Complete Semaglutide Injection Guide: Step-by-Step Instructions

Quick Answer: Semaglutide is injected subcutaneously (under the skin) once weekly using either a pre-filled pen or a syringe with vial. Inject in your abdomen, thigh, or upper arm, rotating sites each week. The injection takes about 30 seconds and is generally painless when done correctly. Store unused medication in the refrigerator (36-46°F) and bring to room temperature before injecting for maximum comfort.

Table of Contents

• Types of Semaglutide Delivery Systems
• Before You Inject: Preparation
• Choosing Your Injection Site
• Step-by-Step: Injecting with a Pen
• Step-by-Step: Injecting with Vial and Syringe
• Injection Site Rotation Strategy
• Proper Storage Requirements
• Safe Needle Disposal
• Common Injection Mistakes to Avoid
• Troubleshooting Injection Problems
• Reducing Injection Pain and Discomfort
• Frequently Asked Questions

Types of Semaglutide Delivery Systems

Semaglutide is available in several delivery formats, each with its own advantages:

1. Pre-Filled Injection Pens (Brand-Name)

Examples: Wegovy pen, Ozempic pen

How it works:

• Pre-loaded with multiple doses (or single-use)
• Dose selector dial sets the amount
• Built-in needle that attaches to the pen
• Push-button mechanism delivers the dose
• Dose counter shows remaining medication

Pros:

• Easiest to use (no drawing up medication)
• Most convenient for travel
• Precise dosing (pre-measured)
• Minimal preparation required
• Lower chance of dosing errors

Cons:

• Significantly more expensive
• Requires insurance or high out-of-pocket cost
• Limited dose flexibility
• Disposal of entire pen required when empty

2. Multi-Dose Vials with Syringes (Compounded)

Examples: Compounded semaglutide from 503B pharmacies

How it works:

• Medication in a glass vial
• You draw your dose into a syringe
• Typically insulin syringes (1mL with fine needles)
• Vial contains multiple doses

Pros:

• Significantly more affordable ($200-400/month)
• Dose flexibility (easy to adjust amounts)
• Less waste (use only what you need)
• Widely available through compounding pharmacies

Cons:

• Requires more steps (drawing up medication)
• Slightly higher learning curve initially
• Need separate supplies (syringes, alcohol wipes, sharps container)
• Requires careful dose measurement

3. Single-Dose Pre-Filled Syringes

How it works:

• Each syringe pre-filled with exact dose
• Ready to inject (no drawing required)
• Some compounding pharmacies offer this format

Pros:

• Convenient (ready to use)
• Accurate dosing (pre-measured)
• More affordable than brand-name pens
• No drawing required

Cons:

• Generates more waste than vials
• Less dose flexibility
• More packaging/shipping material
• Slightly higher cost than multi-dose vials

For information about cost differences between these options, see our semaglutide cost guide.

Before You Inject: Preparation

Proper preparation ensures safe, effective, and comfortable injections.

Supplies Checklist

Item	Purpose	Where to Get
Semaglutide (pen or vial)	The medication	Pharmacy, compounding pharmacy
Alcohol wipes	Sterilize injection site	Pharmacy, online, big box stores
Insulin syringes (if using vials)	Administer the injection	Pharmacy (no prescription needed for syringes)
Sharps container	Safe needle disposal	Pharmacy, online (or use thick-walled detergent bottle)
Gauze or cotton ball	Stop bleeding after injection	Pharmacy, online
Bandage (optional)	Cover injection site	Pharmacy, online

Pre-Injection Checklist

• ✓ Wash hands thoroughly with soap and water (20+ seconds)
• ✓ Gather all supplies in a clean, well-lit area
• ✓ Remove medication from refrigerator 30 minutes before injecting (room temperature injection is more comfortable)
• ✓ Check medication for clarity (should be clear and colorless—do not use if cloudy or discolored)
• ✓ Check expiration date
• ✓ Choose and prepare injection site
• ✓ Ensure sharps container is nearby for immediate disposal

Choosing Your Injection Site

Semaglutide can be injected in three body areas. All are equally effective—choose based on personal preference and comfort.

