Learning how to inject Ozempic in the stomach correctly is essential for safe and effective diabetes management. Ozempic (semaglutide) is a once-weekly GLP-1 receptor agonist licensed in the UK for type 2 diabetes treatment. The abdomen offers a convenient, accessible injection site with ample surface area for proper site rotation. Mastering the subcutaneous injection technique ensures optimal medication absorption, minimises discomfort, and reduces the risk of injection-site complications. This guide provides step-by-step instructions aligned with UK clinical practice, covering preparation, injection technique, site rotation, and when to seek medical advice. Always receive initial training from your GP or diabetes specialist nurse before starting treatment.

Understanding Ozempic and Subcutaneous Injection

Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for the treatment of type 2 diabetes mellitus only. It is not indicated for type 1 diabetes, diabetic ketoacidosis, or solely for weight loss. It works by mimicking the action of the naturally occurring hormone GLP-1, which stimulates insulin secretion in response to elevated blood glucose levels, suppresses glucagon release, and slows gastric emptying. These combined mechanisms help improve glycaemic control and may contribute to weight reduction in some patients.

Ozempic is administered via subcutaneous injection, meaning the medication is delivered into the fatty tissue layer beneath the skin. It should never be injected into a vein or muscle. This route of administration allows for gradual absorption of the medication into the bloodstream, providing sustained therapeutic effects throughout the week. The pre-filled pen device is designed for once-weekly dosing, which enhances convenience and adherence compared to daily injectable therapies.

The stomach (abdominal) area is one of three recommended injection sites for Ozempic, alongside the thigh and upper arm. All three sites are equally suitable, and you should rotate between them. The abdomen is often chosen by patients due to its accessibility and relatively large surface area for site rotation. Understanding the proper technique for subcutaneous injection is essential for ensuring medication efficacy, minimising discomfort, and reducing the risk of injection-site reactions.

Before initiating Ozempic therapy, patients should receive comprehensive training from their GP, practice nurse, or diabetes specialist nurse. This training typically includes hands-on demonstration of the injection technique, pen operation, and guidance on safe disposal of used needles. The MHRA-approved patient information leaflet provides detailed instructions and should be reviewed carefully before each injection, particularly when starting treatment.

Preparing for Your Ozempic Injection

Proper preparation is fundamental to safe and effective Ozempic administration. Begin by gathering all necessary supplies: your Ozempic pen (stored in the refrigerator between 2°C and 8°C until first use), a new needle for each injection, an alcohol wipe, and a sharps disposal container. Once in use, the pen may be stored at room temperature (below 30°C) or continued in the refrigerator for up to 6 weeks (42 days), but should never be frozen. Always keep the pen cap on when not in use.

Before handling the pen, wash your hands thoroughly with soap and water to reduce infection risk. Remove the Ozempic pen from storage and allow it to reach room temperature naturally for approximately 15–30 minutes if refrigerated, as injecting cold medication may cause discomfort. Inspect the solution through the pen window—it should be clear and colourless. Do not use the medication if it appears cloudy, discoloured, or contains particles, and contact your pharmacist for a replacement.

Attach a new needle to the pen for each injection, following the manufacturer's instructions. Remove both the outer and inner needle caps carefully. Before your first use of a new pen, you must perform a flow check to ensure the pen is working correctly and to remove any air bubbles. Turn the dose selector to the flow check symbol, hold the pen with the needle pointing upwards, and press the dose button until the dose counter returns to zero. A drop of medication should appear at the needle tip.

Select your injection site on the abdomen, avoiding the area around your navel (belly button). Avoid injecting into areas with scars, bruises, moles, or skin that is tender, red, or hard. Clean the chosen site with an alcohol wipe using a circular motion, and allow the skin to dry completely before proceeding—this prevents stinging and reduces infection risk. Remember to always remove the needle after each injection and never store the pen with a needle attached. Never share your pen with anyone else, even if you change the needle.

Step-by-Step Guide to Injecting Ozempic in the Stomach

Once you have prepared your pen and selected your injection site, follow these steps for proper administration. Set your prescribed dose by turning the dose selector until the correct dose aligns with the dose pointer. The dose counter will display your selected dose. When starting Ozempic, you'll typically begin with 0.25 mg once weekly for 4 weeks, then increase to 0.5 mg once weekly. Your doctor may later increase your dose to 1 mg or 2 mg if needed. Always verify you have selected the correct dose before proceeding.

Position yourself comfortably, either sitting or standing, ensuring you have good visibility of the injection site. Using your non-dominant hand, gently pinch a fold of skin on your abdomen between your thumb and forefinger. This technique lifts the subcutaneous tissue away from the underlying muscle, ensuring the medication is delivered into the correct layer. The pinched area should be approximately 2–3 centimetres wide.

Insert the needle into the pinched skin at a 90-degree angle (straight in) using a swift, dart-like motion. This technique is generally less painful than a slow, hesitant insertion. Once the needle is fully inserted, press and hold the dose button firmly until the dose counter shows "0". This indicates the full dose has been delivered. Crucially, keep the needle in the skin and continue holding the dose button for at least 6 seconds after the counter reaches zero. This ensures complete medication delivery and prevents leakage.

