Ozempic is prescribed through online medical consultations.
Manage your weight effortlessly with a once-weekly self-injection. Consultations are available daily from 9:00 to 22:00, with same-day shipping available.
What is the diet drug Ozempic?
Ozempic is a type of medication originally used to treat diabetes, known as a GLP-1 receptor agonist. "GLP-1" is a type of hormone called incretin, which promotes the secretion of insulin, a hormone that lowers blood sugar. While GLP-1 is a substance naturally present in our bodies, introducing it externally as a GLP-1 receptor agonist not only helps regulate blood sugar but also suppresses appetite and makes you feel full more easily. As a result, you can reduce your food intake, which can lead to weight loss.
Ozempic was approved by the FDA (U.S. Food and Drug Administration) in 2017 and is used worldwide. It is also approved and sold in Japan for type 2 diabetes.
About the 2mg type (adjustable dose)
Ozempic starts with a dose of 0.25mg once a week, then increases to 0.5mg, and then 1.0mg.
Conventional Ozempic subcutaneous injections were available in three strengths—0.25mg, 0.5mg, and 1.0mg—with each dose in a separate syringe. This meant that unused medication could be wasted if the dose needed to be changed partway through.
Currently, there is a type containing 2mg in one pen, allowing you to inject only the necessary dose by adjusting the dial yourself. Additionally, the previous type required injecting the entire pen, which contained a larger volume of medication. Concerns were raised that many patients experienced pain due to the thicker needle (approximately 0.33mm) attached to the device. Now, the volume of medication injected per dose is reduced, and thinner needles (approximately 0.18mm), such as 32G or 34G, can be used (needles are sold separately). Our clinic offers this 2mg type.
How to use Ozempic
How to increase the dose
| Dose | Purpose | Next step |
|---|---|---|
| 0.25mg | Initial dose to acclimatize the body. This period is to minimize gastrointestinal symptoms. | Continue for 4 weeks, then increase to 0.5mg |
| 0.5mg | Dose at which effects become apparent | If the effect is insufficient, wait at least 4 weeks, then increase to 1.0mg |
| 1.0mg | Maintenance dose. This dose has the greatest weight loss effect. | ― |
The timing for increasing the dose will be determined by your doctor, based on changes in your weight and the presence of gastrointestinal symptoms. Do not increase the dose on your own.
Administration method
Ozempic is a GLP-1 receptor agonist administered once a week.
The injection site should always be in the subcutaneous area (a fatty area). If there are no wounds or implants, the abdomen is generally the easiest site for most people. Inject approximately three finger-widths away from the navel. Shifting the injection site slightly each time can help reduce stress on the same area.
Storage method
Before first use, store in a refrigerator (2-8°C). Do not freeze. If frozen, the product cannot be used. After first use, store in the refrigerator or at room temperature (1-30°C) and use within 8 weeks. Avoid temperatures exceeding 40 degrees Celsius, such as direct sunlight or inside a car during summer, as this can alter the ingredients.
If you miss a dose
If you miss an injection and the period until your next scheduled injection is 2 days (48 hours) or more, inject immediately when you remember, and then continue with your regularly scheduled day. If the period until your next scheduled injection is less than 2 days (48 hours), do not inject at that time; instead, inject on your next regularly scheduled day. Do not inject two doses at once.
Column: Does Ozempic really maintain its effect for a full week?
Patients often ask, "Does Ozempic really maintain its effect for a full week?" The chart below shows the blood concentration of semaglutide from the day of administration to 7 days later in individuals using Ozempic 0.5mg and 1.0mg. The blood concentration does not drop sharply in the latter half of the administration period; instead, it follows a gentle curve, indicating that the GLP-1 effect is gently maintained even with weekly administration.
What are the effects of Ozempic? How much weight can you lose and in what timeframe?
Study ①: Weight loss in individuals with type 2 diabetes (SUSTAIN 1)
This study involved individuals with type 2 diabetes who were managing their condition solely through diet and exercise. They were administered semaglutide 0.5mg, 1.0mg, or a placebo (inactive substance) and followed for 30 weeks. This was a large-scale clinical trial conducted in 72 countries, including Japan. The chart below tracks the changes in weight.
Compared to the placebo group, the semaglutide group showed significant weight loss starting from 4 weeks after administration. At the 30-week mark, the average weight reduction from baseline was 3.73kg for the semaglutide 0.5mg group and 4.53kg for the 1.0mg group. Considering that the placebo group only saw a 0.98kg reduction, it can be said that the weight loss effect of semaglutide is clearly evident.
Study ②: Weight loss in obese individuals without diabetes
This study investigated subcutaneous semaglutide administration in obese individuals (without diabetes) with a BMI between 30 and 45. When comparing the group that gradually increased their dose from 0.25mg to 0.5mg to 1.0mg with the placebo group, the placebo group showed no weight loss after 12 weeks (in fact, they gained 1kg). In contrast, the semaglutide group experienced approximately 5kg of weight loss (Figure A).