1. Abdomen (Most Common)

Injection area:

• At least 2 inches (5cm) away from belly button
• Anywhere in the "soft" area of your lower abdomen
• Avoid the area directly around your navel
• Avoid areas with scars or skin changes

Advantages:

• Easiest to reach (no assistance needed)
• Good visibility (can see what you're doing)
• Large injection area with plenty of subcutaneous fat
• Easy to rotate sites
• Generally painless with good technique

Disadvantages:

• May be uncomfortable if waistband rubs injection site
• Visible if wearing crop tops or swimwear immediately after

2. Thigh (Front or Outer)

Injection area:

• Front of thigh, middle third area
• Outer thigh (side)
• Avoid inner thigh (more sensitive, closer to blood vessels)
• Choose area with adequate subcutaneous fat

Advantages:

• Easy to access while sitting
• Good for people with less abdominal fat
• Large area for rotation
• Private (covered by clothing)

Disadvantages:

• May be less comfortable (more nerve endings)
• Tighter skin can make injection slightly more difficult
• Harder to pinch skin if very lean

3. Upper Arm (Back of Arm)

Injection area:

• Back of upper arm (triceps area)
• Between shoulder and elbow
• Outer back portion (not the inner arm)

Advantages:

• Discreet location
• Works well for people uncomfortable with abdomen/thigh
• Good absorption

Disadvantages:

• Difficult to reach (may need assistance)
• Harder to see what you're doing
• Limited area for rotation
• Requires more flexibility to self-inject

Areas to Avoid

• ❌ Within 2 inches of belly button
• ❌ On or near moles, scars, bruises, or skin changes
• ❌ Areas of hard, thick, or tender skin
• ❌ Directly over bones
• ❌ Previous injection site (wait at least 1 week)
• ❌ Waistline where clothing rubs

Step-by-Step: Injecting with a Pen

These instructions apply to Wegovy and Ozempic pens. Always follow your specific pen's instructions, as designs vary.

Step 1: Prepare the Pen

• Remove pen from refrigerator 30 minutes before injection
• Remove pen cap
• Check medication in viewing window (should be clear and colorless)
• Attach a new needle to the pen (twist until secure)
• Remove both needle caps (outer and inner)

Step 2: Prime the Pen (First Use Only)

• Turn dose selector to flow check symbol (or smallest dose)
• Point needle upward and tap pen gently to remove air bubbles
• Press injection button fully
• A drop of medication should appear at needle tip
• If no drop appears, repeat priming up to 6 times
• Note: You only need to prime before the first injection with a new pen, not every injection

Step 3: Select Your Dose

• Turn dose selector to your prescribed dose
• Dose counter should show your dose amount
• If you turn past your dose, you can turn back (don't worry about waste)
• Check dose window to confirm correct amount

Step 4: Prepare Injection Site

• Choose your injection area (abdomen, thigh, or arm)
• Clean site with alcohol wipe in circular motion
• Let site air dry completely (10-15 seconds—do not blow on it or fan it)

Step 5: Inject

• Pinch skin gently between thumb and forefinger (creates a raised area)
• Insert needle straight into skin at 90-degree angle (push firmly—needle should go all the way in)
• Release your pinch
• Press injection button fully until it stops
• Keep button pressed and count to 6 slowly (ensures full dose delivery)
• Release button and withdraw needle straight out

Step 6: After Injection

• Do not rub injection site
• If bleeding, apply gentle pressure with gauze or cotton ball
• Carefully replace outer needle cap (or use one-handed recapping technique)
• Unscrew and discard needle in sharps container
• Replace pen cap and store pen in refrigerator

Step-by-Step: Injecting with Vial and Syringe

These instructions are for compounded semaglutide in multi-dose vials.

