Ozempic (semaglutide): Overview, how it works, and more

Ozempic is one of the most talked-about medications right now. But beyond that, it’s also one of the most-talked about topics…period. A sort of cultural shorthand for any and all of the GLP-1 medications revolutionizing diabetes and obesity treatment, it’s in the news and on the minds of millions — for good reason. Numerous studies show just how effective it is. But what is Ozempic exactly? How do you take an Ozempic prescription? What are the side effects? Get the answers to those questions — and more — below.

What is Ozempic?

Ozempic is an injectable prescription medication that was approved to treat type 2 diabetes by the FDA in 2017. It is intended to be used alongside a healthy diet and exercise to help manage blood sugar. The active medication in Ozempic is semaglutide, which belongs to a class of drugs called glucagon-like peptide-1 receptor agonists, or GLP-1s.

Ozempic generic

The generic name for Ozempic is semaglutide, but you cannot purchase Ozempic as a generic medication at this time. The patent for Ozempic does not expire until 2026, after which generic versions may become available.

Ozempic uses

Many people tend to use the term Ozempic as a “catch all” for GLP-1 weight-loss medications, but it’s not actually approved for weight loss. (The brand name for the version of semaglutide that’s FDA-approved for weight loss is Wegovy.)

What is Ozempic used for?

Ozempic is used to manage blood sugar in adults who have type 2 diabetes. As a secondary benefit, many people also find that they lose weight when taking Ozempic. “Semaglutide has multiple [mechanisms] for glucose control as well as weight control,” says Dr. Devika Umashanker, M.D., a bariatric medicine physician with Hartford HealthCare Medical & Surgical Weight Loss in Glastonbury, CT.

According to Novo Nordisk, the manufacturer of Ozempic, 56 to 73 percent of people taking the medication lowered their A1C to under seven percent, depending on the dose taken. This is the American Diabetes Association’s recommended A1C goal for most patients managing diabetes. As for weight loss, one randomized controlled trial published in The Lancet Diabetes & Endocrinology found that people with diabetes taking a 2 mg dose (the largest Ozempic dose available) of semaglutide lost 15 pounds over a period of 40 weeks.

How does Ozempic work?

The active medication in Ozempic is semaglutide, a GLP-1 receptor agonist. GLP-1 is a hormone that naturally exists in your body. “When we eat, food goes down through our GI tract, which triggers the release of certain gut hormones. GLP-1 is one of these hormones, among many others,” explains Dr. Gitanjali Srivastava, M.D., Medical Director for Obesity Medicine at Vanderbilt University Medical Center.

Semaglutide mimics the effects of this GLP-1 hormone, but it lasts longer. It increases insulin secretion from the pancreas and decreases the secretion of glucagon, which lowers blood sugar levels. Semaglutide also slows “gastric emptying” (the movement of food out of your stomach), which helps you feel full longer, and sends signals to the satiety center of your brain that you’re not hungry. “GLP-1 is the satiety hormone,” explains Srivastava. “You’ll have less hunger and fewer cravings.” That’s what leads to weight loss. “To be able to have one medication that can have two benefits is pretty magnificent,” says Umashanker.

Ozempic dosage

Ozempic is available in four doses. You will likely start at the lowest dose for four weeks, which allows your body to acclimate to the medication, decreasing the risk of side effects. Under the guidance of your healthcare provider, you’ll then increase your Ozempic dosage until you reach a maintenance dose, which is one that is effective (manages your blood sugar well) and tolerable (causes the fewest side effects).

Forms and strengths

Ozempic is a once-weekly injectable medication. Those taking Ozempic use an injector pen to give themselves the medication at home. There is a recommended Ozempic dosing schedule, but your provider may tweak it depending on how your body is responding to the medication. Here’s how it tends to go:

• Weeks 0-4: 0.25 mg is the starting weekly dose
• Weeks 5-8: 0.5 mg weekly dose
• Weeks 9-12: 1 mg weekly dose, if recommended
• Weeks 13+: 2 mg weekly dose, if recommended

Ozempic side effects

Certain side effects are more likely than others when taking Ozempic, and there are things you can do to minimize them.

