Semaglutide (weekly injection)

Semaglutide (weekly injection) is taken as a weekly injection under the skin, and is started low and increased in steps. There are 6 steps in the schedule. Where a step has another above it, at least 28 days must pass before an increase can be requested; the last step is the maintenance dose and has nothing above it.

This page describes the medication in general. What you were prescribed, and where you are in the schedule, is in the app.

Keep it at 2–8 °C (36–46 °F).

It may sit at 8–30 °C (46–86 °F) for up to 28 days — the clock starts the first time you use it, or the first time it leaves the fridge — whichever happens first. After that it must be thrown away, even if it looks fine. Degraded medication does not look degraded.

• Do not freeze it. Keep it away from the back wall and the freezer compartment, where a domestic fridge often drops below zero.
• If it has frozen, throw it away and tell us — a peptide that has been frozen looks exactly like one that has not, and it no longer works reliably.
• Keep it in the carton until you use it. Light degrades it.
• Once it has been out of the fridge for its allowance, it is finished, even if it goes back in the fridge afterwards. The clock does not reset.
• Never use it past the expiry date printed on the carton.

• Check the name, the strength and the expiry date on the carton against what you were prescribed.
• Take it out of the fridge around 30 minutes before you inject. Cold liquid stings; this is for comfort, not a rule. Never warm it in hot water, a microwave, or on a radiator.
• Look at the liquid. It should be clear and colourless. Do not use it if it is cloudy, discoloured, or has anything floating in it.
• Wash your hands with soap and water and dry them.
• If your pen takes a separate needle, screw on a new one for this injection. If it is a single-dose pen the needle is already inside and hidden — you do not attach anything, and the whole pen is thrown away afterwards.
• Never re-use a needle. A used needle is blunt, which hurts more and damages the tissue under the skin, and it is no longer sterile.
• Use a new sterile syringe and needle for every dose. Wipe the rubber top of the vial with a fresh alcohol swab and let it dry before the needle goes in.
• Draw up exactly the volume written on your prescription — not "about" it. Then hold the syringe needle-up, tap it so the bubbles rise, and push them out until liquid appears at the tip.

• Choose a site: your abdomen at least 5 cm (2 inches) away from your navel, the front of your thigh, or the back of your upper arm. The arm is much easier if someone else does it.
• Use a different site from last week, and never the same spot twice running. Injecting into one spot repeatedly builds firm tissue under the skin, and a dose that lands in that tissue absorbs unpredictably — which looks like the medication no longer working.
• Avoid skin that is sore, bruised, red, hard, scarred, or covered by stretch marks.
• Clean the spot with an alcohol swab and let it dry completely. Injecting through wet alcohol is most of the sting people blame on the needle.
• Hold the pen flat against the skin at a right angle and press. Keep pressing until your own pen says the dose is finished — some count to 6, some to 10, some show a window or a plunger that stops moving. Lifting off early leaves part of the dose on your skin, and there is no way to tell how much.
• Pinch up a fold of skin, put the needle in at the angle your pharmacy showed you for the needle length they supplied, and push the plunger down steadily until the syringe is empty.
• Time of day does not matter, and it does not matter whether you have eaten.
• Never share a pen, a needle or a syringe with anyone, even after changing the needle. Hepatitis B, hepatitis C and HIV are all transmitted this way.

• Put the used needle, syringe or pen straight into a sharps container. Do not try to put the cap back on by hand — recapping is when most needlestick injuries happen.
• A drop of blood or a small bruise is normal. Press gently with a clean tissue; do not rub the site.
• A small red, itchy or firm patch that appears within a day or two and settles over the following few days is the usual reaction. Spreading redness, heat, pus or a fever is not — that is an infection and needs to be seen.

Sharps disposal is regulated by each US state, and the rules genuinely differ: some treat home-generated sharps as ordinary household waste, others require a licensed collection route and prohibit kerbside disposal. Check your own state health department before you throw a full container away.

• Put every used needle, syringe and pen straight into an FDA-cleared sharps disposal container, the moment you finish injecting. Not on the side, not in a drawer.
• If you do not have one yet, a heavy-duty plastic household container will do until you get one — a laundry detergent bottle is the usual example. It needs a tight, puncture-proof lid, it needs to stand upright without tipping, and it needs to be labelled so nobody opens it by mistake.
• Keep the container upright, out of reach of children and pets, and away from anywhere it could be knocked over.
• Close it and swap it for a new one when it is about three-quarters full. Reaching in to compress a full container is how people are injured.
• Get rid of the full container the way your state or town requires — drop-off sites, household hazardous waste collection, mail-back programmes and pharmacy take-back schemes are all used in different places, and only some of them exist near you.
• Never put loose needles or syringes in your household rubbish or your recycling.
• Never flush a needle down the toilet.
• Never share a pen, needle or syringe with anyone, even after changing the needle — hepatitis B, hepatitis C and HIV all transmit this way.

• Semaglutide injection US labelling and Instructions for Use: store at 2-8 °C (36-46 °F) before use; in-use allowance 28 days (2.4 mg weight-management pen) or 56 days (1 mg diabetes pen) at up to 30 °C (86 °F); solution is clear and colourless; do not freeze.
• FDA consumer guidance, Safely Using Sharps (Needles and Syringes) at Home, at Work and on Travel: immediate disposal into an FDA-cleared container, the heavy-duty household container fallback, the three-quarters-full replacement point, and the direction to state and local disposal programmes because requirements vary by jurisdiction.