glucose. Take overdoses seriously, as they can negatively impact your health.

If you know or suspect that you took too much Ozempic, take action immediately even if you aren’t currently experiencing any side effects. Talk to your doctor in advance to get advice on how to handle symptoms of hypoglycemia and inform your doctor of any occurrences.

You don’t have to overdose on Ozempic to suffer gastrointestinal side effects, some of which can be severe. Talk to your doctor about any side effects you experience and ask how to proceed if you have experienced negative effects from taking Ozempic.

Some patients reported excessive vomiting, abdominal pain, intestinal blockages and gastroparesis after taking Ozempic. These side effects have led to Ozempic lawsuits that claim Novo Nordisk failed to warn patients about the risk.

Compounded Ozempic Overdoses

In December 2023, poison control centers reported a 1,500% increase in semaglutide overdoses, most of which were from people using compounded versions of the drug. Compounded versions of semaglutide come in vials, and patients must measure out the dose to self-administer. Unfortunately, this leaves room for error.

“Ozempic comes in preloaded single-use syringes, which is great to avoid injecting too much or overdoses,” said Adamrovich. “Where this can become problematic is when using compounded GLP medications that are not preloaded single-use syringes. They have to be drawn out of a vial, and specific directions from the clinician must be followed to inject the correct dose. Each vial has a certain amount of liquid, and suspended in that liquid is a certain number of milligrams of the medication.”

Patient Susan Duval told Drugwatch she received her vial of compounded semaglutide from a weight loss clinic, but the confusing instructions she received caused her to inject several doses at once and accidentally overdose. She suffered severe vomiting, headaches, inability to eat or drink and flu-like body aches.

“When the compound semaglutide arrived from the compound pharmacy, the pamphlet said, ‘How do you give yourself a subcutaneous shot? Semaglutide 2.5 mg dosing on an insulin syringe,’ so I figured I must have to take 2.5 mg, which was 100 units. This is the amount you should take after being on the medication for longer than six months!” Duval said.

To avoid overdoses, Adamrovich cautions patients to follow all the clinician’s instructions and ask questions if they don’t understand the instructions.

“I feel the prescribing physician and the information that comes from the pharmacy should be congruent. Had this been the case, I wouldn’t have taken a massive dose the first time,” Duval said.