Common side effects

Side effects can happen to anyone taking Ozempic, but they tend to be worse when you first start taking the medication or go up in a dose. Some of the most common Ozempic side effects are:

• Nausea
• Constipation
• Reflux
• Vomiting

Reach out to your provider if you experience any of these, especially if they’re severe. They may be able to help if the side effects are difficult to control or are making life really tough. For example, they can reduce the dose or add in another medication to alleviate the symptoms, like a stool softener for constipation. “This is a collaborative and open conversation that we have with patients,” says Umashanker. “And if we don’t see symptoms resolved with a treatment plan, we have to assess if this is the right medication for you.” You can find the full list of side effects on the manufacturer's site.

Serious side effects

While Ozempic has been linked to a type of thyroid cancer called medullary thyroid carcinoma, this connection has only been shown in studies on animals, not humans. Still, if you have a personal or family history of medullary thyroid carcinoma, Ozempic is not right for you, says Umashanker.

There are a number of other potential serious complications that your provider may talk to you about, including:

• Acute gallbladder disease
• Acute kidney injury
• Diabetic retinopathy complications
• Hypersensitivity reactions (such as anaphylaxis)
• Hypoglycemia (low blood sugar)
• Pancreatitis

All of these won’t apply to everyone who is using Ozempic. That’s why it’s important to have an open discussion with your provider about your individual risks and how to best manage them.

Alternatives to Ozempic

Ozempic may be effective at blood sugar management, but that doesn’t mean it’s the best option for everyone. If your side effects are too severe or you’re having trouble accessing Ozempic due to barriers like insurance approval or shortages, there are alternatives for Ozempic you and your provider may consider, including these other GLP-1s approved for type 2 diabetes:

• Victoza (liraglutide)
• Trulicity (dulaglutide)
• Rybelsus (an oral version of semaglutide)
• Mounjaro (tirzepatide, which combines a GLP-1 with a second hormone, GIP)

The right choice for you depends on factors like your goals, medication preferences (such as injection versus oral), health history, and more.

Ozempic warnings and precautions

Ozempic is not right for everyone, and there are some people who should not take it. If you have a personal or family history of medullary thyroid cancer or have multiple endocrine neoplasia syndrome type 2, you should not take Ozempic. In addition, if you have had a serious hypersensitivity reaction to Ozempic or its ingredients, such as anaphylaxis, Ozempic is not right for you. And finally, Srivastana does not recommend Ozempic to patients who are trying to conceive or are pregnant or breastfeeding. If patients have a history of pancreatitis or gallstones, she also exercises caution before prescribing Ozempic to them.

Something else to know is that Ozempic can raise your risk for pulmonary aspiration during general anesthesia/deep sedation (this is when you inhale something into your airways, which can cause infection). Make sure your surgeon or other provider is aware that you’re taking Ozempic so they can advise you on how to stay safe, such as having you skip a dose before the procedure.

Ozempic interactions

Before starting any new medication, you’ll want to talk to your provider about other medications — over-the-counter and prescription — or supplements you’re taking since some can interact with Ozempic. For example, when Ozempic is taken with insulin secretagogues (such as sulfonylurea) or insulin, it can increase the risk of your blood sugar going too low, a condition called hypoglycemia. Your doctor will be able to tell you what to do, such as adjusting the dose of other diabetes medications you’re taking.

Ozempic cost and coupons

The cost of Ozempic hinges on your insurance coverage. Insurance plans may or may not cover Ozempic, so it’s important to connect with your insurance provider to see what your plan covers and what is needed to qualify for coverage.

Without insurance coverage, Ozempic can be expensive. The list price of Ozempic is currently $968.52 for any of the four doses, according to the manufacturer. With insurance, the price you pay will differ depending on factors like your deductible and copay. There is also a Patient Assistance Program for people who qualify, as well as a savings card that can reduce the price to $25 per prescription.

The bottom line

Ozempic is a medication used to treat type 2 diabetes. Its active ingredient, semaglutide, is a GLP-1 receptor agonist (the same class of drugs that includes tirzepatide and liraglutide). Ozempic improves insulin secretion, leading to better blood sugar management, and also results in weight loss due to its impact on appetite. There are potential side effects, many gastrointestinal in nature, and your provider will be able to give you tips on how to reduce them.