Ozempic 0.5 mg solution for injection in pre-filled pen
Spain
Table of Contents
Package leaflet: Information for the user
Introduction
Package leaflet: information for the patient
Ozempic 0.5 mg solution for injection in pre-filled pen
semaglutide
Read the entire leaflet carefully before you start using this medicine, because it contains important information for you.
- Keep this leaflet, as you may need to read it again.
- If you have any questions, ask your doctor, pharmacist, or nurse.
- This medicine has been prescribed for you only, and you should not give it to other people, even if they have the same symptoms as you, because it may harm them.
- If you experience any adverse reactions, consult your doctor, pharmacist, or nurse, even if they are adverse reactions not listed in this leaflet. See section 4.
Leaflet contents
- What Ozempic is and what it is used for
- What you need to know before using Ozempic
- How to use Ozempic
- Possible side effects
- How to store Ozempic
- Contents of the pack and other information
1. What Ozempic is and what it is used for
Ozempic contains the active substance semaglutide. It helps your body reduce blood sugar levels only when these levels are too high, and can help prevent heart disease in patients with type 2 diabetes mellitus (T2DM). It also helps slow the decline in kidney function in patients with T2DM through a mechanism separate from glucose lowering.
Ozempic is used to treat adults (aged 18 years and older) with T2DM when diet and exercise are not sufficient:
- as the sole antidiabetic medication when you cannot use metformin (another diabetes medicine), or
- in combination with other diabetes medicines: when these are not sufficient to control your blood sugar levels. These may be medicines taken orally or by injection, such as insulin.
It is important that you continue to follow the diet and exercise plan recommended by your doctor, pharmacist, or nurse.
2. What you need to know before using Ozempic
Do not use Ozempic
- if you are allergic to semaglutide or any of the other ingredients of this medicine (listed in section 6).
Warnings and precautions
Talk to your doctor, pharmacist, or nurse before starting to use this medicine.
This medicine is not the same as insulin and you should not use it if:
- you have type 1 diabetes, a condition in which the body produces no insulin
- you develop diabetic ketoacidosis, a complication of diabetes characterized by high blood sugar levels, difficulty breathing, confusion, excessive thirst, sweet-smelling breath, or a sweet or metallic taste in the mouth.
Ozempic is not insulin and therefore should not be used as a substitute for insulin.
If you know you are going to undergo surgery requiring anesthesia (a state of unconsciousness), inform your doctor that you are taking Ozempic.
Gastrointestinal problems and dehydration
During treatment with this medicine, you may experience nausea, vomiting, or diarrhea. These side effects may cause dehydration (loss of fluids). It is important to drink plenty of fluids to avoid dehydration. This is especially important if you have kidney problems. If you have any doubts, consult your doctor.
Severe and persistent stomach pain that may be due to acute pancreatitis
If you have severe and persistent pain in the stomach area, contact your doctor immediately, as this could be a sign of acute pancreatitis (inflammation of the pancreas). See section 4 for warning signs of pancreas inflammation.
Low blood sugar (hypoglycemia)
Combining a sulfonylurea or insulin with this medicine may increase the risk of low blood sugar (hypoglycemia). See section 4 for symptoms of low blood sugar. Your doctor may ask you to monitor your blood sugar levels. This will help your doctor decide whether the dose of sulfonylurea or insulin needs to be adjusted to reduce the risk of low blood sugar.
Diabetic eye disease (retinopathy)
If you have diabetic eye disease and are using insulin, this medicine may cause worsening of your vision, which may require treatment. Inform your doctor if you have diabetic eye disease or experience eye problems during treatment with this medicine. Use of Ozempic 2 mg is not recommended if you have potentially unstable diabetic eye disease.
Sudden changes in vision
If you experience sudden loss of vision or rapid worsening of vision during treatment with this medicine, consult your doctor immediately for advice. This may be due to a very rare side effect called non-arteritic anterior ischemic optic neuropathy (NAION) (see section 4: Serious side effects). Your doctor may perform an eye examination and you may need to stop treatment with this medicine.
