Ozempic
Ozempic, a brand name semaglutide drug, is an injectable medication that treats Type 2 diabetes. It has also been used off-label as a weight loss drug. Common, minor side effects include nausea, vomiting and diarrhea. The drug has a boxed warning for thyroid tumors.
What Is Ozempic?
Ozempic (semaglutide) is a prescription drug approved by the U.S. Food and Drug Administration to treat Type 2 diabetes. It is also used to reduce the risk of major cardiovascular events in adults with Type 2 diabetes who already have cardiovascular disease. It belongs to the glucagon-like peptide 1 (GLP-1) receptor agonist class of medications.
The drug isn’t FDA-approved to treat obesity, but some doctors have been prescribing it for off-label uses such as weight loss in people without Type 2 diabetes.
- Mounjaro (tirzapatide)
- Wegovy (semaglutide)
- Rybelsus (semaglutide)
- Saxenda (liraglutide)
- Victoza (liraglutide)
- Byetta (exanatide)
- Bydureon (exenatide extended release)
Along with diet and exercise, Ozempic is indicated to improve blood sugar in adults with Type 2 diabetes. It may also reduce the risk of major strokes, heart attacks or death in people who already have heart disease.
People with Type 1 diabetes shouldn’t use this drug, and studies haven’t shown if Ozempic is safe in children under 18 years of age.
How Does Ozempic Work?
Ozempic is a once-a-week injection that works in the pancreas, liver and stomach to reduce blood sugar. According to Novo Nordisk, Ozempic is designed to respond when your blood sugar rises by working with the body’s natural processes to lower sugar levels.
- When your blood sugar is high, Ozempic helps the pancreas make more insulin.
- Ozempic slows the food leaving the stomach.
- Ozempic prevents the liver from creating too much glucose and releasing it into the blood.
Dosages for Ozempic include 0.5 mg, 1 mg or 2 mg. Doctors will adjust the dose depending on a person’s need for blood sugar control.
Using Ozempic Correctly
Before you use Ozempic for the first time, your health care provider will show you how to inject it. The patient information that comes with your medication also has tips on how to use Ozempic correctly.
- Inject Ozempic under the skin in the thigh, upper arm or stomach. Don’t inject Ozempic into your muscle or vein.
- You can use Ozempic with or without food.
- Ozempic should be injected one time each week. Take your dose at the same time of day and the same day each week.
- If you miss a dose, take the next dose as soon as you remember it as long as it’s five days before your next dose. If it’s beyond five days, wait until it’s time for your next scheduled dose.
- If you are using insulin, don’t inject Ozempic and insulin next to each other, and don’t mix insulin and Ozempic together in the same injection.
- Change the spot where you inject Ozempic each week.
- Get regular checkups to monitor your blood sugar.
- Don’t change your diet or exercise plan without talking to your doctor.
- Don’t share Ozempic injector pens with other people.
- Be aware of the signs of low or high blood sugar and tell your health care provider right away if you experience symptoms.
If you have any questions about correct Ozempic use, make sure to ask your health care provider or pharmacist.
Ozempic Side Effects
Common, mild Ozempic side effects such as nausea, stomach upset or constipation usually go away after your body gets used to the medication. If any of these persist or are bothersome, make sure to tell your health care provider right away.
- Abdominal Pain
- Constipation
- Diarrhea
- Nausea
- Vomiting
Nausea, vomiting and diarrhea increased in patients taking the 1 mg dose versus the .5 mg dose of Ozempic. More patients in clinical trials who experienced gastrointestinal issues discontinued treatment versus people who took a placebo.
Less Common Side Effects
Novo Nordisk said it received reports of less common, more serious side effects such as hypersensitivity, rash, swelling and gallbladder issues in post-marketing reports. However, because these reports are voluntary, the drug maker can’t definitively link these adverse events directly to Ozempic.
- Allergic reactions
- Changes in blood work
- Dizziness
- Fatigue
- Gallstones
- Hypoglycemia
- Increase in heart rate
- Injection site reactions
Ozempic delays gastric emptying, which means it slows the speed at which food moves through the stomach. Some patients reported gastroparesis after taking Ozempic. This means food moved very slowly or stopped moving through the stomach and into the small intestine. The drug’s warning label doesn’t mention this potential side effect.
Acute gastroparesis may cause severe vomiting, abdominal pain, problems digesting food, feelings of constant fullness and malnutrition. It can lead to hospitalization. Some patients have filed Ozempic lawsuits claiming Novo Nordisk failed to warn that Ozempic could lead to this severe side effect. One claim named both Ozempic and Mounjaro as the cause of severe gastrointestinal side effects.
Ozempic Precautions & Interactions
Ozempic’s drug label includes several precautions and drug interaction warnings, such as a boxed warning for thyroid tumors and cancer. In animal studies, researchers found semaglutide caused dose-dependent thyroid C-cell tumors and medullary thyroid carcinoma.
However, researchers don’t know if these findings are the same in humans. People at risk for MTC shouldn’t use Ozempic.
- Ozempic may harm a fetus. Pregnant women shouldn’t use Ozempic unless the benefits outweigh the risks.
- Patients taking GLP-1 receptor agonists such as Ozempic have reported kidney injuries and renal failure that may require hemodialysis.
- One Ozempic patient had a confirmed case of chronic pancreatitis. Symptoms include severe abdominal pain that radiates to the back that may or may not be accompanied by vomiting.
- Patients in clinical trials with Type 2 diabetes and a higher risk of cardiovascular problems who took Ozempic had more incidents of diabetic retinopathy compared to those who took a placebo.
Ozempic may interact with insulin or a sulfonylurea and increase the risk of hypoglycemia. Doctors may have to reduce the dosage of these drugs when starting Ozempic treatment if a patient has to take them together with Ozempic.
Because Ozempic slows the movement of food through the stomach it may affect how well a person absorbs oral medications. In clinical trials, Ozempic didn’t affect absorption to a “clinically relevant degree,” but people who take other medications should talk to their doctor about any risks.
Ozempic for Weight Loss & Other Off-Label Uses
Ozempic is not approved for weight loss, but some doctors prescribe it for this off-label use. Off-label prescribing is allowed by the FDA with a doctor’s discretion. According to a study published in June 2023 in The Lancet, Ozempic has been shown to help a person lose about 15% of their body weight
Off-label use of a drug can be risky. There are no clinical trials to prove the safety and efficacy of using Ozempic for weight loss. However, Novo Nordisk makes another semaglutide drug, Wegovy, that the FDA has approved for weight loss.
Wegovy and Ozempic are both semaglutides, but they have slightly different dosages for what the FDA approved them for. A person must have a body mass index of 30 or above or have a BMI of 27 along with additional health risks to qualify for a Wegovy prescription. Doctors may use the same criteria to prescribe Ozempic off label.
Ozempic Shortage
High demand has led to an Ozempic shortage. Many celebrities have talked about using Wegovy to lose weight, and this has led to a Wegovy shortage. In the absence of Wegovy, weight loss patients have turned to Ozempic.
As of August 2023, the Ozempic shortage had not yet abated, and manufacturers couldn’t keep up with demand. In addition to high demand, there is no generic Ozempic. In fact, in 2022, Novo Nordisk sued several generic manufacturers that applied for FDA approval to make generic Ozempic.
In June 2023, Novo Nordisk also sued some pharmacies, medical spas and weight loss clinics that tried to sell generic Ozempic and Wegovy because semaglutide is still under patent. Brand name Ozempic costs an average of $1,000 a month. Currently, most insurance plans don’t cover Ozempic for weight loss.
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