Before you inject for the first time
Your pharmacist or prescriber should demonstrate the first injection. Most pharmacies offer a "first injection consultation" that takes 15-20 minutes, request one if you weren’t offered it. Online video resources from Novo Nordisk are also available, but in-person demonstration is the gold standard.
You’ll need: your Ozempic pen, a new needle (32G recommended), alcohol swab, sharps container (Australian Standards-approved). The Sharps Disposal Helpline (1800 800 002) can advise on local collection points.
Step-by-step injection process
Step 1: Warm the pen
Remove the pen from the fridge 30 minutes before injection. Cold semaglutide stings noticeably more than room-temperature medication. This is the single biggest comfort improvement most patients discover.
Step 2: Inspect the medication
Look through the pen's window. Medication should be clear and colourless. Don’t use if cloudy, discoloured, or contains visible particles. Don’t use if past the use-by date or if the pen has been frozen.
Step 3: Attach a new needle
Remove the pen cap. Tear off the paper tab from a fresh needle. Screw the needle straight onto the pen (not at an angle). Remove the outer needle cap and the inner needle cap. Keep the outer cap, you’ll use it to safely remove the needle after injection.
Step 4: Flow check (new pens only)
For a brand new pen, perform a flow check before your first injection. Dial the dose selector to the flow check position (marked with a droplet symbol). Hold the pen needle-up. Press the dose button. A small drop of medication should appear at the needle tip. If not, repeat. Once flow is confirmed, you don’t need to repeat this on subsequent injections from the same pen.
Step 5: Dial your dose
Turn the dose selector to your prescribed dose (0.25mg, 0.5mg, or 1.0mg). Confirm the correct dose number aligns with the dose pointer. The pen will click as you turn it. If you dial past your dose, simply turn back, the pen tracks remaining medication accurately.
Step 6: Choose injection site
Three approved sites:
- Abdomen. Most common. Inject 5cm or more from your navel. Easy to reach, consistent subcutaneous fat layer.
- Front of thigh. Inject into the front-outer thigh, mid-way between hip and knee.
- Back of upper arm. Requires help from someone else; difficult to self-inject. Use the fleshy back/outer area.
Rotate sites weekly. Don’t inject into the same exact spot two weeks in a row. Rotating prevents lipohypertrophy (fatty lumps) and reduces local skin irritation. Many patients use a simple pattern: Week 1 left abdomen, Week 2 right abdomen, Week 3 left thigh, Week 4 right thigh, repeat.
Step 7: Clean the site
Wipe the chosen injection site with an alcohol swab. Let it dry fully before injecting (injecting through wet alcohol stings).
Step 8: Inject
Pinch the skin gently to lift the subcutaneous layer away from underlying muscle. Insert the needle at 90 degrees (perpendicular to the skin) in a quick smooth motion. Press the dose button fully. The dose counter will count down to 0.
Step 9: Hold and withdraw
Once the counter reaches 0, KEEP THE NEEDLE IN PLACE for an additional 6 seconds. This ensures the full dose is delivered (semaglutide is a slow-injection medication; pulling out too quickly can leave medication in the needle). Then withdraw smoothly. If a small spot of blood appears, apply gentle pressure with a tissue (don’t rub).
Step 10: Dispose safely + store
Replace the outer needle cap. Unscrew the needle from the pen. Drop into your Australian Standards sharps container, never into household rubbish. Replace the pen cap (without needle attached). Store in fridge OR at room temperature below 30°C. Mark the in-use date on the pen if not refrigerating, discard after 6 weeks.
Common mistakes to avoid
- Cold injecting. Hurts more, no benefit. Always warm first.
- Reusing needles. Each needle is single-use. Reused needles dull, hurt more, and risk infection.
- Injecting too quickly. Hold for 6 seconds after counter reaches 0 to ensure full dose delivery.
- Same-spot injections. Causes lipohypertrophy (lumpy fat deposits) that reduces medication absorption.
- Storing pens in warm cars or in direct sunlight. Damages the medication. Use an insulated bag.
- Disposing of needles in household rubbish. Illegal in most Australian jurisdictions and unsafe for waste handlers.
- Doubling up on missed doses. Significantly worsens side effects. Skip and resume schedule.
When to seek prescriber advice about injection technique
- Persistent injection site reactions (redness, swelling, lumps lasting more than 48 hours)
- Lipohypertrophy (lumpy fat deposits at frequently-used sites)
- Suspected missed dose (no medication delivered, counter didn’t move correctly)
- Severe pain on injection (not just brief pinch)
- Difficulty with manual dexterity (some patients with arthritis benefit from injection aids)