What you should know about microdosing Ozempic

In this article:

• Microdosing Ozempic
• 5 reasons for microdosing Ozempic
• Does it work?
• Risks and considerations
• The bottom line

In this article

• Microdosing Ozempic
• 5 reasons for microdosing Ozempic
• Does it work?
• Risks and considerations
• The bottom line

Ozempic (semaglutide), an injectable diabetes medication manufactured by Novo Nordisk, is well-known for helping people lose a significant amount of weight and keep it off. However, taking this medication is a long-term commitment—and one that can be expensive. Enter the latest trend: microdosing, or taking very small amounts of a drug. Many are hoping to reap the benefits of glucagon-like peptide-1 agonists (or GLP-1 agonists) like Ozempic without taking the full recommended dosage—to save money on injector pens, to reduce side effects, or to manage the amount of weight lost. It’s gaining popularity among influencers on social media, in some wellness circles, and among regular folks who just want to lose a few pounds without breaking the bank.

“I can say that the concept of microdosing Ozempic is something gaining attention, and patients may naturally have questions about it,” says Annie DePasquale, MD, a family medicine physician and founder of Collaborating Docs in Arlington, Virginia. However, experts question whether taking a small dose, or microdose, of this kind of medication actually works.

Can you microdose Ozempic?

Microdosing Ozempic means taking less than your prescribed amount or an amount smaller than the smallest dose available. The dosage amounts of Ozempic are 0.25 mg, 0.5 mg,1 mg, and 2 mg, injected once a week. Typically, people begin by taking 0.25 mg of Ozempic once a week for four weeks. At week 5, they move up to a 0.5 mg dose once per week. People who have trouble controlling their blood sugar on that amount may need to bump up to 1 mg per week for four weeks—or even 2 mg per week.

Because Ozempic comes in a prefilled pen, a user has to turn a wheel on the device to measure the dose. The wheel clicks as it turns. A user could dispense a smaller dose by carefully managing how they dispense it, also known as “counting clicks.” Or, a person would need to use compounded semaglutide to obtain the smaller dose. The specific amount of the microdose could vary widely, depending on what someone decides to take and how accurately they select the dose. Some studies have reported people taking doses of semaglutide as low as 0.05 mg.

Microdosing Ozempic is “using these medications in a smaller dose than what is clinically validated,” says Alexandra Sowa, MD, an obesity physician and author of The Ozempic Revolution. While many people take Ozempic for its weight-loss benefits, the U.S. Food and Drug Administration (FDA) originally approved this medication to help people with Type 2 diabetes control their blood sugar levels. However, doses smaller than the FDA-approved ones haven’t been studied to be effective for blood sugar control. 

The FDA approved another version of the injectable semaglutide, Wegovy, specifically to help people with obesity or who are overweight and have a weight-related medical condition.  Wegovy comes in five strengths: 0.25 mg. 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. People who take Wegovy also start with a weekly 0.25 mg dose, and they eventually work their way up to a maintenance dose of either 1.7 mg or 2.4 mg per week.

On average, people who take medications like Ozempic and Wegovy lose 15% to 20% of their body weight, although this can vary. The results of the STEP clinical trial program suggest that people who took a higher weekly dose (2.4 mg) of semaglutide tended to lose more weight than people on a smaller weekly dose (1 mg). Microdosing could result in less or slower weight loss.

Why are people microdosing Ozempic?

There are many reasons someone might want to use Ozempic at much lower dosage levels than usually prescribed. Some common reasons offered as potential benefits of microdosing include:

Controlling weight loss

Some patients believe that they don’t need a high dose of Ozempic because they don’t want to lose a large amount of weight. Or, they are reluctant to take the full dose because of the stigma associated with being overweight and taking medication to help. Some people seem to think, “I don’t really need it if I’m taking less than what my doctor prescribed,” says Dr. Sowa. “It’s rooted in weight bias.”

Anecdotal reports reveal that others use microdosing as a maintenance dose to stay at a steady weight after initial weight loss on a higher dose of Ozempic.