After the 6-second count, release the dose button and withdraw the needle from your skin at the same angle it was inserted. Release the pinched skin fold. A small amount of bleeding at the injection site is normal—if this occurs, apply gentle pressure with a clean cotton ball or gauze for a few seconds. Do not rub the injection site, as this may affect medication absorption.

Immediately dispose of the used needle safely by carefully recapping it using the outer needle cap only (if your needle type allows), then removing the needle from the pen and placing it in an approved sharps container. Never reuse needles, as this increases infection risk and may cause needle blockage. If the dose counter stops before reaching 0, the needle may be blocked—change to a new needle and repeat the dose. Replace the pen cap and store the pen appropriately until your next dose.

Injection Site Rotation and Best Practices

Systematic injection site rotation is essential for maintaining healthy skin and ensuring consistent medication absorption. Repeatedly injecting into the same spot can potentially lead to changes in the fatty tissue under the skin, which may affect medication absorption and cause unpredictable blood glucose control.

When injecting into the abdomen, divide the area into quadrants (upper right, upper left, lower right, lower left), avoiding the area around the navel. Use a different quadrant each week, and within each quadrant, vary the exact injection spot. Some patients find it helpful to keep a simple diary or use a smartphone app to track injection sites and dates, ensuring they maintain an effective rotation pattern.

Best practices for injection technique include:

• Timing consistency: Administer Ozempic on the same day each week, though the time of day may vary. If you need to change your injection day, ensure at least 3 days (72 hours) have passed since your last dose.

• Missed doses: If you miss a dose and it has been less than 5 days, inject as soon as you remember. If more than 5 days have passed, skip the missed dose and resume your regular schedule. Never inject two doses within 3 days (72 hours).

• Needle length: 4mm needles are generally suitable for most adults. Your healthcare provider may recommend a specific length based on your body composition. Longer needles may require a skinfold technique or angled insertion.

• Injection depth: Always inject subcutaneously, not intramuscularly. If you are very lean, your healthcare provider may advise pinching the skin and injecting at a 45-degree angle to avoid muscle injection.

• Alcohol wipes: Allow the skin to dry completely after cleaning to prevent stinging and ensure the alcohol has effectively disinfected the area.

Regularly inspect your injection sites for any signs of reaction, including persistent redness, swelling, itching, or hard lumps. If you notice any concerning changes, discuss these with your GP or diabetes nurse, who may recommend adjusting your rotation pattern or investigating potential causes.

Common Side Effects and When to Seek Medical Advice

Gastrointestinal side effects are the most commonly reported adverse reactions with Ozempic, particularly during treatment initiation and dose escalation. These include nausea, vomiting, diarrhoea, abdominal pain, and constipation. These effects typically diminish over time as your body adjusts to the medication. To minimise gastrointestinal symptoms, eat smaller, more frequent meals, avoid high-fat foods, and stay well hydrated. If nausea is severe or persistent, contact your GP, as dose adjustment or anti-emetic medication may be appropriate.

Injection site reactions such as mild redness, itching, or swelling are generally minor and resolve spontaneously within a few days. Applying a cool compress may provide relief. However, if you develop severe pain, significant swelling, or signs of infection (increasing redness, warmth, pus), seek medical advice promptly. Rarely, allergic reactions may occur—if you experience widespread rash, difficulty breathing, or facial swelling, this constitutes a medical emergency requiring immediate attention via 999 or A&E.

Hypoglycaemia (low blood glucose) is uncommon with Ozempic monotherapy but may occur when used in combination with insulin or sulfonylureas. Symptoms include trembling, sweating, confusion, rapid heartbeat, and hunger. If you experience these symptoms, check your blood glucose if possible and treat with fast-acting carbohydrates (glucose tablets, sugary drink) as advised in your diabetes management plan. Discuss recurrent hypoglycaemia with your diabetes team, as medication adjustment may be necessary.

Seek urgent medical advice if you experience:

• Severe, persistent abdominal pain, particularly if radiating to the back, which may indicate pancreatitis—a rare but serious complication. Stop taking Ozempic and seek immediate medical care.

• Symptoms of thyroid tumours, including a lump in the neck, hoarseness, difficulty swallowing, or shortness of breath (though the relevance to humans remains uncertain, animal studies have shown thyroid C-cell tumours)

• Signs of diabetic retinopathy complications, such as sudden vision changes, particularly if you have pre-existing eye disease. This risk may be higher in those with pre-existing diabetic retinopathy, especially if on insulin treatment.

• Severe dehydration from persistent vomiting or diarrhoea, especially if you cannot maintain fluid intake

• Symptoms of gallbladder problems, including severe upper abdominal pain, fever, and yellowing of skin or eyes

Regular follow-up with your healthcare team is essential for monitoring treatment response, adjusting doses appropriately, and identifying any adverse effects early. NICE guidance recommends reviewing HbA1c levels, weight, and tolerability at regular intervals. Always report any concerns to your GP or diabetes specialist nurse, and never discontinue Ozempic without medical guidance, as this may affect your glycaemic control.

You can report any suspected side effects to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or via the Yellow Card app.

Frequently Asked Questions