Patients with delayed gastric emptying (gastroparesis)
If you have slow (delayed) gastric emptying, known as gastroparesis, using Ozempic may cause severe or serious gastrointestinal side effects. Consult your doctor before using Ozempic.
Children and adolescents
This medicine is not recommended for children and adolescents under 18 years of age, as safety and efficacy have not yet been established in these age groups.
Other medicines and Ozempic
Tell your doctor, pharmacist, or nurse if you are taking, have recently taken, or might need to take any other medicines, including herbal medicines or other medicines obtained without a prescription.
In particular, inform your doctor, pharmacist, or nurse if you are taking medicines containing any of the following ingredients:
- Warfarin or other similar oral anticoagulants to reduce blood clotting. You may need frequent blood tests to monitor how quickly your blood clots.
- If you are using insulin, your doctor will advise you on how to reduce your insulin dose and recommend more frequent monitoring of your blood sugar levels to prevent hyperglycemia (high blood sugar) and diabetic ketoacidosis (a diabetes complication that occurs when the body cannot break down glucose due to insufficient insulin).
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medicine.
This medicine should not be used during pregnancy because it is unknown whether it affects the fetus. Therefore, use of contraceptive methods is recommended while taking this medicine. If you plan to become pregnant, consult your doctor about changing your treatment, as you must stop using this medicine at least 2 months beforehand. If you become pregnant while using this medicine, contact your doctor immediately, as your treatment will need to be changed.
Do not use this medicine during breastfeeding, as it is unknown whether it passes into breast milk.
Driving and use of machines
It is unlikely that Ozempic will affect your ability to drive or operate machinery. However, if you use this medicine in combination with a sulfonylurea or insulin, you may experience low blood sugar (hypoglycemia), which may impair your concentration. Do not drive or operate machinery if you experience any symptoms of low blood sugar. See section 2, “Warnings and precautions,” for information about increased risk of low blood sugar, and section 4 for symptoms of low blood sugar. Consult your doctor for further information.
Sodium content
This medicine contains less than 1 mmol of sodium (23 mg) per dose; this is essentially “sodium-free.”
3. How to use Ozempic
Always follow exactly the instructions provided by your doctor for administering this medicine. If in doubt, consult your doctor, pharmacist, or nurse again.
How much to use
- The starting dose is 0.25 mg once weekly for four weeks.
- After four weeks, your doctor will increase the dose to 0.5 mg once weekly.
- Your doctor may increase the dose to 1 mg once weekly if your blood sugar level is not adequately controlled with the 0.5 mg once-weekly dose.
- Your doctor may increase the dose to 2 mg once weekly if your blood sugar level is not adequately controlled with the 1 mg once-weekly dose.
Do not change your dose unless your doctor tells you to.
How to administer Ozempic
Ozempic is administered as an injection under the skin (subcutaneous injection). Do not inject into a vein or muscle.
- The best injection sites are the front of the thigh, the front of your waist (abdomen), or the upper arm.
- Before using the pen for the first time, your doctor or nurse will show you how to use it.
Detailed instructions for use can be found on the reverse side of this leaflet.
When to use Ozempic
- You should use this medicine once a week, preferably on the same day each week.
- The injection can be given at any time of day, regardless of meals.
To help you remember to inject this medicine only once a week, it is advisable to write down on the carton the chosen day of the week (for example, Wednesday) as well as the date of each injection.
If necessary, you may change the day for your weekly injection, provided at least 3 days have passed since the last injection. Once the new administration day is selected, continue with the weekly dosing schedule.
If you use more Ozempic than you should
If you use more Ozempic than you should, contact your doctor immediately. You may experience adverse effects such as nausea.
If you forget to use Ozempic
If you forget to inject a dose and:
- 5 days or fewer have passed since you should have used Ozempic, take it as soon as you remember. Then take your next dose as usual on the scheduled day.
- more than 5 days have passed since you should have used Ozempic, skip the missed dose. Then take your next dose as usual on the scheduled day.
Do not use a double dose to make up for a missed dose.
If you stop using Ozempic
Do not stop treatment with this medicine without consulting your doctor. If you stop, your blood sugar levels may increase.