Quieting the “food noise”

Medications like semaglutide work, in part, by suppressing the appetite. Many people who take these meds talk about how they no longer think about food or eating as much as they once did. In addition to quieting their cravings and reducing their hunger, the medication also helps with satiety. They eat, and they feel full sooner. Some people seem to believe that they don’t need a full dose to receive the appetite-curbing, cravings-reducing benefits.

Decreasing side effects

GLP-1 medications are effective but are known to cause gastrointestinal side effects. Some people turn to microdosing to try to minimize common side effects of Ozempic, like nausea, vomiting, and constipation.

“While this practice is not clinically supported, some theories suggest that microdosing may minimize side effects like nausea or gastrointestinal discomfort while still providing some level of appetite suppression or metabolic benefit,” says Dr. DePasquale. “However, this approach has not been rigorously studied, and dosing outside of approved guidelines may result in suboptimal outcomes or unforeseen risks.”

Lowering cost

Ozempic and Wegovy are expensive, and insurance coverage varies widely. Your insurance company may only pay for part of the cost of Ozempic if you have Type 2 diabetes. Or, it may not cover it at all for weight loss. Some patients try to stretch their dollar by using smaller doses of Ozempic. However, there are other ways to save. SingleCare coupons can help to lower your out-of-pocket expenses without skimping on your dose.

Ozempic coupons, Wegovy coupons

Does microdosing Ozempic work?

Some people feel that microdosing Ozempic is working for them. The problem, says Dr. Sowa, is that microdosing hasn’t been proven to work as an effective weight-loss strategy. The drug’s efficacy has only been studied in clinical trials at certain doses.

“They have only been approved at the FDA-approved levels because that’s where you see the benefits…that outweigh any risks,” says Dr. Sowa. “We did not see that benefit at the lower doses, and that’s why we dispense them at higher doses.”

Dr. DePasquale also cites the specific dosing regimens that have been approved, saying, “I would explain that deviating from these protocols, such as microdosing, has not been rigorously studied and could result in reduced effectiveness or unintended side effects.”

Risks of Ozempic microdosing

Technically, microdosing is an off-label use, and it comes with potential risks:

• Reduced effectiveness: Taking a medication like Ozempic at a much smaller dose may not produce the results that influencers are purporting to experience. “They are claiming benefits that are not proven,” says Dr. Sowa. Plus, adds Dr. DePasquale, someone who attempts to microdose Ozemic with the hopes of controlling their blood sugar may find that it’s not effective enough to do so. They may get frustrated and stop taking it altogether, which could also be risky.
• Inconsistent use: Ozempic is designed for long-term use, and people need to commit to using it appropriately to realize the benefits. If someone starts taking it, then stops taking it, and then starts taking it at a different dose, it can be harmful to their metabolic health, much like yo-yo dieting is. “I’m a little worried about the patient who is starting microdosing without clear guidance about this being a long-term medication,” Dr. Sowa says.
• Inaccurate dosing: Because Ozempic comes in a prefilled injector, some may purchase compounded semaglutide to obtain a microdose. Compounded semaglutide comes in a glass vial, and it needs to be administered with a syringe. This can lead to inaccurate dosing due to potential errors in measuring the medication with a syringe.
• Compromised quality products: Additionally, compounded semaglutide has risks, including impurities or inaccurate ingredients. “It’s hard to validate what’s in those medicines,” says Dr. Sowa. In fact, the FDA issued a July 2024 statement to warn about receiving a growing number of reports about adverse effects associated with using compounded injectable semaglutide products. The adverse events included gastrointestinal symptoms, headache, migraine, fainting, dehydration, gallstones, and acute pancreatitis.

The bottom line

Microdosing Ozempic may seem appealing, especially if you only want to shed a few pounds or cannot afford the medication. However, there is no solid data to suggest that it works—or that it works well enough to take the risk.

Before taking any weight-loss medications, talk to your healthcare provider about what’s most appropriate for you, given your current weight and health status. Your healthcare provider can help you determine a safe and effective plan to meet your goals that fits within your budget.