Introduction: Your First Semaglutide Injection
If you're starting semaglutide treatment, the thought of self-injecting might feel intimidating. This is completely normal. Most people worry about the injection more than they worry about any other aspect of treatment—and most are pleasantly surprised at how painless and simple it actually is.
The good news: semaglutide injections are genuinely easy to administer at home. The needle is tiny (shorter than a typical pen tip), and most people feel nothing or just slight pressure during the injection. After your first one, anxiety usually drops dramatically.
This guide walks you through everything: what semaglutide actually is, why it's given as an injection, a detailed step-by-step procedure, managing needle anxiety, pain reduction tips, and honest answers to beginner questions.
Medical Context
This guide is educational and does not replace your doctor's instructions. Always follow the specific instructions provided by your healthcare provider and medication packaging. If you have concerns, contact your doctor before injecting.
What is Semaglutide? The Simple Version
Semaglutide is a synthetic hormone that mimics a naturally occurring hormone in your body called GLP-1 (glucagon-like peptide-1). This hormone controls hunger and blood sugar.
When you take semaglutide, it tells your brain you're fuller faster, reduces your desire to eat, and slows how quickly your stomach empties. The result: you eat less without feeling deprived or starving.
It's the same active ingredient sold under brand names like Ozempic (for diabetes) and Wegovy (for weight loss). NaijaBody provides pharmaceutical-grade compounded semaglutide at a fraction of the cost.
How It Works
Signals fullness to your brain
How It's Given
Weekly subcutaneous injection
Typical Results
15-18% weight loss (6 months)
Why Injection Instead of a Pill?
You might wonder: why can't this just be a tablet you swallow?
Semaglutide is a peptide hormone—a protein made of amino acids. If you swallowed it as a pill, your stomach acid would destroy it before your body could use it. It would be like trying to digest your own muscle tissue: it just breaks down.
The injection delivers semaglutide directly into the subcutaneous tissue (the layer of fat just under your skin), bypassing your digestive system. From there, it enters your bloodstream intact and works as intended.
The silver lining: one injection per week means you only have to do this seven times per month, not multiple times daily like some medications.
Key Advantages of Weekly Injections
- One injection per week (vs. daily pills)
- No stomach acid destroys the medication
- Consistent, predictable dosing
- Minimized side effects from inconsistent absorption
- No need to time it with meals
Pre-Injection Checklist: 13 Essential Items
Before you inject, prepare your space and gather supplies. This takes about 5 minutes and dramatically reduces anxiety.
Before You Start
- Washed hands thoroughly with soap and water
- Semaglutide pen or vial stored at room temperature (not cold from fridge) for 30 minutes
- Alcohol wipe or cotton ball soaked in 70% isopropyl alcohol
- New sterile needle (do not reuse)
- Sharps disposal container or sealable container for used needle
- Clean, flat surface (kitchen counter, bathroom sink)
- Good lighting (you need to see what you're doing)
- Comfortable position (sitting, standing, or lying down—whatever feels safe)
- Optional: numbing ice pack if you're anxious about pain
- Optional: watch or timer for any pre-injection wait time
- Optional: stress ball or fidget toy if anxiety is high
- Optional: small mirror if you're injecting your belly
- Written injection instructions nearby (medication package or printed guide)
Temperature Matters
Cold medication hurts more when injected. If you store semaglutide in the fridge, remove it 30 minutes before injection and let it sit at room temperature. This is one of the most effective pain-reduction techniques.
Step-by-Step Injection Procedure: 8 Steps
This is where the anxiety typically dissolves into reality. The actual procedure is straightforward and takes about 5-10 seconds of active injection time.
Step 1: Choose Your Injection Site
Semaglutide is injected subcutaneously (under the skin, not into muscle). The best locations are areas with fatty tissue:
- Abdomen (belly): Most common and easiest for self-injection. Pinch the skin 2 inches below your belly button, or use the love-handle area on the sides.
- Thighs: Good alternative. Pinch skin on the outer or inner thigh.
- Back of arm: Harder to do yourself; ask someone for help if possible.
Rotate injection sites weekly to avoid lipohypertrophy (hardened areas from repeated injections in one spot). If you injected your belly last week, use your thigh this week.
Step 2: Clean the Injection Site
Wipe the skin with an alcohol wipe or cotton ball soaked in 70% isopropyl alcohol. Use firm, circular motions. Let it air-dry for 30 seconds before injecting—this kills bacteria and makes the injection less irritating.
Do not touch the cleaned area again with your unwashed fingers.
