Key facts
- Injection type: Subcutaneous (under the skin), not intramuscular or intravenous
- Frequency: Once weekly, on the same day each week
- Pen: Ozempic FlexTouch pre-filled pen — no mixing or drawing up required
- Needle: NovoFine or NovoTwist, typically 32-gauge, 4–5 mm
- Sites: Abdomen, front of thigh, or upper arm — rotate each week
- Storage: Fridge (2–8°C) before use; room temperature (below 30°C) or fridge for up to 8 weeks once in use
Before your first injection
Your prescriber, pharmacist or diabetes nurse should demonstrate how to use the Ozempic FlexTouch pen before your first injection. This guide complements that training but does not replace it. If you are unsure about any step, contact your pharmacy or diabetes team.
What comes in the box
- One Ozempic FlexTouch pre-filled pen (containing four weekly doses at the prescribed strength)
- Patient information leaflet (PIL)
- Pen needles are dispensed separately on a separate prescription line — usually NovoFine Plus 32G 4 mm or NovoTwist 32G 5 mm
Pen strengths: Ozempic pens come in two strengths — 0.25 mg / 0.5 mg (red label) and 1 mg / 2 mg (blue label). Check that your pen matches the dose prescribed by your clinician. The dose selector on the pen will only allow you to dial your prescribed dose.
Step-by-step injection guide
Preparation
- Wash your hands thoroughly with soap and water.
- Check the pen: Look at the label to confirm the correct medication and strength. Check the expiry date. Inspect the solution through the pen window — it should be clear, colourless and free of particles. Do not use it if it appears cloudy or discoloured.
- Attach a new needle: Remove the paper tab from the needle. Push the needle straight onto the pen and turn until tight. Do not reuse needles.
- Perform an air shot (new pen only): With a new pen, you must do an air shot to prime it. Turn the dose selector to the flow check symbol (two drops). Hold the pen with the needle pointing up. Press and hold the dose button until the dose counter returns to 0 and a drop appears at the needle tip. If no drop appears, repeat up to six times. If still no drop, do not use the pen — contact your pharmacy.
Selecting your dose
- Turn the dose selector until the dose counter shows your prescribed dose (0.25, 0.5, 1, or 2 mg).
- If you select the wrong dose, simply turn the selector forwards or backwards to correct it. The pen will not allow you to dial a dose greater than the amount remaining in the pen.
Choosing and preparing the injection site
- Choose your site: The abdomen (at least 5 cm from the navel), the front of either thigh, or the back of either upper arm. If someone else is helping you inject, the upper arm is a convenient choice.
- Clean the area with an alcohol swab or soap and water. Allow the skin to dry completely before injecting.
- Rotate sites: Do not inject into the same spot each week. Rotate between different areas within your chosen region, and alternate between regions (e.g. left thigh one week, right abdomen the next).
Injecting
- Insert the needle: Pinch a fold of skin if needed (particularly if you are lean). Insert the needle at a 90-degree angle with a quick, smooth motion. You do not need to aspirate (pull back the plunger).
- Press the dose button: Press the dose button all the way in and hold it down.
- Count to six: Keep the needle in the skin and hold the button down while you slowly count to six. This ensures the full dose is delivered. The dose counter should show 0.
- Remove the needle: Pull the needle straight out. A small drop of blood or liquid at the injection site is normal — press gently with a cotton ball or tissue if needed.
After injecting
- Remove and dispose of the needle: Carefully remove the needle from the pen using the outer needle cap (never the inner cap). Place used needles in a sharps bin, not in household waste. Your pharmacy can provide a sharps bin free of charge. When full, return it to your pharmacy or local authority for safe disposal.
- Replace the pen cap and store the pen correctly (see storage section below).
- Record the date and injection site in your diary or phone.
Injection sites explained
| Site | Pros | Tips |
|---|---|---|
| Abdomen | Consistent absorption; large area for rotation | Stay at least 5 cm from the navel; avoid the waistline area |
| Front of thigh | Easy to self-inject; good for patients with limited abdominal tissue | Use the middle third of the thigh; avoid the inner thigh |
| Upper arm | Good alternative; comfortable for many | Use the back/outer area; usually easier with assistance from another person |
Do not inject into: Areas with scars, moles, bruises, stretch marks, or areas of lipodystrophy (hard lumps or dents under the skin). Do not inject through clothing.
Site rotation: why it matters
Injecting into the same spot repeatedly can cause lipodystrophy — either lipoatrophy (loss of fat creating a dent) or lipohypertrophy (accumulation of fat creating a lump). Lipohypertrophy can also affect drug absorption, leading to unpredictable blood sugar levels or reduced medication effectiveness.
