Ozempic

Ozempic is a prescription-only medication containing the active ingredient semaglutide for the treatment of type 2 diabetes mellitus. It belongs to the group of GLP-1 receptor agonists and is given once weekly as a subcutaneous injection.

Semaglutide mimics the action of the body's own gut hormone GLP-1, which is released after eating. It improves blood sugar control, supports weight loss and has a proven cardiovascular protective effect.

Ozempic is manufactured by Novo Nordisk and is approved for the treatment of type 2 diabetes in adults when metformin alone is not sufficient or is not tolerated.

Semaglutide acts via the GLP-1 receptor on several levels:

Glucose-dependent insulin release:

• Stimulates insulin secretion from the pancreas only when blood sugar is elevated
• Inhibits glucagon release (lowers sugar production by the liver)

Gastric emptying:

• Slows gastric emptying
• Blood sugar spikes after meals are flattened

Feeling of fullness:

• Acts on the satiety center in the brain
• Reduces appetite and food intake

Cardiovascular protection: In the SUSTAIN-6 study, semaglutide showed a reduction in serious cardiovascular events in patients with diabetes.

Ozempic is suitable for:

• Adults with type 2 diabetes for whom diet and exercise alone are not sufficient
• As an add-on to metformin or other oral antidiabetic medications
• Patients with increased cardiovascular risk
• Overweight people with type 2 diabetes (additional weight benefit)

Not suitable:

• Type 1 diabetes
• Diabetic ketoacidosis
• Pregnancy and breastfeeding

Prefilled pen for subcutaneous injection:

• 0.25 mg once weekly (starting dose, 4 weeks)
• 0.5 mg once weekly (first therapeutic dose)
• 1.0 mg once weekly (if needed, after at least 4 weeks)
• 2.0 mg once weekly (maximum dose)

Dose escalation:

• Start with 0.25 mg for 4 weeks (adjustment phase)
• Then increase to 0.5 mg
• Further increases only if the effect is insufficient

Use:

• Once weekly, on the same day of the week
• Subcutaneous injection into the abdomen, thigh or upper arm
• Change the injection site regularly
• Regardless of meals

Injection: 1. Take the prefilled pen out of the refrigerator (30 min beforehand) 2. Set the dose on the pen 3. Pinch a skin fold, insert the needle 4. Press the pen button and hold for 6 seconds 5. Pull out the needle, do not rub the site

Important notes:

• If a dose is missed: make it up within 5 days, then return to the regular day
• Store the pen in the refrigerator (2-8 °C); after first use, up to 6 weeks at room temperature

Ozempic must not be used in cases of:

• Hypersensitivity to semaglutide or the excipients

Outside the approved indication:

• Type 1 diabetes (Ozempic is only approved for type 2 diabetes)

Use with caution in:

• History of pancreatitis
• Diabetic retinopathy (close monitoring)
• Severe kidney or liver impairment
• Concurrent use of insulin or sulfonylureas (risk of hypoglycemia)

Pregnancy/breastfeeding: Contraindicated. Stop at least 2 months before a planned pregnancy.

Very common (>10%):

• Nausea
• Diarrhea

Common (1-10%):

• Vomiting
• Abdominal pain
• Constipation
• Decreased appetite
• Headache
• Fatigue
• Gallstones

Uncommon:

• Pancreatitis (inflammation of the pancreas)
• Increased heart rate
• Injection site reactions

Note: Nausea occurs mainly at the start and when the dose is increased, and usually improves within a few weeks. Slow dose escalation reduces these symptoms.

Insulin and sulfonylureas: Increased risk of hypoglycemia. A dose reduction of these medications may be necessary.

Oral medications: Because gastric emptying is slowed, the absorption of other medications may be delayed. Particular attention is needed with time-critical medications.

Warfarin/anticoagulants: Check INR values more frequently at the start.