Ozempic (Semaglutide)

What is Ozempic?

Ozempic (semaglutide) is a once-weekly injectable prescription medicine that belongs to the GLP-1 receptor agonist class. It is approved by the European Medicines Agency (EMA) for the treatment of type 2 diabetes in adults and is also used off-label by doctors for weight management in eligible patients.

How does Ozempic work?

Ozempic works by mimicking the action of glucagon-like peptide-1 (GLP-1), a naturally occurring hormone released by the gut after eating. When semaglutide binds to GLP-1 receptors throughout the body, it triggers several clinically significant responses:

• Appetite suppression: Signals in the brain’s hypothalamus reduce hunger and increase feelings of fullness (satiety), leading to reduced caloric intake.
• Slowed gastric emptying: Food moves more slowly from the stomach to the small intestine, prolonging the sensation of fullness after meals.
• Blood glucose regulation: Semaglutide stimulates insulin release from the pancreas in response to food and suppresses the release of glucagon, a hormone that raises blood sugar levels.
• Cardiovascular effects: Clinical data published by the EMA indicates that semaglutide reduces the risk of major adverse cardiovascular events in patients with type 2 diabetes and established cardiovascular disease.

Because the GLP-1 receptors targeted by semaglutide are distributed across multiple organ systems — including the brain, gut, heart, and pancreas — Ozempic’s effects extend beyond blood sugar control to include meaningful body weight reduction.

Who is Ozempic for?

Ozempic is indicated for adults with type 2 diabetes mellitus when diet and exercise alone are insufficient to achieve adequate glycaemic control. In clinical practice, independent doctors may also consider prescribing semaglutide off-label for weight management in adults who meet specific eligibility criteria, typically including:

• A body mass index (BMI) of 30 or above, or
• A BMI of 27 or above with at least one weight-related comorbidity such as hypertension, dyslipidaemia, or obstructive sleep apnoea

Ozempic is not appropriate for everyone. It is not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC), people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or those who are pregnant or planning to become pregnant. A full medical assessment by a qualified doctor is required before any prescription can be issued.

Dosage

Ozempic is administered once weekly by subcutaneous injection (under the skin of the abdomen, thigh, or upper arm). The standard titration schedule, as per EMA-approved prescribing guidance, is:

Phase	Dose	Duration
Starting dose	0.25 mg once weekly	4 weeks
Maintenance step 1	0.5 mg once weekly	At least 4 weeks
Maintenance step 2 (if needed)	1 mg once weekly	Ongoing or as directed
Maximum dose	2 mg once weekly	As clinically indicated

The starting dose of 0.25 mg is used to minimise gastrointestinal side effects during the initial weeks of treatment. Dose escalation should only occur under a doctor’s supervision. Patients should not adjust their dose without consulting their prescribing doctor.

Ozempic is available as a pre-filled injection pen. Injections can be given at any time of day, with or without food.

Side effects

As with all medicines, Ozempic may cause side effects. Not all patients experience them, and many resolve as the body adapts to the medication.

Common side effects (may affect more than 1 in 10 people)

• Nausea
• Diarrhoea
• Vomiting
• Constipation
• Abdominal pain or discomfort

These gastrointestinal effects are most common during the first weeks of treatment and typically become less severe over time. Eating smaller meals, avoiding high-fat foods, and staying well-hydrated may help manage them.

Less common but serious side effects

• Pancreatitis: Persistent severe abdominal pain that may radiate to the back. Stop treatment and seek immediate medical attention if this occurs.
• Gallbladder problems: Including gallstones (cholelithiasis) and cholecystitis. Report any upper-right abdominal pain, fever, or jaundice to a doctor promptly.
• Diabetic retinopathy complications: Reported in patients with pre-existing diabetic eye disease. Regular eye examinations are recommended.
• Hypoglycaemia: Risk is increased when semaglutide is used in combination with insulin or sulphonylureas.
• Acute kidney injury: Typically secondary to dehydration caused by gastrointestinal side effects.
• Allergic reactions: Serious allergic reactions, including anaphylaxis, have been reported rarely.