A simple rotation system:
- Week 1: Right side of abdomen
- Week 2: Left side of abdomen
- Week 3: Right thigh
- Week 4: Left thigh
- Repeat the cycle, varying the exact spot within each region by at least 2–3 cm
Storage and handling
Before first use
- Store in the refrigerator at 2–8°C
- Do not freeze — if accidentally frozen, discard the pen
- Keep in the original packaging to protect from light
- Check expiry date before use
Once in use
- Can be stored at room temperature (below 30°C) or in the fridge for up to 8 weeks (56 days)
- Always replace the pen cap after each use to protect from light
- Never store the pen with a needle attached (this can cause air bubbles, contamination or leakage)
- After 8 weeks, discard the pen even if it still contains medication
Temperature tip: If you store your pen in the fridge, take it out 30 minutes before injection and allow it to reach room temperature. Cold medication can be more uncomfortable to inject and may cause more stinging at the site.
Common mistakes and how to avoid them
| Mistake | Why it matters | Solution |
|---|---|---|
| Not counting to six | Full dose may not be delivered | Always hold the button down and count slowly to six after pressing |
| Reusing needles | Risk of infection, increased pain, needle tip damage | Use a new needle for every injection |
| Injecting into the same spot | Lipodystrophy, erratic absorption | Follow a rotation plan and record each site |
| Forgetting the air shot on a new pen | First dose may be incomplete due to air in the cartridge | Always perform an air shot when using a new pen for the first time |
| Storing with needle attached | Air can enter the cartridge; medication can leak; contamination risk | Remove the needle after every injection and replace the pen cap |
| Injecting into muscle | Faster absorption, increased side effects | Pinch the skin; use 4–5 mm needles; inject at 90° |
What to do if you miss a dose
If you forget your weekly injection:
- Within 5 days (120 hours) of the missed dose: Inject as soon as you remember, then continue on your usual day the following week.
- More than 5 days late: Skip the missed dose and inject on your next scheduled day. Do not take a double dose to make up for a missed one.
If you want to change your usual injection day, ensure there are at least two days (48 hours) between doses. For example, if you normally inject on a Monday and wish to switch to a Wednesday, take your Monday dose as usual, skip Tuesday, and inject on Wednesday the following week.
Travelling with Ozempic
Many UK patients travel abroad with their GLP-1 medication. Here are the key considerations:
- Carry in hand luggage: Never put Ozempic in checked luggage. Cargo hold temperatures can drop below freezing, which would ruin the medication.
- Prescriber letter: Carry a letter from your GP or prescriber confirming that the medication and needles are for your personal medical use. This helps at security and customs.
- Cooling pouch: A medical cooling wallet or pouch is useful if you will be without refrigeration for extended periods. These use gel packs to keep medication cool (but not frozen) for several hours.
- Needles in hand luggage: UK airport security allows needles in hand luggage when accompanied by the medication they are used with. The prescriber letter provides additional documentation.
- Time zones: If crossing time zones, inject on the same calendar day as your usual schedule. A few hours’ variation is not clinically significant for a weekly injection.
- Sharps disposal: Take a small sharps container for used needles. Do not dispose of needles in hotel bins. Most pharmacies worldwide will accept used sharps containers.
Disposing of sharps safely in the UK
Used needles and pen needles are classified as clinical waste and must not be placed in household bins or recycling. In the UK:
- Your pharmacy will provide a free sharps bin (usually yellow, available on prescription as a Drug Tariff item)
- When full, return the sealed sharps bin to your pharmacy or contact your local council for collection
- Some GP surgeries and hospitals also accept used sharps bins
- Never put loose needles in bins, bags or bottles — always use a proper sharps container
Frequently asked questions
Where do you inject Ozempic?
Ozempic is injected subcutaneously into the abdomen (at least 5 cm from the navel), the front of the thigh, or the upper arm. Rotate injection sites each week to reduce the risk of lipodystrophy.
What time of day should I inject Ozempic?
Any time of day, with or without food. Choose a consistent time that is easy to remember. Many patients set a weekly phone reminder. If changing your injection day, ensure at least 48 hours between doses.
Does the Ozempic injection hurt?
Most patients describe a brief, mild pinch. The FlexTouch pen uses very fine needles (32-gauge, 4–5 mm). Injecting at room temperature, using a quick insertion motion and always using a new needle all help minimise discomfort. Read more about managing side effects.
How do I store Ozempic?
Unused pens: refrigerator at 2–8°C. In-use pens: room temperature (below 30°C) or fridge for up to 8 weeks. Never freeze. Discard after 8 weeks even if medication remains.
Can I travel with Ozempic by air?
Yes. Carry it in hand luggage with a prescriber letter. Use a cooling pouch if needed. Needles are permitted in hand luggage when accompanied by the medication.
Related guides
Sources
- Novo Nordisk — Ozempic Summary of Product Characteristics (SmPC), MHRA
- Novo Nordisk — Ozempic FlexTouch Instructions for Use (patient insert)
- BNF — Semaglutide monograph (bnf.nice.org.uk)
- NHS — How to dispose of used sharps (nhs.uk)
- Diabetes UK — Injection technique matters (diabetes.org.uk)
- NICE CKS — Injection technique guidance (cks.nice.org.uk)