Ozempic (semaglutide) is a prescription medication used for adults with type 2 diabetes to lower their blood sugar levels (A1C). It is also used to reduce the risk of kidney function decline in diabetics with chronic kidney disease (CKD) and lower the risk of heart attack or stroke in certain patients with type 2 diabetes and heart disease.
Ozempic works by increasing insulin release, slowing stomach emptying, and reducing sugar production by the liver, which results in improved blood sugar levels, prolonged fullness, and controlled appetite, which may lead to weight loss.
Ozempic mimics a natural hormone called GLP-1, which is released when we eat to help balance blood sugar and make us feel full after meals. Ozempic is from a class of medicines called GLP-1 agonists.
Ozempic injection can be self-administered once a week, under the skin using an autoinjector (pen).
Ozempic FDA Approval
Ozempic is FDA-approved to treat:
- Type 2 diabetes in adults to control blood sugar (glucose) control along with diet and exercise
- Reduce major cardiovascular event risks (such as heart attack, stroke, or death) in adults with type 2 diabetes with known heart disease
- Reduce the risk of kidney disease worsening, kidney failure, and death due to cardiovascular disease in patients with type 2 diabetes and chronic kidney disease.
Ozempic FDA approval was granted on December 5, 2017. There is no Ozempic generic. Each of the different brands of semaglutide (Ozempic, Rybelsus, Wegovy) is made by Novo Nordisk, but they are FDA-approved for different conditions. Wegovy is FDA-approved for weight management, and Rybelsus is approved for type 2 diabetes mellitus.
WARNING: Ozempic is not approved for type 1 diabetes treatment, and it is not known if it can be used in people with pancreatitis.
Benefits of Ozempic Treatment
- Blood sugar control and HbA1C reduction*
- Significant weight loss support
- Lower risk of heart attack and stroke
- Improved cardiovascular health in type 2 diabetes patients
- Slows the decline of kidney disease and improves cardiovascular outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes.
*HbA1C (A1C) measures your average blood sugar level over the past 2-3 months.
Ozempic and Type 2 Diabetes
The benefit of using Ozempic in diabetes is a reduction in A1C this was seen in the 30-week SUSTAIN 1 clinical trial (NCT02054897):
- 73% of Ozempic 0.5 mg patients achieved an A1C of 7% or less.
Ozempic for CKD and heart disease
The FLOW phase 3b clinical trial (NCT03819153) found two important benefits of using Ozempic in adults with type 2 diabetes and CKD:
- 24% lower risk of their kidney disease getting worse
- 4.9% lower risk of dying from heart problems.
How Does Ozempic Work?
Ozempic is a GLP-1 agonist that mimics a natural hormone called GLP-1, which is released after eating to help regulate blood sugar and promote a feeling of fullness. Ozempic works by helping the pancreas produce more insulin, slowing stomach emptying, and reducing the amount of sugar produced and released by the liver. This results in improved blood sugar control, prolonged fullness, and a decreased appetite, which may contribute to weight loss.
Ozempic’s mechanism of action involves binding to and activating the GLP-1 receptor, which stimulates insulin secretion, lowers glucagon levels, and delays gastric emptying after meals.
The exact way Ozempic reduces the risk of kidney-related complications is not fully understood.
“Oatzempic” is a term coined on social media, referring to a blended drink made from oats, water, and lime juice, that may make you feel fuller for longer and help you eat less. However, there are no clinical trials to prove this drink helps you lose weight (see Oatmeal Ozempic for Weight Loss? Oatzempic).
Ozempic for weight loss
Ozempic’s active ingredient, semaglutide, is used for weight loss and weight management, under the brand name Wegovy.
Ozempic was shown to be effective for weight loss in a 30-week semaglutide SUSTAIN 1 clinical trial (NCT02054897). Semaglutide patients had:
- 7.7 lbs (3.5 kg) more weight loss than placebo (with a 1 mg dose)
- 5.7 lbs (2.6 kg) more weight loss than placebo (with a 0.5 mg dose)
Ozempic helped with weight loss and weight loss maintenance when used with diet and exercise in clinical trials, however, it is not FDA-approved for weight loss. Wegovy is the brand of semaglutide approved for weight loss. See Wegovy vs Ozempic: Which is right for you? Or Ozempic for weight loss, for more information.
