Does Ozempic cause bruising?

In this article:

• Does Ozempic cause bruising?
• Why does Ozempic cause bruising?
• How to prevent Ozempic bruising
• Ozempic alternatives
• Other Ozempic side effects
• When to see your healthcare provider about Ozempic bruising

In this article

• Does Ozempic cause bruising?
• Why does Ozempic cause bruising?
• How to prevent Ozempic bruising
• Ozempic alternatives
• Other Ozempic side effects
• When to see your healthcare provider about Ozempic bruising

Initially approved by the Food and Drug Administration (FDA) to help control blood glucose for people with Type 2 diabetes, Ozempic (semaglutide) has also been approved to reduce the risk of major adverse cardiovascular events in people with heart disease and Type 2 diabetes. It’s a popular drug, but it’s not without side effects. We’ll share why some people report Ozempic bruising as well as what you can do about it. 

Does Ozempic cause bruising?

Ozempic itself doesn’t cause bruising, but its mode of administration can. Ozempic is administered as a subcutaneous injection into the fatty tissue just beneath the skin. But not many people experience bruising from Ozempic. In fact, only 0.6% of people on the 0.5 mg dose and 0.3% of patients taking the 1 mg dose experienced an injection site reaction, such as bruising, in semaglutide’s clinical trials. And Ozempic’s label reports that only 0.2% of patients reported injection site reactions in placebo-controlled trials. So, chances are relatively low that you’ll see bruising, but it’s something to watch for.

Why does Ozempic cause bruising?

Ozempic is an injectable drug, and every injection, regardless of the medicine, can lead to bruising. According to Monelle Burrus, nurse practitioner and founder of Verve Health weight loss clinic in Oregon, “There will always be skin damage if the needle pierces small blood vessels in the area that will be injected.” 

On top of that, “Certain areas of the body, like the abdomen or thigh (common injection sites), may be more prone to bruising due to blood vessel density or tissue sensitivity,” says Dr. David Garcia, DO, founder of Polaris Rejuvenation. These damaged vessels may bleed into the surrounding area, forming a bruise.

Ozempic is a self-administered drug, so you’ll give the injections to yourself. Bruising can also arise from injecting the drug incorrectly—like pressing too hard. In a study on self-administered insulin injections, researchers concluded that bruising was often the result of patients pushing the pen into the skin. Additionally, “injecting the substance into a blood vessel or reusing a particular area of the body” may increase the risk of bruising, says Burrus. “Also, some medications and diseases might increase the risk of the development of bruises in the patients.”

The good news is that injection site bruising usually isn’t a big deal. It might look concerning, but it’s ultimately harmless, and these bruises typically only last a few days at most. That said, if an injection site bruise doesn’t go away or comes with new or worsening side effects, see your healthcare provider, who can determine whether the bruising is due to another cause.

How to prevent Ozempic bruising

Avoiding bruises while taking Ozempic is largely a matter of injection technique. As the saying goes, practice makes perfect, but even people who have never self-administered injections before can take some precautions to reduce the chances of discomfort:

• Get a demonstration. Your healthcare provider can show you how to use the injector properly so you can avoid some of the common pitfalls that might cause bruising.

RELATED: How to use an Ozempic pen

• Pick the right location. “Avoid injecting the veins and instead prefer the areas with more subcutaneous fat,” says Burrus. You’ll also want to avoid muscles. The Ozempic website recommends the skin of your abdomen, thigh, or upper arm.
• Rotate the injection location. Per Dr. Garcia, “Rotating injection sites and using the proper technique (e.g., injecting at a 90-degree angle and applying gentle pressure after the injection) can help reduce the risk of bruising.” Switch up the site with every injection so you don’t disrupt the same blood vessels over and over.

• Identify blood thinners that could contribute. “Some individuals may take blood thinners or have conditions that make their blood thinner, which increases the risk of bruising from even minor trauma, including injections,” Dr. Garcia says. And this doesn’t just mean prescription drugs like Warfarin. NSAIDs like ibuprofen and supplements like vitamin E can also cause blood thinning. Your healthcare provider can discuss the risks and benefits of blood thinners with you.

• Apply a cold compress. One systematic review and meta-analysis found that applying cold to the site before and after a subcutaneous injection of the blood thinner heparin reduced discomfort and bruising. Another study demonstrated that compression (without cold) after injection of heparin had similar benefits. Although these studies focused on a specific drug, the findings may be applicable to other injectable medicines.
• Don’t touch it. You might be tempted to touch or massage a bruise, but this might actually make it worse. Instead, just let it heal.

Ozempic alternatives

You can’t get an injection site reaction if you don’t have an injection site, and there are some alternatives that come as an oral medication instead of an injectable one. The FDA approved oral semaglutide (Rybelsus) in 2019, and other oral GLP-1 medications like orforglipron are in development.

But GLP-1 medications aren’t the only way to treat Type 2 diabetes. Metformin is another popular and effective option, and according to the American Diabetes Association, DPP-4 inhibitors, SGLT2 inhibitors, sulfonylureas, and thiazolidinediones are other viable alternatives. Each one has oral formulations, so they won’t pose the same risk of injection site bruising.

RELATED: Ozempic vs. metformin

“For certain patients who have uncontrolled Type 2 diabetes, insulin replacement therapy might be beneficial,” Burrus says. Plus, “exercise and diet come first in the management of diabetes, and these may help in the unnecessary use of drugs.”

These alternatives won’t necessarily work for every situation, but your healthcare provider can give you a better idea of which might be best for your particular condition.

Other Ozempic side effects

While bruising is possible with Ozempic, it’s relatively rare compared to some of the drug’s other side effects. The most common Ozempic side effects are nausea, vomiting, diarrhea, abdominal pain, and constipation. Nausea is easily the most prevalent, though. In clinical trials reported on the drug’s label, 15.8% of patients taking the 5 mg dose and 20.3% of patients taking the 1 mg dose reported nausea. Additionally, 5% and 9.2% (respectively) reported vomiting, while 8.5% and 8.8% reported diarrhea.

RELATED: Why does Ozempic cause nausea?

Aside from gastrointestinal side effects, Ozempic may also cause hypoglycemia (low blood sugar) when taken with other diabetes medications like sulfonylureas or insulins. It has been associated with complications from diabetic retinopathy. In rare cases, it can lead to serious adverse reactions like pancreatitis, kidney injury, gallstones, gallbladder inflammation, facial swelling, and allergic reactions. Thyroid tumors have been noted in semaglutide studies on rodents. If you notice or suspect any of these symptoms, see a healthcare professional as soon as possible.

When to see your healthcare provider about Ozempic bruising

Most of the time, bruising around your injection site is nothing to worry about. These small bruises should go away within a few days. But there are certain situations when you should seek out medical assistance.

According to Burrus, “If one gets unusual or too many bruises while on Ozempic, it is wise to seek medical advice. For instance, this is very important when the bruises appear together with other signs like swelling and skin discoloration. These might be [from] more serious problems like bleeding issues or adverse drug effects. Checking in with the doctor regularly is quite essential to any of the patients taking this medication.”

You should also see a healthcare provider if you notice:

• New or unexplained bruising: If you start seeing bruises appear seemingly out of nowhere in places other than your injection site, it might indicate another issue.
• Bruising that doesn’t go away: Bruises or discoloration that don’t go away could be a sign of infection or other conditions.
• Other serious side effects: If your bruising comes with any of the severe adverse events listed above, get it checked out right away.

Regardless of other concerning symptoms, if injection site bruises are causing you pain or discomfort, contact your healthcare provider. They can help you determine the cause and show you an injection technique that might reduce their frequency.