If you have any further questions about the use of this medicine, ask your doctor, pharmacist, or nurse.
4. Possible adverse effects
Like all medicines, this medicine can cause adverse effects, although not everyone experiences them.
Serious adverse effects
Frequent (may affect up to 1 in 10 people)
- Complications of diabetic eye disease (retinopathy); if you have eye problems such as changes in vision during treatment with this medicine, you must inform your doctor.
Uncommon (may affect up to 1 in 100 people)
- Inflamed pancreas (acute pancreatitis), which may cause severe, persistent pain in the stomach and back. If you experience such symptoms, seek medical attention immediately.
Rare (may affect up to 1 in 1,000 people)
- Severe allergic reactions (anaphylactic reactions, angioedema). You must seek medical help and inform your doctor immediately if you experience symptoms such as breathing difficulties, swelling of the face, lips, tongue and/or throat with difficulty swallowing, and palpitations.
Very rare (may affect up to 1 in 10,000 people)
- A condition of the eye called non-arteritic anterior ischemic optic neuropathy (NAION), which may cause painless vision loss in one eye. You should contact your doctor immediately if you experience sudden vision loss or progressive worsening of vision (see section 2: “Sudden changes in vision”).
Frequency not known (cannot be estimated from available data)
- Intestinal obstruction. A severe form of constipation with other symptoms such as stomach pain, abdominal swelling, vomiting, etc.
Other adverse effects
Very common (may affect more than 1 in 10 people)
- Nausea; this effect usually resolves with time
- Diarrhea; this effect usually resolves with time
- Low blood sugar level (hypoglycaemia) when this medicine is used with medicines containing sulfonylurea or insulin
Common (may affect up to 1 in 10 people)
- Vomiting
- Low blood sugar level (hypoglycaemia) when this medicine is used with oral antidiabetic medicines other than sulfonylureas or insulin
Warning signs of low blood sugar may appear suddenly. Some of these symptoms include: cold sweat, cold and pale skin, headache, palpitations, nausea or excessive hunger, changes in vision, drowsiness or weakness, nervousness, anxiety or confusion, difficulty concentrating, or tremors.
Your doctor will advise you on how to treat low blood sugar and what to do if you notice these warning symptoms.
Low blood sugar is more likely to occur if you are also taking a sulfonylurea or insulin. Your doctor may reduce the dose of these medicines before you start using this medicine.
- Indigestion
- Inflamed stomach (gastritis); symptoms include stomach pain, nausea, or vomiting
- Reflux or heartburn; also known as “gastroesophageal reflux disease” (GERD)
- Stomach pain
- Stomach bloating
- Constipation
- Burping
- Gallstones
- Dizziness
- Fatigue
- Weight loss
- Decreased appetite
- Gas (flatulence)
- Increase in pancreatic enzymes (such as lipase and amylase)
- Headache
Uncommon (may affect up to 1 in 100 people)
- Changes in taste of food and drinks
- Rapid heartbeat
- Injection site reactions, such as bruising, pain, irritation, itching, and rash
- Allergic reactions such as rash, itching, or hives
- Delayed stomach emptying
Frequency not known (cannot be estimated from available data)
- Change in skin sensitivity
Reporting of adverse effects
If you experience any adverse effect, talk to your doctor, pharmacist, or nurse, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly through the national reporting system included in Appendix V.
By reporting adverse effects, you can help provide more information on the safety of this medicine.
5. Storage of Ozempic
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date stated on the label of the pen and on the carton after EXP. The expiry date refers to the last day of the month indicated.
Before opening:
Store in a refrigerator (between 2 °C and 8 °C). Do not freeze. Keep away from the cooling element of the refrigerator. Store the pen with the cap on to protect it from light.
After first opening:
Ozempic 0.5 mg (4-dose pen)
- The pen may be stored for up to 6 weeks if kept below 30 °C or in a refrigerator (between 2 °C and 8 °C), away from the cooling element of the refrigerator. Do not freeze Ozempic and do not use it if it has been frozen.