Furthermore, this study gathered participants who had received treatment for 12 weeks and allowed them to eat freely during lunch, dinner, and snack times, while also observing their calorie intake. As a result, the semaglutide group showed reduced calorie intake in all situations compared to the placebo group (Figure C). Also, looking at the content of the food consumed, the semaglutide group showed a decrease in high-fat food consumption (Figure D).
Study ③: Comparison of Ozempic and Trulicity (SUSTAIN 7)
GLP-1 preparations can be categorized by their active ingredients, such as semaglutide, liraglutide, and dulaglutide. Ozempic (injection) and Rybelsus (tablet) contain "semaglutide," Victoza (injection) and Saxenda (injection) contain "liraglutide," and Trulicity (injection) contains "dulaglutide." The following study compares semaglutide and dulaglutide.
SUSTAIN 7 was a large-scale clinical trial (Phase 3b) involving 16 countries and 194 hospitals. It included 1,201 individuals with type 2 diabetes who were only prescribed metformin. They were administered either semaglutide 0.5mg, 1mg, dulaglutide 0.75mg, or 1.5mg for 40 weeks.
Weight changes began to show differences around 4-8 weeks after administration, and ultimately, semaglutide resulted in greater weight loss than dulaglutide. At 40 weeks, the average weight change was a reduction of 4.6kg for semaglutide 0.5mg, 2.3kg for dulaglutide 0.75mg, 6.5kg for semaglutide 1mg, and 3.0kg for dulaglutide 1.5mg. In both low-dose and high-dose comparisons, the semaglutide group showed higher weight loss efficacy.
While appetite suppression is seen early, this is not a drug for rapid, significant weight loss in the short term.
As indicated by the research results above, while Ozempic's appetite-suppressing effects appear early, it is not a medication for rapid, significant weight loss in the short term. Most clinical trials also publish their results over a period of 12 weeks (3 months) to 1 year. Although individuals without diabetes tend to experience greater weight loss, if dietary and exercise therapies are not considered at all, the results will be slower to appear.
If you are looking to lose weight efficiently while using GLP-1 as support, please also incorporate dietary and exercise therapies.
You can start today with a once-a-week injection, making it easy to continue.
I'm using Ozempic but not losing weight! What should I do?
Re-evaluate your entire lifestyle
-
Check if you have continued for a sufficient period. It is said that it takes about 2 weeks for the body to get used to a suppressed appetite and adapt to a smaller food intake. If you stop within 2 weeks, your appetite and food intake may return before your body has adjusted to less food, making it easier to rebound. Just as losing weight by reducing food intake for one day does not happen immediately, using medication to naturally suppress appetite does not lead to immediate weight loss. To lose weight at a manageable pace, an effect evaluation is typically needed around 3 months. Even if you don't see weight loss in a week, please try to continue without giving up.
If you have urgent plans or have continued for a long time in the past without losing weight, please consult our official LINE for advice on achieving the maximum effect within a safe range. - Check if you are eating a balanced diet. GLP-1 works by suppressing appetite and is not a nutrient like a supplement. While you should need less food than usual, the effect will be diminished if your diet is high in fats and sugars or is unbalanced.
- Incorporating moderate exercise will also make it easier to lose weight. If you only continue with injections without any exercise, the rate of weight loss will be gradual. Incorporating aerobic exercise, such as walking, can increase muscle strength and boost your basal metabolism, making it more efficient.
What are the side effects of Ozempic?
The most common are gastrointestinal symptoms
Among the side effects of Ozempic, gastrointestinal disorders are the most frequent. Nausea and diarrhea, in particular, are reported to occur with a frequency of over 5%. This is considered a temporary intensification of the drug's inherent action, and if not extremely severe, symptoms often gradually subside within 2-3 weeks with continued use.
Hypoglycemia is reported to be rare.
GLP-1 is a hormone that promotes insulin secretion to lower blood sugar when blood sugar levels rise. Therefore, GLP-1 receptor agonists, including Ozempic, which mimic this action, are considered medications unlikely to cause hypoglycemia.
In the SUSTAIN 1 results below, there were 0 reports of hypoglycemia in semaglutide users and 3 in placebo users. Of course, reports are not zero, and if you restrict carbohydrates too much or exercise excessively, hypoglycemia can occur even without medication. Avoid extreme diets and follow the correct usage and eating habits to significantly reduce the risk of hypoglycemia.
There are also reports of acute pancreatitis (inflammation of the pancreas) occurring at a frequency of 0.1%. While the conclusion of this overseas study is that the causal relationship with GLP-1 receptor agonist use is unclear, please keep it in mind as a potential risk. If you experience severe abdominal pain after use, please contact us immediately.