Step 1: Calculate Your Dose

• Check your vial concentration (example: 2.5mg/mL means 2.5mg per 1mL)
• Calculate volume needed for your dose (your provider will tell you, or use concentration to calculate)
• Example: 0.25mg dose with 2.5mg/mL concentration = 0.1mL to draw
• Mark your syringe at the correct line

Step 2: Prepare Supplies

• Wash hands thoroughly
• Gather vial, insulin syringe, alcohol wipes, sharps container
• Remove vial from refrigerator (let warm for 15-30 minutes)
• Check medication (should be clear, not cloudy)

Step 3: Draw Medication

• Remove cap from vial (if first use)
• Clean rubber stopper with alcohol wipe and let dry
• Remove syringe from packaging
• Pull back plunger to draw air equal to your dose amount
• Insert needle through rubber stopper into vial
• Push plunger to inject air into vial (makes drawing easier)
• Turn vial upside down (needle tip should be in liquid)
• Pull plunger to draw medication to correct dose line
• Check for air bubbles—tap syringe and push bubbles out if present
• Ensure you still have correct dose amount after removing bubbles
• Remove needle from vial

Step 4: Prepare Injection Site

• Choose injection area (rotate from previous week)
• Clean with alcohol wipe in circular motion
• Let air dry completely (10-15 seconds)

Step 5: Inject

• Pinch skin to create raised area
• Insert needle at 90-degree angle quickly but smoothly
• Release pinch
• Push plunger slowly and steadily until all medication is delivered
• Wait 2-3 seconds, then withdraw needle straight out

Step 6: After Injection

• Do not rub injection site
• Apply pressure with gauze if bleeding
• Immediately place entire syringe (uncapped) in sharps container
• Return vial to refrigerator
• Record date, dose, and injection site in your log

Injection Site Rotation Strategy

Rotating injection sites prevents lipohypertrophy (lumps under skin), ensures consistent absorption, and reduces discomfort.

Rotation Methods

Method 1: The Quadrant System

1. Divide your abdomen into 4 quadrants (upper right, upper left, lower right, lower left)
2. Week 1: Inject in upper right quadrant
3. Week 2: Inject in upper left quadrant
4. Week 3: Inject in lower right quadrant
5. Week 4: Inject in lower left quadrant
6. Week 5: Return to upper right (should be fully healed)

Method 2: Body Area Rotation

1. Week 1: Right side of abdomen
2. Week 2: Left side of abdomen
3. Week 3: Right thigh
4. Week 4: Left thigh
5. Week 5: Return to right abdomen

Method 3: Clock System (Abdomen)

1. Imagine a clock face on your abdomen (belly button = center)
2. Week 1: Inject at 12 o'clock position
3. Week 2: Inject at 3 o'clock position
4. Week 3: Inject at 6 o'clock position
5. Week 4: Inject at 9 o'clock position
6. Week 5: Return to 12 o'clock

Tracking Your Sites

Keep a simple log to track rotation:

• Calendar with notes ("Left abdomen," "Right thigh," etc.)
• Phone note or app
• Printed body diagram where you mark each site
• Photo log (take picture of injection site immediately after)

Important: Wait at least 7 days before reusing the exact same spot. Using the same site too frequently increases risk of lipohypertrophy and reduced absorption.

Proper Storage Requirements

Correct storage maintains medication potency and safety:

Unopened Medication

Condition	Requirement
Temperature	36-46°F (2-8°C) in refrigerator
Location	Away from freezer compartment (do not freeze)
Duration	Until expiration date on package
Light exposure	Keep in original carton to protect from light

Opened/In-Use Medication

Type	Storage	Duration
Wegovy pen	Refrigerate (36-46°F) with pen cap on	Up to 28 days after first use
Ozempic pen	Refrigerate or room temp (up to 86°F)	Up to 56 days after first use
Compounded vials	Refrigerate (36-46°F)	Per pharmacy instructions (typically 28-60 days)