Ozempic 0.5 mg (8-dose pen)
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The pen may be stored for up to 8 weeks if kept below 30 °C or in a refrigerator (between 2 °C and 8 °C), away from the cooling element of the refrigerator. Do not freeze Ozempic and do not use it if it has been frozen.
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When not in use, store the pen with the cap on to protect it from light.
Do not use this medicine if you notice that the solution is not clear and colourless or almost colourless.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines and packaging no longer required. This will help protect the environment.
6. Contents of the pack and other information
Composition of Ozempic
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The active substance is semaglutide.
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Ozempic pens with 4 doses
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1.5 ml: One ml of injectable solution contains 1.34 mg of semaglutide. A pre-filled pen contains 2 mg of semaglutide in 1.5 ml of solution. Each dose contains 0.5 mg of semaglutide in 0.37 ml.
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3 ml: One ml of injectable solution contains 0.68 mg of semaglutide. A pre-filled pen contains 2 mg of semaglutide in 3 ml of solution. Each dose contains 0.5 mg of semaglutide in 0.74 ml.
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Ozempic pens with 8 doses
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3 ml: One ml of injectable solution contains 1.34 mg of semaglutide. A pre-filled pen contains 4 mg of semaglutide in 3 ml of solution. Each dose contains 0.5 mg of semaglutide in 0.37 ml.
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The other components are: disodium phosphate dihydrate, propylene glycol, phenol, water for injections, sodium hydroxide/hydrochloric acid (for pH adjustment). See also section 2 “Sodium content”.
Appearance of the product and contents of the pack
Ozempic is a clear, colourless or almost colourless injectable solution in a pre-filled pen.
1.5 ml: Each pre-filled pen contains 1.5 ml of solution, allowing administration of 4 doses of 0.5 mg.
3 ml: Each pre-filled pen contains 3 ml of solution, allowing administration of 4 doses of 0.5 mg.
3 ml: Each pre-filled pen contains 3 ml of solution, allowing administration of 8 doses of 0.5 mg.
Ozempic 0.5 mg solution for injection is available in the following pack sizes:
1 pen and 4 NovoFine Plus disposable needles.
1 pen and 8 NovoFine Plus disposable needles.
3 pens and 12 NovoFine Plus disposable needles.
Only some pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Novo Nordisk A/S
Novo Allé
DK-2880 Bagsværd
Denmark
Date of the most recent revision of this leaflet:
Other sources of information
Detailed information on this medicine is available on the European Medicines Agency website: http://www.ema.europa.eu.
Instructions for use
Ozempic 0.5 mg solution for injection in a pre-filled pen delivering 4 doses
semaglutide
Instructions for Use of Ozempic 0.5 mg Solution for Injection in a Pre-filled Pen | |
Read these instructions carefully before using your pre-filled Ozempic pen. Ask your doctor, nurse, or pharmacist for guidance on how to correctly inject Ozempic. Start by checking the pen to ensure it contains Ozempic 0.5 mg, then review the following images to become familiar with the different parts of the pen and the needle. If you are blind or have reduced vision and cannot read the dose counter on the pen, do not use this pen without assistance. Seek help from someone with good eyesight who knows how to use the Ozempic pre-filled pen. Your pen is a pre-filled, dose-adjusting pen. It contains 2 mg of semaglutide and allows you to select only 0.5 mg doses. An unused pen contains four doses of 0.5 mg. Use the table inside the box lid to keep track of how many injections you have administered and when you administered them. The pen is designed to be used with disposable 30G, 31G, and 32G needles up to 8 mm in length. The package includes NovoFine Plus needles. Please note: The size of the pen may differ from the pen shown in the image. These instructions apply to all Ozempic 0.5 mg pens. |
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Important Information Pay special attention to these notes, as they are important for the safe use of the pen. | |
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Check that the paper tab and the outer needle cap are undamaged, as damage could compromise sterility. If you notice any damage, use a new needle.
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Ensure the needle is properly attached.
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The needle is covered by two caps. You must remove both caps. If you forget to remove both caps, no solution will be injected.
