For many people with type 2 diabetes, Ozempic is an excellent weekly treatment option to better manage blood sugar levels and improve HbA1c

There are different doses available, and which you take will depend on your health history and health goals, lifestyle, and reason for taking Ozempic. 

Figuring out how much Ozempic to take can take time, and it should always be a decision made jointly with your doctor. 

This article will explain everything you need to know about Ozempic dosing. 

Ozempic pen in front of a box of Ozempic pens

What dose do you typically start with?

If you’re new to Ozempic, or semaglutide in general, your doctor will want to start you on a low dose. This is because Ozempic may cause adverse side effects including nausea, vomiting, diarrhea, constipation, low blood sugar, and suppressed appetite, which can be difficult and debilitating. 

To minimize the likelihood of side effects, starting at a lower dose is the best way to make sure that your body is getting used to the medication without overwhelming your system. 

According to the manufacturer, a typical starting dose is 0.25 milligrams (mg) once per week for the first four weeks. 

If you are seeing improvements in blood sugar levels and insulin resistance without adverse side effects, your doctor may increase your dose after the first four weeks. 

“My doctor wasn’t too keen on prescribing it at first, but agreed we should try it for insulin resistance and gave me a 3-month prescription to start. That was 15 months ago.”

Stevie Cook, T1D (read about Stevie’s experience with Ozempic)

What is a normal Ozempic dose? 

There is no “normal” dose of Ozempic, per se, because that will vary by the patient. But there are specific increments that people take Ozempic in and they are as follows:

  • New to treatment: 0.25 mg once per week for the first four weeks
  • Ongoing treatment: 0.5 mg once per week starting on week five 

If blood sugar levels are still not under control with 0.5 mg once per week, your doctor may increase your dose.

How and when can you increase your dose? 

You most likely will not be able to increase your initial dose till after you’ve been on the medication for at least four weeks. 

At week five, your doctor may advise you to double your dose to 0.5 mg for four additional weeks. You should closely monitor your blood sugar levels and take note of any adverse side effects when increasing your dose. 

If you’re tolerating 0.5 mg well and not seeing improvements in blood sugar control, your doctor may advise an additional increase in your dose. 

Note that this will require a new prescription because a larger dose comes in a bigger semaglutide dosing pen. 

If you’re requiring a larger dose, your doctor may advise you to either take 1 mg or 2 mg once weekly. 

What is the right dose for me? 

This can only be determined between you and your doctor. Your dose may vary based on your health history, health goals, lifestyle, height, weight, level of insulin resistance, diet, and daily activity level as well. 

In general, higher doses will yield more results such as lower blood sugar levels, weight loss, and improved A1Cs. 

However the higher the dose, the more likely you are to experience adverse side effects, such as nausea, vomiting, diarrhea, and low blood sugar levels, especially in the beginning when your body is getting used to the medication.

Keep this in mind as your scale up your doses, and only ever do so under the guidance of your doctor. 

What is the right dose for weight loss? 

First and foremost: Ozempic is not FDA-approved as a weight loss drug. However, studies show that Ozempic can and does help people lose weight. Since it is not FDA-approved as a weight loss drug, there is no official dose specifically to achieve weight loss. 

Ozempic will be more effective if you combine the therapy with healthy eating and exercise. If you’re concerned with your weight or are interested in losing weight, talk with your doctor as there are other weight loss drugs approved by the FDA that you can take if you have diabetes. 

Wegovy, the sister drug of Ozempic, is another semaglutide that has been approved by the FDA for weight loss. The weekly dose of that medication is 2.4 mg and can aid in weight loss if the plan of care is agreed upon between you and your doctor. 

What happens if I stop taking Ozempic?

Do not stop taking any diabetes medications without the guidance of your doctor. If you should happen to stop taking Ozempic, unfortunately, studies have shown, that regaining lost weight and higher blood sugar levels (and the accompanying insulin resistance) are likely. 

People who stop taking Ozempic gain back, on average, two-thirds of the weight they’ve lost while on the medication. 

If you are experiencing debilitating side effects, Ozempic doesn’t fit into your lifestyle, or your health insurance doesn’t cover the medication, talk with your doctor about alternatives that can be a good replacement for you. 

Are there different Ozempic pens? 

To make dosing easier, Ozempic is available in different dosing pens. They come in the following:

  • An injectable pen that delivers doses of 0.25 mg and 0.5 mg. The pen contains a total of 2 mg of Ozempic and can last between 1 and 2 months, depending on your dose
  • An injectable pen that delivers doses of 1 mg. This pen contains 4 mg of Ozempic and will last a patient 1 month
  • The largest pen delivers doses of 2 mg. This pen contains 8 mg of Ozempic and will last a patient 1 month

Note that if you jump from 0.5 mg to 1 mg or from 1 mg to 2 mg, your doctor will need to write you a new prescription for a larger dose. 

What is the strongest Ozempic? 

All of the Ozempic pens contain the same exact active ingredient, semaglutide, and the larger dosing pens do not have a stronger formulation of the drug. 

When people increase their dose of Ozempic, they are just increasing the amount they take per week. 

What do I do if I forget to take my dose? 

If you miss a dose of Ozempic, take it as soon as possible within 5 days of your missed dose. If you miss a dose for more than 5 days, skip that week and continue taking your Ozempic on your regular schedule. 

Missing one dose will not significantly affect your blood sugar levels or insulin resistance. 

What is the maximum weekly dose? 

The maximum dose of Ozempic is 2 mg, administered once weekly on the same day and at the same time. It can be taken both with and without food. 

You can change the day of the week that you take Ozempic, as long as your last dose was taken 2 or more days before

Never take more Ozempic than you are prescribed. If you overdose on Ozempic, you may experience debilitating side effects, including nausea, vomiting, and low blood sugar, which can be fatal (especially if you’re also on insulin). 

Monitor for signs and symptoms of extremely low blood sugar that include:

  • Dizziness
  • Confusion
  • Increased heart rate 
  • Shallow breathing
  • Shakiness 
  • Grogginess 
  • Fatigue
  • Unconsciousness 

Seek emergency medical attention immediately if you suspect that you’ve overdosed on Ozempic.