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 insufficiently controlled type 2 diabetes alongside diet and exercise: alone when metformin is inappropriate because of intolerance or contraindications, or added to other diabetes medicines. It is not authorised as a weight-management medicine in the EU. A weight-management indication for another semaglutide product must not be transferred to Ozempic. Any off-label prescribing decision requires individual clinical assessment.

The EU contraindication is allergy to semaglutide or an excipient. Pregnancy, breastfeeding and other precautions are discussed below. US thyroid-tumour contraindications must not be presented as the EU contraindication list; tell the doctor your full medical and family history.

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:

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. The 0.25 mg dose is not a maintenance dose. Take a missed dose within 5 days; after that, skip it and resume the usual weekly day. A change of weekly day requires more than 72 hours between doses.

Side effects

Ozempic may cause adverse effects; this list is not exhaustive.

Very common effects

Nausea and diarrhoea are very common (at least 1 in 10). Hypoglycaemia is also very common when used with insulin or a sulphonylurea.

Common effects

Vomiting, constipation, abdominal pain, bloating and indigestion are common (at least 1 in 100 but fewer than 1 in 10). Digestive symptoms often occur early in treatment. Persistent vomiting or diarrhoea can cause dehydration and worsen kidney function; seek advice if you cannot keep fluids down.

Symptoms requiring medical attention

• Persistent severe abdominal pain, sometimes extending to the back: stop treatment and seek urgent care for possible pancreatitis. Do not restart if pancreatitis is confirmed.
• Sudden loss of vision: seek urgent eye assessment. Semaglutide must be discontinued if non-arteritic anterior ischaemic optic neuropathy (NAION) is confirmed.
• Breathing difficulty or swelling of the face or throat: seek emergency care for a possible severe allergic reaction.
• Upper abdominal pain, fever or jaundice: seek assessment for gallbladder disease.
• Severe constipation with pain, bloating or vomiting: seek urgent assessment for possible intestinal obstruction.

Diabetic retinopathy may worsen, particularly with rapid glucose improvement. The doctor should arrange appropriate monitoring. Seriousness and frequency are different; these warnings do not share one frequency category.

Ozempic vs alternatives

Products differ in indication and dosing. This is not a ranking or a stock check.

For injectable Wegovy, 7.2 mg weekly is an option only for adults with an initial BMI ≥30 after at least 4 weeks at 2.4 mg weekly. It is not an Ozempic dose or an adolescent regimen. Wegovy also has separate oral product information; this table concerns the injection.

Results from trials using semaglutide 2.4 mg for weight management cannot be presented as expected weight loss with Ozempic. Products and doses are not interchangeable without a prescriber’s assessment.

Online assessment for Ozempic (Semaglutide)

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 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 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 pharmacy partner. Dispensing and delivery depend on the pharmacy, applicable rules and availability; neither a prescription nor this article guarantees supply.

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 are allergic to semaglutide or an ingredient.

Pregnancy and breastfeeding: do not use during pregnancy or breastfeeding. Stop at least 2 months before a planned pregnancy, with a clinical plan for diabetes management. Contact the prescriber if pregnancy occurs.

Tell the doctor about previous pancreatitis, retinopathy, kidney or liver disease, gallbladder disease, eating disorders and gastroparesis. Previous pancreatitis requires caution; it is not the EU contraindication. Use of semaglutide is not recommended in patients with severe gastroparesis. Ozempic is not insulin, and is not for type 1 diabetes or diabetic ketoacidosis. Use is not recommended with NYHA class IV heart failure.

No renal dose adjustment is required, but end-stage experience is limited; severe hepatic impairment requires caution. Safety and efficacy below 18 years have not been established. Retinopathy with insulin requires close monitoring; 2 mg is not recommended with uncontrolled or potentially unstable diabetic retinopathy.

Interactions and procedures: insulin or sulphonylurea doses may need clinician-led reduction to limit hypoglycaemia. Do not stop insulin yourself. Warfarin or other coumarin anticoagulants require more frequent INR monitoring when starting semaglutide. The studied oral contraceptives did not show a clinically relevant loss of exposure; delayed gastric emptying is not evidence that semaglutide reduces contraceptive efficacy. Discuss other oral medicines requiring rapid absorption. Tell the anaesthesia team before general anaesthesia or deep sedation because delayed stomach emptying can increase aspiration risk.

Dietary change and physical activity remain part of diabetes care. Follow the complete leaflet and your prescriber’s instructions.

In Spain, distance sale of prescription medicines is prohibited under Article 3.5 of Royal Legislative Decree 1/2015. An online assessment does not remove this restriction. Dispensing and access depend on the exact product and applicable national rules.

Sources

• EMA: Ozempic product information, sections 4.1–4.8.
• EMA: Wegovy product information, injectable sections 4.1–4.2.

This information does not replace individual medical advice or the complete product leaflet.