How to inject semaglutide: A complete guide for beginners

Key Points

• Semaglutide (Ozempic, Wegovy, Rybelsus) is a GLP-1 medication that helps manage blood sugar and weight
• Proper injection technique ensures maximum effectiveness and minimizes side effects
• Consistency with weekly dosing significantly improves your chances of seeing positive results

Starting semaglutide injections might feel intimidating at first. You might be wondering if you're doing it right, whether it will hurt, or how to make sure you're getting the full benefits of your medication.

You're not alone in these concerns. With a little practice, giving yourself a semaglutide injection can become a quick, simple part of your weekly routine.

Let's walk through everything you need to know to inject semaglutide properly and confidently.

What is semaglutide & how does it work?

Before diving into injection techniques, let's understand what semaglutide is and how it works in your body.

Semaglutide belongs to a class of medications called GLP-1 receptor agonists. These drugs work by mimicking a hormone in your body (GLP-1) that helps regulate blood sugar and hunger signals.

When you inject semaglutide, it:

• Slows down digestion so you feel full longer
• Reduces appetite and food cravings
• Helps your pancreas release insulin when blood sugar is high

Unlike many medications, semaglutide only needs to be injected once weekly rather than daily. This is because it has a half-life of about seven days, meaning it stays active in your system for about a week.

Semaglutide is available under several brand names: Ozempic (FDA-approved for type 2 diabetes), Wegovy (FDA-approved for weight management), and Rybelsus (an oral form for type 2 diabetes, not injected).

Essential supplies for your semaglutide injection

Before your first semaglutide injection, gather your semaglutide pen (checking the expiration date), a new pen needle (never reuse needles!), an alcohol swab, a cotton ball or tissue (optional), and a sharps container for disposal.

Proper storage of semaglutide

Store unopened pens in the refrigerator (36°F to 46°F or 2°C to 8°C). Never freeze them and keep away from direct heat and light.

After first use, your pen can be stored at room temperature (below 86°F or 30°C), should be used within 56 days (eight weeks), and should not be refrigerated once in use.

Step-by-step guide: How to inject semaglutide properly

The injection process can be broken down into four simple stages:

1. Prepare your pen: Wash your hands thoroughly, check that the liquid is clear and colorless, and let a refrigerated pen reach room temperature for 15-20 minutes. Remove the pen cap, attach a new needle, prime the pen if it's new (following manufacturer instructions), and dial your prescribed dose.
2. Choose and clean your injection site: Semaglutide should be injected subcutaneously in your abdomen (at least 2 inches from your belly button, avoiding the waistline), thigh (the outer side of your upper thigh, avoiding the inner thigh, or upper arm (the back fatty portion, halfway between your shoulder and elbow).

Once you've selected your site, clean it with an alcohol swab and let it dry completely.

1. Inject the medication: Gently pinch a fold of skin at the cleaned site, insert the needle at a 90-degree angle, press the dose button fully while counting to 6, then remove the needle while keeping the button pressed.
2. Dispose of the needle: Finally, after injecting, dispose of the used needle in a sharps container immediately and store your pen properly until the next use.

You can note your injection site for future rotation and mark your calendar for your next dose to ensure you don’t miss it.

Be sure to rotate your injection sites to prevent tissue damage, as research shows that reusing injection sites can lead to lipohypertrophy which can impair medication absorption.

Your semaglutide dosing schedule

What if I miss a semaglutide dose?

If you forget your weekly dose, don't panic. There is, luckily, some flexibility in how often you can take your semaglutide dose (though of course, it’s best to aim for consistency).

If it's been less than 5 days since your scheduled injection:

• Take it as soon as you remember
• Continue your regular weekly schedule from the new day

If it's been 5 days or more:

• Skip the missed dose
• Take your next injection on your regular scheduled day

Never take a double dose to make up for a missed one.

Changing your weekly injection day

If you need to change which day of the week you inject, make sure at least 48 hours (2 days) have passed since your last injection, then begin your new schedule. This waiting period helps maintain proper medication levels in your body.

Best time of day to inject semaglutide

The best time to take your dose is whenever is most convenient for you. Consistency is the most important thing here. The actual timing of the dose doesn’t appear to affect the medication’s efficacy. Set an alarm to remind yourself of when to take the medicine so you don’t miss your dose day, but don’t stress too much about the actual timing.

Minimizing semaglutide side effects

Reducing injection pain

Good news is, semaglutide is generally not that painful to inject. Patients report other injectable medications being much more uncomfortable.

To further minimize any discomfort:

• Let the pen reach room temperature before injecting
• Ensure the alcohol is completely dry before inserting the needle
• Relax the muscle in the injection area
• Use a fresh needle every time
• Try taking some deep breaths before injecting if you’re nervous

When it comes to preparing for your first few injections, “I usually remind my clients to stay hydrated, focus on fiber and protein, and ask a partner for help if they need support,” says Sarah Logan, RD. 

“I also like to remind clients of the importance of eating enough on GLP-1s. Eating enough is essential for energy so that they can still work out and let the medication help their body aid them in fat loss (rather than trying to eat as little as possible).”