Step 3: Attach the Needle
Remove the outer needle cap. Hold the pen (or vial) at the top, align the needle tip with the pen cartridge thread, and screw it on firmly until it's snug. Do not over-tighten.
If using a pen, you may see a flow of liquid when you first attach the needle—this is normal.
Step 4: Prime the Needle (Pens Only)
If using a prefilled pen, you must prime it. Hold the pen upright with the needle pointing up. Click or press the dose button until a small drop of liquid appears at the needle tip. This ensures the pen is working and primed for dosing.
If using a vial, skip this step and proceed to drawing up your dose.
Step 5: Dial or Draw Your Dose
For a pen: Turn the dose dial to your prescribed dose (usually 0.25mg for your first week, increasing gradually). You'll hear a click for each 0.1mg.
For a vial: Draw your dose into an insulin syringe according to your doctor's instructions.
Double-check: confirm your dose matches your prescription before proceeding.
Step 6: Pinch and Stabilize
Using your non-dominant hand, gently pinch the skin at your chosen injection site. Create a fold of skin about 1-2 inches. This helps the needle enter at the correct depth (just under the skin, not into muscle).
Keep the pinch stable throughout the injection—don't move.
Step 7: Insert the Needle
Hold the pen or syringe at a 45- to 90-degree angle (nearly perpendicular to your skin). In one smooth, quick motion, insert the needle fully into the pinched skin. Do not hesitate or go slowly.
Most people feel a tiny pinch or nothing at all. If you feel sharp pain, stop, withdraw, and try again at a different site.
Step 8: Inject and Withdraw
For a pen: Press the dose button slowly and steadily. You should see the dose counter decreasing. Once it reaches zero, hold the button down for 3 additional seconds to ensure all medication is delivered. Then slowly withdraw the needle.
For a syringe: Push the plunger slowly and steadily. Once empty, count to 3, then withdraw the needle.
Withdraw the needle at the same angle you inserted it.
That's it. The injection is complete.
What To Do Immediately After Injection
- Apply pressure if needed: If there's slight bleeding, press a tissue to the site for 10 seconds. This is normal.
- Remove and dispose of the needle: If using a pen, unscrew the needle and place it immediately into a sharps container or sealed container. Never leave it exposed.
- Dispose of properly: Never throw needles in the trash. Use a medical sharps bin or sealable hard plastic container.
- No bandage needed: Unless the injection site is bleeding, you don't need to cover it.
- Return medication to storage: Place your semaglutide back in the fridge (if using pens designed for refrigeration).
- Resume normal activities: You can exercise, bathe, and eat normally immediately after injection.
Sharps Disposal
Never put used needles in household trash or down the toilet. Many pharmacies and healthcare centers accept sharps containers for free disposal. Ask at your local pharmacy.
Common Beginner Mistakes to Avoid
Learning from others prevents your own mistakes:
1. Injecting cold medication
Taking semaglutide straight from the fridge and injecting immediately increases pain and bruising. Let it warm to room temperature for 30 minutes. This is the #1 pain prevention tactic.
2. Reusing needles
Reused needles become dull, bend, and harbor bacteria. Always use a sterile needle for each injection, even if it's the same day or next day.
3. Injecting into the same spot repeatedly
Injecting in the same location weekly causes lipohypertrophy—hardened, numb areas that reduce medication absorption. Rotate sites: belly this week, thigh next week, arm the week after, then back to belly at a different spot.
4. Hesitating during needle insertion
Slowly inserting the needle actually increases pain. Do it quickly and smoothly. The faster, controlled motion is less painful than lingering.
5. Injecting into muscle instead of fat**
Semaglutide must go subcutaneously (under the skin), not into muscle. This is why you pinch the skin—to ensure you're hitting the fat layer, not the muscle below. If you hit muscle, you'll feel sharp pain. Stop, withdraw, and try again at a different angle or site.
6. Forgetting to prime the needle (pens)**
If using a pen, you must prime it before dosing. Skipping this step means the dose doesn't deliver fully. Prime every time.
7. Moving the injection site during injection**
Once the needle is in, stay still. Moving or shifting can cause the needle to bend, hurt, or not deliver medication evenly. Keep your pinch stable.
Managing Needle Anxiety: Practical Tips
Needle anxiety is real and common. Here are evidence-based strategies to reduce it:
Before the Injection
- Breathing: Practice deep breathing (inhale for 4 counts, hold for 4, exhale for 6). Do this for 2-3 minutes before injection.
- Visualization: Close your eyes and visualize the injection going smoothly. Imagine it being painless. This primes your brain.