Storage Guidelines

• ✓ Always store in refrigerator between injections
• ✓ Remove from fridge 30 minutes before injection (more comfortable at room temp)
• ✓ Keep in original packaging until ready to use
• ✓ Store upright when possible
• ✓ Keep away from direct light
• ✓ Label opened date on vial/pen
• ✓ Check expiration dates before each use

Do NOT:

• ❌ Freeze medication (discard if frozen)
• ❌ Store in freezer compartment or door (temperature fluctuates)
• ❌ Leave in direct sunlight or hot car
• ❌ Use medication that has been frozen, even if thawed
• ❌ Use medication that is cloudy, discolored, or contains particles
• ❌ Store with needle attached (increases contamination risk)

Travel Storage

• Use insulated medication travel case with ice pack
• Do not place directly on ice (can freeze)
• Carry in carry-on luggage (never checked baggage—cargo holds can freeze)
• Bring original prescription label
• If refrigeration unavailable temporarily (8-12 hours), keep in coolest location
• Return to proper storage as soon as possible

Safe Needle Disposal

Proper disposal protects you, your family, waste workers, and the environment.

Sharps Container (Best Option)

• Purchase FDA-approved sharps container ($10-15 at pharmacy)
• Place immediately after use (never recap first if avoidable)
• Fill only to fill line (typically 3/4 full)
• Seal container when full
• Dispose per local regulations (pharmacy take-back, mail-back program, or household hazardous waste)

DIY Sharps Container (If Needed)

If you don't have an official sharps container, use:

• Heavy-duty laundry detergent bottle (thick plastic)
• Bleach bottle
• Metal coffee can with plastic lid

Requirements:

• Made of heavy-duty plastic or metal
• Leak-resistant and puncture-proof
• Has tight-fitting lid
• Label clearly: "SHARPS - DO NOT RECYCLE"

Local Disposal Options

• Pharmacy take-back: Many pharmacies accept sealed sharps containers
• Mail-back programs: Purchase mail-back kit, ship to disposal facility
• Household hazardous waste: Check with local waste management for collection events
• Syringe exchange programs: Some communities offer free disposal

NEVER:

• ❌ Throw loose needles in trash
• ❌ Put needles in recycling
• ❌ Flush needles down toilet
• ❌ Recap needles if avoidable (needle stick risk)
• ❌ Use glass containers (can break)

Common Injection Mistakes to Avoid

1. Not Letting Alcohol Dry

Problem: Injecting through wet alcohol causes stinging and can inactivate some medications.

Solution: Wait 10-15 seconds after cleaning for complete evaporation.

2. Injecting Cold Medication

Problem: Cold medication causes more discomfort and can increase injection site reactions.

Solution: Remove from fridge 30 minutes before injection. Roll vial gently between palms to warm.

3. Reusing Needles

Problem: Dulls needle, increases pain, raises infection risk, can damage medication.

Solution: Always use a fresh needle for each injection. Needles are inexpensive—don't reuse.

4. Not Rotating Sites

Problem: Causes lipohypertrophy (hard lumps), poor absorption, increased pain.

Solution: Use a rotation strategy and track sites systematically.

5. Injecting Through Clothing

Problem: Introduces bacteria, dulls needle, prevents proper visualization.

Solution: Always expose skin completely. Fully remove or pull up clothing.

6. Not Counting Full Hold Time

Problem: Withdrawing needle too quickly can cause medication leakage, reducing dose.

Solution: Count to 6 slowly with pen injections, 2-3 with syringes, before withdrawing.

7. Injecting at Wrong Angle

Problem: Shallow angle goes into muscle (painful) or too superficial (poor absorption).

Solution: 90-degree angle for most people. 45-degree only if very lean and instructed by provider.

8. Forgetting to Prime Pen

Problem: Air in needle, inaccurate dosing.

Solution: Prime before first use of each new pen. Check for medication drop at needle tip.