Comparison of side effects in clinical trials (SUSTAIN 1)
This is a modified Japanese table excerpted from the "Safety of Semaglutide" paper published in 2021, which discusses the safety of semaglutide based on the results of over 20 clinical trials, including the SUSTAIN 1 study mentioned in the effects section above.
In the semaglutide administration group, there were 0 reports of hypoglycemia, which is lower than the placebo group. Furthermore, there were 0 reports of pancreatic disease, thyroid disease, or acute kidney injury. The most frequently reported side effects were gastrointestinal symptoms, with nausea reported by 8% of the placebo group, compared to 20% in the semaglutide 0.5mg group and 24% in the 1mg group.
Symptoms requiring immediate contact
- Acute pancreatitis: Severe pain from the pit of the stomach to the back, persistent nausea and vomiting
- Cholecystitis/gallstones: Pain in the upper right abdomen, fever, yellowing of skin or whites of eyes
- Hypoglycemia: Cold sweats, intense hunger, trembling hands, disorientation
Who cannot use it / who needs caution
- Those with a history of medullary thyroid carcinoma or family history thereof, or those with Multiple Endocrine Neoplasia type 2
- Those with a history of pancreatitis
- Pregnant or breastfeeding individuals, or those planning pregnancy
- Individuals with type 1 diabetes, or those with diabetes using insulin or SU drugs (increases the risk of hypoglycemia)
- Those with severe gastrointestinal disease, or those who have been told they have slow gastric motility
- Those with a history of eating disorders
- Individuals under 18 years of age
For those with scheduled gastroscopy or surgery
GLP-1 medications slow down gastric motility, requiring caution during examinations or surgeries involving anesthesia. Please inform us in advance if you have any scheduled endoscopic examinations or surgeries. Also, inform the medical institution performing the examination or surgery that you are using Ozempic. A temporary discontinuation of the medication may be necessary.
Differences from other GLP-1 preparations
There are several options for GLP-1 receptor agonists. You can choose according to your lifestyle and goals.
| Drug (Ingredient) | Usage | Features |
|---|---|---|
| Ozempic (Semaglutide) | Once-weekly subcutaneous injection | Only once a week, no restrictions on timing of administration |
| Rybelsus (Semaglutide) | Once-daily oral medication | For those who dislike injections. Take upon waking, on an empty stomach. |
| Mounjaro (Tirzepatide) | Once-weekly subcutaneous injection | Acts on both GLP-1 and GIP, tends to have a greater weight loss effect. |
| Victoza (Liraglutide) | Once-daily subcutaneous injection | A daily injection type. Dosage is gradually increased from a small amount. |
Victoza (liraglutide), administered once daily, is a medication that has been used since before the advent of once-weekly types. It is sometimes chosen by individuals who prefer to manage their dosage with a small, consistent daily rhythm. Our clinic primarily recommends once-weekly types (Ozempic and Mounjaro), but if you have a preference, please discuss it during your consultation.
Common side effects include gastrointestinal symptoms such as nausea, upset stomach, constipation, and diarrhea. These tend to appear when starting or increasing the dose and often lessen as the body adjusts over time. For all GLP-1 medications, confirmation of suitability and physical condition is required, and a doctor's diagnosis and prescription are prerequisites. Avoid self-medication and consult a doctor to determine which type is best for you.
Concomitant use with Metformin, SGLT2 inhibitors, and Xenical, which affect sugar and fat absorption, may also be considered.
Information on off-label use and private medical care
- Approval Status: Ozempic is a medication approved in Japan for the treatment of type 2 diabetes. Its use by individuals without diabetes for weight management is considered off-label use.
- Procurement Channel: We use domestically approved products procured through domestic pharmaceutical wholesalers. These are not individually imported products.
- Cost: Since it is off-label use, health insurance does not apply, and the full cost is borne by the patient (private medical care).
- Risks: In the case of off-label use, if side effects occur, the pharmaceutical side effect relief system may not apply. Please refer to the above for information on side effects.
- Efficacy: The degree of efficacy varies among individuals, and the same results are not guaranteed for everyone.
After purchase, we will conduct a medical interview and a video consultation with a doctor. If the doctor determines that prescription is possible, we will prescribe the medication. Please adhere to the correct usage methods and strive for sustainable weight management.
You can start today.
Frequently Asked Questions
Related pages
- Mounjaro (GLP-1/GIP Injection)
- Metformin (Supports Sugar Metabolism)
- SGLT2 Inhibitors (Sugar Cut)
- Xenical (Fat Cut)
- About Online Consultations／About Fees
References
(1) Ozempic Interview Form (Novo Nordisk Pharma)
(2) Sorli C, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1). Lancet Diabetes Endocrinol. 2017;5:251-260.
(3) Blundell J, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obes Metab. 2017;19:1242-1251.
(4) Pratley RE, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7). Lancet Diabetes Endocrinol. 2018;6:275-286.
(5) Smits MM, van Raalte DH. Safety of Semaglutide. Front Endocrinol. 2021;12:645563.