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A drop of solution may appear at the tip of the needle. This is normal, but even so, you must perform a flow check if this is a new pen and the first time you are using it. See step 2, “Flow Check with Each New Pen”. Do not attach a new needle to the pen until you are ready to administer the injection. |
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Always use a new needle for each injection. This helps prevent needle blockage, contamination, infection, and inaccurate dosing. | |
Never use a bent or damaged needle. | |
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Press and hold the injection button until the dose counter returns to ‘0’. The ‘0’ must align with the dose marker. A drop of solution should appear at the tip of the needle. |
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A small drop may remain at the needle tip, but it will not be injected. If no drop appears, repeat step 2, “Flow Check with Each New Pen”, up to 6 times. If still no drop appears, change the needle and repeat step 2, “Flow Check with Each New Pen”, once more. Discard the pen and use a new one if no drop of solution appears despite all attempts. | |
Always ensure a drop appears at the needle tip before first use of a new pen. This confirms that the solution is flowing. If no drop appears, no medication will be injected, even if the dose counter moves. This may indicate that the needle is blocked or damaged. If you do not perform the flow check before the first injection with each new pen, you may not receive the prescribed dose and may not achieve the intended effect of Ozempic. | |
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Continue turning until the dose counter stops and displays 0.5 mg. |
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Only the dose counter and dose marker will indicate that 0.5 mg has been selected. You can only select 0.5 mg per dose. When your pen contains less than 0.5 mg, the dose counter will stop before reaching 0.5. The dose selector emits different clicks when turned forward, backward, or beyond 0.5 mg. Do not count the pen clicks. | |
Before injecting this medication, always use the dose counter and dose marker to confirm that 0.5 mg has been selected. Do not count the pen clicks. Only 0.5 mg doses should be selected using the dose selector. 0.5 mg must be exactly aligned with the dose marker to ensure you receive the correct dose. | |
How Much Solution Remains | |
If it shows 0.5, there is at least 0.5 mg remaining in the pen. If the dose counter stops before 0.5 mg, there is not enough solution left for a complete 0.5 mg dose. |
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If there is not enough solution in the pen for a complete dose, do not use it. Instead, use a new Ozempic pen. | |
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•Count slowly to 6 while holding the button down.
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If bleeding occurs at the injection site, apply light pressure. |
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A drop of solution may appear at the needle tip after injection. This is normal and does not affect your dose. | |
Always observe the dose counter to confirm how many mg are injected. Hold the button down until the dose counter returns to ‘0’. How to Detect a Blocked or Damaged Needle
What to Do if the Needle is Blocked Change the needle as described in step 5, “After Injection”, and repeat all steps from step 1, “Preparing the Pen with a New Needle”. Ensure you select the full dose required. Never touch the dose counter during injection. This may interrupt the injection. | |
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Always discard the needle after each injection to ensure injections are administered correctly and to prevent needle blockage. If the needle is blocked, no medication will be injected.
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When the pen is empty, discard it without the needle attached, following instructions from your doctor, nurse, pharmacist, or local authorities. | |
Never attempt to reattach the inner needle cap. You may accidentally prick yourself with the needle. Always remove the needle from the pen immediately after each injection. This helps prevent needle blockage, contamination, infection, solution leakage, and inaccurate dosing. | |
Additional Important Information | |
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Maintaining Your Pen | |
Handle the pen with care. Rough handling or misuse may result in inaccurate dosing. If this occurs, you may not achieve the intended effect of this medication. | |
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Instructions for use
Ozempic 0.5 mg solution for injection in a pre-filled pen delivering 8 doses
semaglutide
Instructions for Use of Ozempic 0.5 mg Solution for Injection in a Pre-filled Pen | |
Read these instructions carefully before using your Ozempic pre-filled pen. Ask your doctor, nurse, or pharmacist for guidance on how to correctly inject Ozempic. Begin by checking the pen to ensure it contains Ozempic 0.5 mg, then review the following images to become familiar with the different parts of the pen and the needle. If you are blind or have low vision and cannot read the dose counter on the pen, do not use this pen without assistance. Seek help from someone with good eyesight who knows how to use the Ozempic pre-filled pen. Your pen is a pre-filled, dose-dispensing pen. It contains 4 mg of semaglutide and allows only 0.5 mg doses to be selected. An unused pen contains eight 0.5 mg doses. After administering the intended doses, some solution will remain in the pen. The pen must be discarded. Use the table inside the box lid to record how many injections you have administered and when they were given. The pen is designed to be used with disposable 30G, 31G, and 32G needles up to 8 mm in length. The package includes NovoFine Plus needles. |
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Important Information Pay close attention to these notes, as they are important for the safe use of the pen. | |
| |
|
|
|
|
Check that the paper tab and the outer needle cap are undamaged, as damage may compromise sterility. If any damage is observed, use a new needle.
|
|
Ensure the needle is properly attached.