Troubleshooting Injection Problems

Problem: Medication Leaks After Injection

Possible causes: Withdrawing needle too quickly, not counting hold time, hitting small blood vessel

Solutions:

• Count to 6 slowly before removing needle (pens) or 2-3 seconds (syringes)
• Withdraw needle straight out, don't angle
• Apply gentle pressure (don't rub) if medication appears at surface
• Small leakage (<1 drop) is usually insignificant; don't re-inject

Problem: Injection Is Painful

Possible causes: Cold medication, wet alcohol, reused needle, hitting nerve

Solutions:

• Warm medication to room temperature
• Ensure alcohol completely dry
• Use fresh needle every time
• Try different injection site
• Relax muscles (tension increases pain)
• Insert needle quickly and smoothly (slower = more pain)

Problem: Blood After Injection

Cause: Hit small capillary (completely normal and harmless)

Solutions:

• Apply gentle pressure with clean gauze
• Don't rub (can increase bruising)
• Apply bandage if desired
• Small bruising is normal—rotate sites next time
• Bleeding/bruising doesn't affect medication absorption

Problem: Can't Draw Medication from Vial

Possible causes: Vacuum in vial, needle not in liquid, vial empty

Solutions:

• Inject air into vial equal to dose amount before drawing
• Keep vial upside down with needle tip submerged in liquid
• Check vial volume—may need new vial
• Ensure needle isn't clogged

Problem: Pen Won't Inject

Possible causes: Blocked needle, dose not selected correctly, pen malfunction

Solutions:

• Remove and replace needle with fresh one
• Check dose selector is at correct amount
• Ensure pen isn't empty (check dose counter/window)
• Prime pen again if needed
• If pen still doesn't work, use backup pen and contact pharmacy

Reducing Injection Pain and Discomfort

Most people report semaglutide injections are painless or only cause minor discomfort. These strategies minimize any pain:

Before Injection:

• Use room-temperature medication (30 minutes out of fridge)
• Choose areas with more subcutaneous fat
• Relax your muscles completely
• Take a deep breath and exhale slowly during injection
• Consider using ice for 30 seconds before injection (numbs area slightly)

During Injection:

• Insert needle quickly and smoothly (fast insertion = less pain)
• Push plunger slowly and steadily (fast injection = more stinging)
• Don't tense muscles
• Look away if you're needle-anxious (reduces anticipatory tension)

After Injection:

• Don't rub injection site (can increase irritation)
• Apply gentle pressure if needed
• Rotate sites consistently to prevent sensitization

Needle Selection (If Using Syringes):

• Use shortest needle that reaches subcutaneous fat (typically 4mm-6mm)
• Use thinnest gauge comfortable (31G or 32G for least pain)
• Never reuse needles (dulls tip significantly)

Getting Started with Semaglutide

Learning to inject semaglutide correctly is an important part of your weight loss journey. With the right support and quality medication, the process becomes second nature.

At Contour Health, we provide:

• Injection training: Detailed guidance on proper technique from experienced providers
• Quality medication: Compounded semaglutide from 503B FDA-registered facilities
• Complete supplies: Everything you need included with your order
• Ongoing support: Available to answer questions about injections anytime

Learn more about our compounded semaglutide program and get expert support from day one.

For a comprehensive overview of semaglutide beyond just injection technique, see our complete guide to semaglutide.

Frequently Asked Questions

Does the semaglutide injection hurt?

Most people report semaglutide injections are painless or cause only minor discomfort—similar to a mosquito bite. The needles are very thin (about the width of 2-3 human hairs), and injecting into fatty tissue has fewer nerve endings than muscle. Pain is usually caused by technique issues (cold medication, wet alcohol, muscle tension) rather than the injection itself. With proper technique, 70-80% of people report feeling little to nothing.

Where is the best place to inject semaglutide?

The abdomen (at least 2 inches from your belly button) is the most popular and usually most comfortable site. It's easy to reach, has good subcutaneous fat for most people, provides excellent absorption, and offers a large area for rotation. However, the front/outer thigh and back of the upper arm are equally effective—choose based on personal comfort and ability to rotate sites effectively.

