Ozempic dosing schedule in Canada

Strengths and form

Ozempic is a solution of semaglutide for injection under the skin. It comes in a pre-filled, multi-dose, disposable pen.

The product monograph lists three strengths of the solution: 0.68 mg/mL, 1.34 mg/mL and 2.68 mg/mL.

One carton holds 1 pen. Disposable needles are included in the package.

The product monograph lists six variants of the pen. They deliver three kinds of dose:

• A pen that delivers doses of 0.25 mg or 0.5 mg. It contains 2 mg of semaglutide (4 or 6 doses) or 4 mg of semaglutide (8 doses).
• This pen is for dose escalation and for maintenance treatment at the 0.5 mg dose.
• A pen that delivers 1 mg doses. It contains 4 mg of semaglutide (4 doses) or 8 mg of semaglutide (8 doses).
• This pen is for maintenance treatment at the 1 mg dose only.
• A pen that delivers 2 mg doses. It contains 8 mg of semaglutide (4 doses).
• This pen is for maintenance treatment at the 2 mg dose only.

Starting dose and dose steps

The recommended starting dose is 0.25 mg once weekly. The product monograph says that 0.25 mg is not a therapeutic dose.

After 4 weeks, the dose should be increased to 0.5 mg once weekly.

If additional glycemic control (blood sugar control) is needed after 4 weeks, the dose may be increased to 1 mg once weekly.

If additional glycemic control is needed after 4 weeks, the dose may then be increased to 2 mg once weekly.

The patient information in the product monograph says: talk to your doctor before you increase your dose. Do not change your dose unless your doctor has told you to.

Maintenance and maximum dose

The maximum recommended dose is 2 mg once weekly.

The product monograph describes pens for maintenance treatment at the 0.5 mg dose, the 1 mg dose and the 2 mg dose.

For patients with renal insufficiency, type 2 diabetes and chronic kidney disease, the product monograph gives 1 mg once weekly as the maintenance dosage. The increase comes after at least 4 weeks on the 0.5 mg dosage.

The product monograph says that no dose adjustment is required based on age. Ozempic is not indicated for pediatric use (under 18 years of age).

Do not stop Ozempic without talking to your doctor. If you stop, your blood sugar levels may increase.

How and when to inject

Ozempic is given once weekly, at any time of the day, with or without meals. It should not be given daily.

The patient information says to use Ozempic on the same day each week if possible.

The day of the weekly injection can be changed if necessary. The time between two doses must be at least 2 days (more than 48 hours).

Ozempic is injected under the skin of the abdomen, the thigh or the upper arm. Do not inject it into a vein or a muscle.

The product monograph says to rotate injection sites with each dose. Do not use the same site for each injection.

Look at the solution before use. It should appear clear and colourless.

Before you use the pen for the first time, your doctor or Diabetes Nurse Educator shows you how to use it.

The product monograph says that patients should not administer the full volume of the pen at any time.

Missed dose

A missed dose should be given as soon as possible within 5 days after the missed dose.

The patient information in the product monograph gives two cases:

• It is 5 days or less since the day of the missed dose: use Ozempic as soon as you remember. Then inject your next dose as usual on your scheduled day.
• It is more than 5 days since the day of the missed dose: skip the missed dose. Then inject your next dose as usual on your scheduled day.
• In both cases: do not take an extra dose or increase the dose to make up for a missed dose.

Ask a health professional

This page repeats what the Canadian product monograph says. It is not medical advice. Ask your pharmacist or your prescriber what applies to you.