- Distraction: Have a movie, podcast, or music playing. Engage your attention elsewhere.
- Temperature: Apply a numbing ice pack to the injection site for 30 seconds before cleaning. This reduces nerve sensitivity.
- Positioning: Sit or lie down. Never stand, as fainting is more likely if anxious and standing.
- Support person: Have someone you trust nearby (not necessarily in the room, but available).
- Countdown: Tell yourself "On 3, I inject." The certainty reduces anxiety. Count down, then inject on 1.
During the Injection
- Don't look: If seeing the needle increases anxiety, don't watch. Look away during insertion and injection.
- Focus on breathing: Continue deep breathing during the injection. This keeps you calm and prevents breath-holding (which increases tension).
- Firm, quick insertion: A fast, smooth insertion hurts less than a slow one. Commit to the motion.
After the First Injection
- Celebrate: Acknowledge that you did it. Anxiety about the first one is typically worse than actually doing it.
- Document your experience: Write down how you felt, where it hurt (or didn't), what worked. This becomes your reference for next week.
- Second injection is easier: Most people report the anxiety drops 70% on the second injection, simply because they know it's not as bad as they feared.
When Anxiety Becomes a Problem
If needle anxiety is severe (past the first few injections), talk to your doctor. Some options: using a different injection site, asking a nurse or family member to supervise the first few, or exploring whether an auto-injector pen might help. You don't have to suffer through this alone.
Pain Management and Bruising
Most people experience no pain or mild discomfort. Here's what to expect and how to minimize it:
Pain During Injection
Semaglutide needles are 31-32 gauge—very thin, about the thickness of a human hair. Most people feel:
- Nothing at all
- A tiny pinch or pressure
- Slight stinging for a second
Sharp pain during injection usually means the needle hit muscle or a nerve. If this happens: stop, withdraw the needle, wait 1 minute, and try again at a different angle or site.
Pain Reduction Techniques (Ranked by Effectiveness)
- Room-temperature medication (30-minute wait): Huge difference. Cold medication causes more pain and bruising.
- Numbing ice pack (30 seconds before injection): Reduces nerve sensitivity. Use ice in a thin cloth, not directly on skin.
- Firm, quick needle insertion: Slow insertion hurts more. Fast and smooth is less painful.
- Proper pinch technique: Pinching the skin slightly changes nerve sensitivity and reduces pain.
- Distraction (music, conversation, watching something): Your brain processes less pain when attention is elsewhere.
- Topical numbing cream (optional): Products containing benzocaine (e.g., Emla cream) numb the area. Apply 20 minutes before injection. Ask your doctor first.
Bruising
Some bruising is normal and not dangerous. Minor bruises (small, light purple spots) typically appear 1-2 days after injection and fade within a week.
To minimize bruising:
- Use room-temperature medication
- Don't massage the injection site after injection
- Avoid anticoagulants (blood thinners) if possible; discuss with your doctor
- Use a fresh needle each time (dull needles cause more tissue damage)
- Inject at a 45-90 degree angle (not shallow)
When to Contact Your Doctor: If bruising is large (bigger than 2 inches), increasingly painful, warm to touch, or shows signs of infection (redness, warmth, pus), contact your doctor. This is rare but possible.
Storage Requirements for Semaglutide
Proper storage ensures your medication stays effective:
| Storage Condition |
Temperature |
Duration |
| Unused semaglutide (in box) |
Refrigerator (2-8°C / 36-46°F) |
Until expiration date (typically 2-3 years) |
| Open/in-use semaglutide pen |
Refrigerator (2-8°C) or room temperature (below 30°C / 86°F) |
28 days after first injection |
| Before each injection |
Room temperature (15-30°C / 59-86°F) |
30 minutes to allow warming |
| Never |
Freezer or direct sunlight |
— |
Storage Tips
- Keep in original box: The box provides light protection. Don't remove the pen until ready to use.
- Store in the fridge door: This keeps temperature stable and keeps it accessible.
- Never freeze: Freezing permanently damages semaglutide.
- Never expose to direct sunlight: Store in a cool, dark place.
- Travel: If traveling, use an insulated medication travel case with ice packs to maintain temperature.
- Used needles: Store in a sharps container. Never leave exposed.
How to Know if Semaglutide is Still Good
Before each injection, inspect the medication. It should be clear and colorless. If it's cloudy, discolored, or has particles, do not use. Dispose of it properly and contact your provider for a replacement.