Can I inject semaglutide in the same spot every week?

No, you should rotate injection sites and wait at least 7 days before reusing the exact same spot. Injecting repeatedly in the same location can cause lipohypertrophy (hard lumps of fatty tissue), poor medication absorption, increased pain, and skin changes. Use a rotation strategy (quadrant system, body area rotation, or clock method) and track your sites to ensure proper rotation.

What happens if I inject semaglutide into muscle instead of fat?

Injecting into muscle (intramuscular vs. subcutaneous) will likely cause more pain and may alter medication absorption—potentially leading to faster absorption and increased side effects. While it's not dangerous, it's not ideal. To avoid this, pinch your skin before injecting to ensure you're in fatty tissue, inject at a 90-degree angle, and use appropriate needle length (4-6mm for most people). If you're very lean, discuss proper technique with your provider.

How long does semaglutide stay good once opened?

Brand-name Wegovy pens are good for 28 days after first use when stored properly in the refrigerator. Ozempic pens last 56 days. Compounded semaglutide vials vary by pharmacy but typically last 28-60 days. Always check your specific product's guidelines, mark the "opened date" on your medication, and discard after the recommended timeframe even if medication remains. Using expired medication may result in reduced effectiveness.

Can I reuse semaglutide needles?

No, you should never reuse needles. Reusing needles causes: 1) Dulling of the needle tip, making injections more painful, 2) Increased risk of infection, 3) Potential contamination of medication, 4) Risk of needle breakage. Needles are inexpensive ($0.10-0.25 each), so reuse is never worth the risks. Always use a fresh, sterile needle for each injection.

What if I see air bubbles in my syringe or pen?

Small air bubbles are harmless but can reduce your dose slightly. For syringes: tap the syringe to bring bubbles to the top, push plunger to expel them, then redraw to correct dose. For pens: prime the pen (turn dose selector to smallest dose or flow check symbol, hold pen upright, tap gently, press injection button until a drop appears). A small amount of air won't harm you—it would take a very large air bubble injected directly into a vein to cause problems, which isn't possible with subcutaneous injections.

Can I inject semaglutide through clothing?

No, never inject through clothing. Injecting through fabric: 1) Introduces bacteria from clothing into the injection site, 2) Prevents proper skin preparation and sterilization, 3) Dulls the needle, 4) Makes it impossible to see what you're doing, 5) Can catch fabric in the injection. Always fully expose the skin, clean with alcohol, and inject directly into bare skin.

Should I rub the injection site after injecting semaglutide?

No, do not rub the injection site after injecting. Rubbing can: 1) Increase local irritation and pain, 2) Potentially affect medication absorption, 3) Increase bruising risk. Instead, if you see a drop of medication at the surface, apply gentle pressure (don't rub) with clean gauze. Otherwise, leave the site alone. It's fine to apply a bandage if desired, but don't massage the area.

Can I travel with semaglutide injections?

Yes, semaglutide can be safely traveled with using proper precautions: 1) Always carry in carry-on luggage (checked baggage cargo holds can freeze medication), 2) Use insulated medication travel case with ice pack (don't place directly on ice), 3) Bring original prescription label and pharmacy information, 4) Pack sharps container for disposal, 5) Research sharps disposal at your destination. For flights, semaglutide and supplies are allowed through TSA security—notify officers you're carrying medication and sharps.

What should I do if medication leaks out after injection?

If you see medication at the injection site after removing the needle, don't worry—small leakage (a drop or less) is common and doesn't significantly reduce your dose. This usually happens when: 1) The needle wasn't held in long enough (count to 6 with pens, 2-3 with syringes), 2) You hit a small blood vessel. To prevent leakage: hold needle in place longer before withdrawing, withdraw straight out without angling, apply gentle pressure (don't rub) immediately after. Don't re-inject to "make up" for minor leakage—you likely received adequate dose.