Ozempic side effects
Common side effects
Common Ozempic side effects include nausea, vomiting, diarrhea, stomach pain, constipation, upset stomach, heartburn, burping, gas, bloating, loss of appetite, runny nose or sore throat, stomach flu symptoms or headache, dizziness, tiredness, and low blood sugar (in people with type 2 diabetes).
Stomach or gastrointestinal side effects are common but tend to be mild and clear up in a few weeks in most people and will not interfere with long-term treatment. Stomach side effects can be more common with higher doses.
The most common gastrointestinal side effect is nausea, which occurs in 15.8% to 20.3% of people taking Ozempic at doses of 0.5 mg or 1 mg, according to clinical trials.
- Others include vomiting (5% to 9.2%), diarrhea (8.5% to 8.8%), stomach-area pain (7.3% to 5.7%), and constipation (5% to 3.1%).
- These side effects occurred at rates higher than the placebo-treated groups (receiving an inactive treatment).
- These Ozempic side effects occurred in 5% or more of type 2 diabetes patients taking Ozempic 0.5 mg and 1mg in the pooled placebo-controlled clinical trials.
More patients receiving Ozempic 0.5 mg (3.1%) and 1 mg (3.8%) discontinued treatment due to stomach side effects than patients receiving placebo (0.4%).
The side effect of hypoglycemia occurred in 3.8% of Ozempic 1mg patients (monotherapy) with type 2 diabetes in placebo-controlled trials. Among diabetic patients taking insulin, with or without metformin, 29.8% experienced symptomatic hypoglycemia, and 1.5% had severe hypoglycemia in patients taking Ozempic 1mg from a pool of placebo-controlled trials.
Ozempic face is a term used to describe the noticeable facial changes seen in some people who are prescribed this medicine. These changes are not a specific side effect of Ozempic, but rather a result of significant weight loss (see Ozempic face: What causes it and how to prevent it?).
Tips for managing stomach side effects
Following these tips may help you manage stomach side effects:
- eat more slowly
- consume smaller meals
- select more bland, low-fat foods (like crackers, toast, and rice)
- avoid greasy, fried foods or sugar treats
- eat foods that contain water (like soup or gelatin)
- don’t lie down right after eating
- drink clear or ice-cold liquids
- if possible, go outside for fresh air if you feel sick to your stomach
Serious side effects
Ozempic can cause serious side effects such as inflammation of the pancreas, vision changes, low blood sugar levels, kidney problems, and serious allergic reactions, and it can also increase the risk of food or liquid getting into your lungs during surgery or a medical procedure (see Ozempic side effects to watch for).
Get emergency medical help if you have signs of an allergic reaction, such as hives, itching, dizziness, fast heartbeats, difficulty breathing, or swelling of your face, lips, tongue, or throat.
This medicine can cause other serious side effects. Call your healthcare provider at once if you have:
- vision changes;
- unusual mood changes, thoughts about hurting yourself;
- pounding heartbeats or fluttering in your chest;
- a light-headed feeling, like you might pass out;
- signs of a thyroid tumor – swelling or a lump in your neck, trouble swallowing, a hoarse voice, feeling short of breath;
- symptoms of pancreatitis – severe pain in your upper stomach spreading to your back, nausea with or without vomiting, fast heart rate;
- gallbladder problems – upper stomach pain, fever, clay-colored stools, jaundice (yellowing of the skin or eyes);
- low blood sugar—headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery;
- kidney problems – swelling, urinating less, blood in urine, feeling tired or short of breath
- stomach flu symptoms – stomach cramps, vomiting, loss of appetite, diarrhea (may be watery or bloody)
- symptoms of ileus (stomach paralysis) – bloating, stomach cramps or pain, nausea or vomiting, constipation or diarrhea, loss of appetite.