Beginner Dosage Protocol: Starting at 0.25mg
If this is your first time using semaglutide, you'll start with a low dose and gradually increase. This is called dose escalation and reduces side effects.
| Week |
Dose |
What to Expect |
| Weeks 1-4 |
0.25mg (once per week) |
Mild appetite reduction, possible nausea (usually mild), increased energy |
| Weeks 5-8 |
0.5mg (once per week) |
Increased appetite suppression, mild nausea may continue, weight loss begins (2-5kg) |
| Weeks 9-12 |
1.0mg (once per week) |
Strong appetite reduction, significant weight loss (5-10kg cumulative), nausea usually resolves |
| Week 13+ |
1.7-2.4mg (once per week) |
Maximum effective dose, sustained weight loss continues, side effects minimal |
Important Notes About Dosing
- Always follow your doctor's dosing schedule. This is a general guideline. Your doctor may adjust based on your response and tolerability.
- Do not skip the 0.25mg starting dose. Starting too high increases nausea and side effects without additional benefit.
- Stick to one day per week: Choose a consistent day (e.g., every Sunday) and inject on the same day each week.
- If you miss a dose: Inject as soon as you remember unless it's within 2 days of your next scheduled dose. Then just resume your regular schedule.
- Side effects during escalation are normal and usually temporary. Nausea typically peaks in week 2-3 at a new dose, then improves by week 4.
Beginner Expectations at 0.25mg
Your first week at 0.25mg is a test dose. You might barely notice hunger reduction, or you might notice it significantly. Both are normal. Your body is adjusting. By week 5 at 0.5mg, the appetite-suppressing effect becomes obvious to most people.
What To Expect After Your First Injection
Immediate (First Hour)
- Injection site: Minor redness, slight soreness (feels like a small bruise), or nothing at all
- General feeling: Most people feel completely normal and resume their day
- Pain: If any, it's usually mild and gone within minutes
First 24 Hours
- Appetite: You may notice slightly reduced hunger, or no change yet
- Nausea: Unlikely at 0.25mg, but if present, it's usually mild and improves with food/hydration
- Energy: Some people report increased energy; others notice no change
- Injection site: Possible mild bruising (appears 12-24 hours later), slight soreness
First 7 Days
- Appetite: Gradual, progressive appetite reduction. By day 3-4, most people notice eating less without trying
- Nausea: If it occurs, it's typically mild, worse in the morning, and improves with small meals
- Digestive changes: Slight constipation is common; drink more water and eat fiber-rich foods
- Sleep: Some people sleep slightly better; others notice no change
- Mood: Elevated mood is common (related to reduced overeating guilt and initial weight loss)
Honest Assessment
At 0.25mg, side effects are usually mild or absent. The appetite reduction is subtle but noticeable. Most people's reaction: "Wait, I'm already full? That's the semaglutide." By the time you reach 0.5mg (week 5), the effect becomes undeniable.
Common Side Effects in the First Weeks
Semaglutide is well-tolerated, but some people experience side effects during the first 4 weeks, especially when doses increase.
Mild Side Effects (Common, Usually Temporary)
Nausea
Most common side effect. Usually peaks 2-3 days after injection and improves by day 7. Management: eat small, frequent meals; avoid fatty or heavy foods; stay hydrated; ginger tea or ginger candies help; take medication with food if approved by doctor.
Constipation or Diarrhea
Digestive changes are expected. Constipation is more common. Management: increase water intake (aim for 3L daily); eat fiber-rich foods (vegetables, whole grains, fruits); light exercise (walking) stimulates digestion; if severe, use stool softener (ask doctor).
Loss of Appetite for Foods You Love
Some people lose interest in previously favorite foods. This is not a side effect—it's the drug working. However, ensure you eat enough to meet caloric needs. Don't skip meals just because you're not hungry.
Headache
Mild headaches can occur, often related to dehydration. Management: drink more water; rest; over-the-counter pain reliever (paracetamol) if needed.
Fatigue
Some people feel more tired in the first week as their body adjusts. This usually resolves by week 2. Ensure you're eating enough and sleeping well.
When to Contact Your Doctor
Contact your doctor immediately if you experience:
- Severe, unrelenting nausea (unable to eat or drink)
- Vomiting that prevents medication or food intake
- Severe abdominal pain
- Signs of allergic reaction: swelling of face, lips, or throat; difficulty breathing
- Chest pain or severe shortness of breath
- Severe headache or vision changes
- Signs of infection at injection site: increasing redness, warmth, pus, fever
Expectation vs. Reality
Most side effects are mild and temporary. By week 4 at 0.25mg, most people feel completely normal with just the appetite-suppressing benefit remaining. The adjustment is usually easier than expected.