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|
The needle is covered by two caps. You must remove both caps. If you forget to remove both caps, no solution will be injected.
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A drop of solution may appear at the tip of the needle. This is normal, but you must still perform a flow check if this is a new pen and you are using it for the first time. See step 2, “Flow Check with Each New Pen”. Do not attach a new needle to the pen until you are ready to administer the injection. |
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Always use a new needle for each injection. This helps prevent needle clogging, contamination, infection, and inaccurate dosing. | |
Never use a bent or damaged needle. | |
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Press and hold the injection button until the dose counter returns to '0'. The '0' must align with the dose marker. A drop of solution should appear at the needle tip. |
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A small drop may remain at the needle tip, but no medication will be injected. If no drop appears, repeat step 2, “Flow Check with Each New Pen”, up to 6 times. If still no drop appears, change the needle and repeat step 2 once more. Discard the pen and use a new one if no drop of solution appears despite these attempts. | |
Always ensure a drop appears at the needle tip before first use of a new pen. This confirms that the solution is flowing. If no drop appears, no medication will be injected, even if the dose counter moves. This may indicate that the needle is blocked or damaged. If you do not perform the flow check before the first injection with each new pen, you may not receive the prescribed dose and may not achieve the intended effect of Ozempic. | |
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Continue turning until the dose counter stops and displays 0.5 mg. |
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Only the dose counter and dose marker will indicate that 0.5 mg has been selected. You can only select 0.5 mg per dose. When the pen contains less than 0.5 mg, the dose counter will stop before reaching 0.5 mg. The dose selector makes different clicking sounds when turned forward, backward, or beyond 0.5 mg. Do not count the clicks of the pen. | |
Before injecting this medication, always use the dose counter and dose marker to confirm that 0.5 mg has been selected. Do not count the clicks of the pen. Only 0.5 mg doses should be selected using the dose selector. The 0.5 mg mark must align exactly with the dose marker to ensure you receive the correct dose. | |
How Much Solution Remains | |
If it shows 0.5, there is at least 0.5 mg remaining in the pen. If the dose counter stops before 0.5 mg, there is not enough solution left for a complete 0.5 mg dose. |
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If there is not enough solution in the pen for a complete dose, do not use it. Instead, use a new Ozempic pen. | |
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If bleeding occurs at the injection site, apply light pressure. |
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A drop of solution may appear at the needle tip after injection. This is normal and does not affect your dose. | |
Always observe the dose counter to confirm how many mg are injected. Keep the button pressed until the dose counter returns to '0'. How to Detect if the Needle is Blocked or Damaged
What to Do if the Needle is Blocked Change the needle as described in step 5, “After Injection”, and repeat all steps starting from step 1, “Preparing the Pen with a New Needle”. Ensure you select the full dose required. Never touch the dose counter during injection. This may interrupt the injection. | |
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Always discard the needle after each injection to ensure proper administration and to prevent needle clogging. If the needle is blocked, no medication will be injected.
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When the pen is empty, discard it without the needle attached, following instructions from your doctor, nurse, pharmacist, or local authorities. | |
Never attempt to reattach the inner cap to the needle. You could be accidentally injured by the needle. Always remove the needle from the pen immediately after each injection. This helps prevent needle clogging, contamination, infection, solution leakage, and inaccurate dosing. | |
Additional Important Information | |
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Maintaining Your Pen | |
Handle the pen with care. Rough handling or misuse may result in inaccurate dosing. If this occurs, you may not achieve the intended effect of this medication. | |
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