Ozempic dosage

Ozempic dosage on the label

This is the label's schedule for the weekly injection in adults with type 2 diabetes.¹

Maintenance for blood sugar control is 0.5 mg, 1 mg or 2 mg once a week.¹ For adults with type 2 diabetes and chronic kidney disease, the label's maintenance dose is 1 mg once a week, reached after at least 4 weeks on 0.5 mg.¹ Whether to raise the dose, and when, is the prescriber's decision; the label ties each increase to a need for more blood sugar control.¹ The 2 mg once-weekly dose joined the label on March 28, 2022.³

Why the dose starts low

The label gives one reason for the slow climb: it lowers the risk of stomach and gut side effects, which in the trials clustered in the dose-increase period.¹ Rates by dose are on the Ozempic side effects page.

Which pen gives which dose

Each multi-dose pen holds 3 mL of solution and is for one patient only.¹

FDA lists an older 2 mg/1.5 mL pen (1.34 mg/mL) as discontinued.³ An opened pen is thrown away 56 days after first use, even if medicine is left.¹

Timing and changing the injection day

Doses fall on the same day each week, at any time of day, with or without meals.¹ The day can be moved as long as at least 2 days (more than 48 hours) separate two doses.¹

Ozempic pill dosage

The tablets have their own schedule, taken once a day by mouth.²

The label says Ozempic tablets and Rybelsus tablets (3, 7 and 14 mg) are not interchangeable milligram for milligram.² People on the 0.5 mg weekly injection may switch: one week after the last 0.5 mg injection, the label starts 4 mg or 9 mg Ozempic tablets, or 7 mg or 14 mg Rybelsus, once a day.²

Other medicines, kidneys and liver

When Ozempic is started, the label says to consider lowering the dose of insulin or of an insulin secretagogue, such as a sulfonylurea, taken with it, to reduce the risk of low blood sugar.¹ Ozempic delays stomach emptying, which could change how other oral medicines are absorbed; trials did not show a clinically relevant effect, but the label advises caution.¹ No dose change is recommended for kidney or liver impairment.¹

Doses are in milligrams, not units

FDA-approved semaglutide injections are dosed in milligrams, at standard concentrations,⁴ and Ozempic comes in prefilled pens and syringes.¹ FDA has received adverse event reports, some needing hospital care, after dosing errors with compounded semaglutide drawn from multi-dose vials.⁴ In most of these reports, patients drew more than the prescribed amount and gave themselves 5 to 20 times more than the intended dose.⁴

FDA says confusion between milliliters, milligrams and syringe 'units' may have contributed.⁴ In several reports, people told to draw 5 units (0.05 mL) on a U-100 insulin syringe drew 50 units (0.5 mL), ten times the intended amount.⁴ Some prescribers also miscalculated when converting milligrams to units or milliliters, and their patients took 5 to 10 times more than the intended dose.⁴ FDA notes that overdose effects include severe nausea, severe vomiting and severe low blood sugar, and that semaglutide's half-life of about one week can mean a long period of observation and treatment.⁴

Why this is not advice for you

These figures are the label schedule for the FDA-approved product.¹ The prescriber sets the starting point, each increase and the maintenance dose for each person.¹ The label numbers belong to the approved product alone: FDA says compounded GLP-1 drugs are not FDA approved or reviewed for safety, effectiveness or quality, and that semaglutide sold 'for research purposes' is an unapproved drug of unknown quality.⁵

Related pages

Back to What is Ozempic?. Trial results by dose are in Ozempic benefits and uses, and pen steps in Ozempic injection sites and pen use. Label schedules across the drug class: GLP-1 dosage.