Managing common GI side effects

The most common side effects of semaglutide are gastrointestinal issues like nausea, vomiting, and diarrhea. These typically occur during dose escalation (as you slowly increase to your maximum dose) and are usually mild to moderate and temporary.

To help manage these side effects, follow the prescribed dose-escalation schedule exactly – it's specifically designed to reduce GI effects. Eat smaller, more frequent meals rather than large ones. Stay well-hydrated throughout the day. Avoid greasy, spicy, or very sweet foods. Consider taking your injection before bedtime if you notice nausea afterward.

When to contact your doctor about side effects

Most side effects should diminish within the first several weeks of starting the medication. While they may be uncomfortable, they should not be unbearable, nor are they likely to be dangerous.

If your side effects are unmanageable, reach out to your doctor. Do not stop taking semaglutide without your provider’s guidance.

Preventing injection site reactions

Injection site reactions (redness, swelling) are very uncommon with semaglutide. Clinical trials showed only about 0.2% of semaglutide-treated patients reported any injection-site reaction.

To prevent any potential issues, always use a new needle, clean the skin properly before injecting, rotate injection sites regularly, and never inject into areas that are bruised, scarred, or irritated.

Common questions about semaglutide injections

How to properly inject semaglutide?

Ensure your semaglutide injection is correct with these steps:

1. Prepare the pen with a new needle and dial your prescribed dose
2. Clean the injection site (abdomen, thigh, or upper arm) with an alcohol swab
3. Gently pinch a fold of skin
4. Insert the needle straight into the fold at a 90-degree angle
5. Press the dose button fully and hold for 6 seconds
6. Remove the needle and properly dispose of it in a sharps container

Is there a wrong way to inject semaglutide?

Yes, it is possible to inject semaglutide wrong. Common mistakes include injecting into muscle instead of fat, reusing needles, not rotating sites, injecting cold medication, and not holding the button down long enough. The most problematic mistake is repeatedly using the exact same spot, which can cause fatty lumps that interfere with medication absorption.

What happens if you inject semaglutide too close to the belly button?

Injecting too close to your belly button (less than 2 inches away) can be more painful and may lead to improper absorption. This area has less fat and more nerves, increasing the risk of hitting muscle instead of fat tissue. Always stay at least 2 inches away from your belly button.

How to make semaglutide more effective?

You have to be consistent with the weekly dosing and follow the recommended dose escalation schedule. But just as importantly, you have to make the necessary lifestyle changes to achieve lasting changes. This includes a balanced diet, regular physical activity, and adequate hydration.

“I help clients prep high protein smoothies and lower density meal options to prevent muscle loss,” says Sarah Logan, RD. “We also pick gut health supplements to manage constipation and prepare healthy snacks in case they need a pick-me-up for low blood sugar if they want to work out (or manage nausea).”

Be prepared to commit to the long-term – it takes several months to see significant results.

Can I mix semaglutide with insulin?

If you also take insulin, do not mix semaglutide and insulin in the same syringe. You can inject in the same general area (e.g., abdomen) but not the exact same spot. Keep at least an inch between injection sites. This ensures both medications work properly without interaction.

What results can I expect from semaglutide?

For diabetes management, semaglutide substantially improves glycemic control. Clinical trials show it lowers blood sugar and A1C levels below 7% (the recommended amount) for a significant number of patients.

Semaglutide can also promote meaningful weight loss. The high-dose formulation (Wegovy, 2.4mg) produces robust weight loss results:

• About 14.9% of body weight lost on average over 68 weeks
• More than half of patients achieved ≥15% weight loss
• Many saw improvements in blood pressure and lipid levels

Remember that results vary between individuals, and lifestyle factors play an important role alongside the medication.

These drugs do not work without significant lifestyle changes. In order to see results, you must adjust your diet and activity levels.

The importance of consistency with semaglutide

Sticking with your semaglutide schedule is crucial for getting the best results. And with semaglutide’s weekly injection schedule, you’re bound to succeed: Research shows that once-weekly regimens significantly improve patient adherence compared to daily medications.

Still, real-world data shows only about 39.1% of semaglutide users took ≥80% of their doses over 12 months. While this was better than many other GLP-1 medications, it highlights the challenge of maintaining consistency.

Tips to stay consistent with your weekly injections:

• Set a weekly reminder on your phone or calendar
• Keep your injection supplies together in an accessible place
• Track each injection in a journal or health app
• Choose a day when you have a consistent weekly routine

Achieve semaglutide success with a registered dietitian

Starting semaglutide injections may feel intimidating at first, but with practice, it becomes a simple part of your weekly routine. By following proper injection techniques, rotating sites, and maintaining consistency, you'll maximize the benefits of your treatment while minimizing side effects.

Remember that proper nutrition works hand-in-hand with semaglutide to help you achieve your health goals. If you're experiencing side effects or have questions about managing your diet while on semaglutide, consider working with a registered dietitian.

A dietitian can develop a personalized eating plan that helps minimize side effects and maximize the health benefits of your medication.

Ready to get the support you need?

Find a registered dietitian specializing in GLP-1 medications with Fay today.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.