This is not a complete list of side effects. Refer to the EMA-approved product information for full prescribing details.

Ozempic vs alternatives

Several GLP-1 receptor agonists and weight management medicines are available in Europe. The table below provides a factual comparison for informational purposes only. A doctor must assess which, if any, of these medicines is appropriate for an individual patient.

Medicine	Active Ingredient	Form	Typical Dose	Approved Indication
Ozempic	Semaglutide	Weekly injection	0.5–2 mg/week	Type 2 diabetes (EU)
Wegovy	Semaglutide	Weekly injection	Up to 2.4 mg/week	Weight management (EU)
Saxenda	Liraglutide	Daily injection	Up to 3 mg/day	Weight management (EU)

Key differences:

• Ozempic vs Wegovy: Both contain semaglutide. Ozempic carries an EMA approval for type 2 diabetes at doses up to 2 mg. Wegovy is approved specifically for chronic weight management at a higher maximum dose of 2.4 mg. Clinical evidence supports greater average weight loss at the higher Wegovy dose.
• Ozempic vs Saxenda: Saxenda contains liraglutide, a different GLP-1 agonist that requires daily (rather than weekly) injections. Clinical head-to-head data indicates semaglutide (Ozempic/Wegovy) produces greater mean weight loss than liraglutide (Saxenda) over comparable treatment periods, per published clinical trial data referenced by the EMA.

How to get Ozempic online in Europe

Ozempic is a prescription-only medicine (POM) in all EU member states. It cannot be legally dispensed without a valid prescription from a licensed medical professional.

Prescrivia operates as a technology intermediary: we do not prescribe medicines, employ doctors, or sell medicines. Instead, our platform connects patients with independent EU-registered doctors who can conduct confidential online health assessments.

The process works as follows:

1. Complete a health assessment: Answer a structured set of health questions designed to capture relevant medical history, current medications, and treatment goals. This assessment is reviewed by an independent doctor.
2. Doctor review: An independent EU-registered doctor reviews your assessment. If semaglutide is clinically appropriate for you, they may issue a prescription. If it is not appropriate, the doctor will explain why.
3. Prescription and fulfilment: If a prescription is issued, it is sent to a licensed EU pharmacy partner. The pharmacy dispenses and ships the medicine directly to you.

Important: Prescrivia does not guarantee that a prescription will be issued. All prescribing decisions are made independently by qualified medical professionals based on your individual clinical circumstances.

Important safety information

Do not use Ozempic if you:

• Have a personal or family history of medullary thyroid carcinoma (MTC)
• Have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Are allergic to semaglutide or any other ingredient in Ozempic
• Are pregnant, planning to become pregnant, or breastfeeding

Tell your doctor before starting Ozempic if you have:

• A history of pancreatitis
• Diabetic retinopathy
• Kidney disease
• Liver disease
• Gallbladder disease
• A history of eating disorders

Drug interactions: Ozempic may interact with other medications, particularly insulin and sulphonylureas (risk of hypoglycaemia), and oral contraceptives (potential reduced absorption due to delayed gastric emptying). Always disclose all current medications to your doctor during the assessment.

Ozempic is not a substitute for lifestyle changes. Dietary modification and regular physical activity remain important components of any weight management or diabetes treatment plan.

Sources

Medical information on this page is based on the following sources:

• European Medicines Agency (EMA). Ozempic (semaglutide) — Summary of Product Characteristics. Available at: ema.europa.eu
• European Medicines Agency (EMA). Assessment report: Ozempic. EMEA/H/C/004174.
• World Health Organization (WHO). Obesity and overweight — Fact sheet. who.int
• Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. 2021;384:989-1002.

This content is reviewed periodically to reflect updated clinical guidance. It is provided for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for advice relevant to your individual health circumstances.