The Three FDA-Approved Injection Sites
Semaglutide is a subcutaneous (under the skin) injection. The FDA has approved three body areas where you can safely inject Wegovy or Ozempic:
- Abdomen (stomach area): Most common, easiest to access yourself
- Thigh (front or outer): Good alternative for self-injection
- Upper arm (back area): Usually requires someone else to help
All three sites work equally well for semaglutide absorption. The "best" site is whichever you can access comfortably and rotate consistently.
Option 1: Abdomen (Recommended for Most)
Best for Self-Injection: Abdomen
Exact Location:
Inject in the abdomen at least 2 inches away from your belly button, anywhere in the lower stomach area. Avoid the area directly around the belly button (within 2-inch radius).
- ✓Easy access: You can see and reach the area yourself
- ✓Large surface area: Plenty of space for rotation
- ✓Fast absorption: Good blood flow in abdominal tissue
- ✓Less painful: More fatty tissue = softer injection
- ✓Most studied: Standard site in STEP clinical trials
- •Avoid if you have abdominal surgery scars in that area
- •May be less comfortable if you have very low body fat
- •Avoid areas with stretch marks or skin irritation
Divide your abdomen into four quadrants (upper left, upper right, lower left, lower right). Rotate through all four areas to give each injection site at least 4 weeks to recover before reusing.
Option 2: Thigh (Front or Outer)
Thigh Injection Area
Exact Location:
Inject in the front or outer part of the thigh, halfway between your knee and hip. Avoid the inner thigh (too many blood vessels and nerves) and the back of the thigh (hard to access).
- ✓ Easy to access while sitting
- ✓ Good alternative if abdomen is tender
- ✓ Large area for rotation
- ✓ Can do yourself without help
- ✓ Good option if abdomen has scarring
- • May be more painful if you have less thigh fat
- • Avoid if you sit for long periods (can irritate site)
- • Slightly slower absorption than abdomen
- • Watch for bruising if you exercise legs frequently
Sit down and relax your thigh muscles before injecting. A tense muscle makes injection more painful. The tissue should feel soft when you pinch it.
Option 3: Upper Arm (Back Area)
Upper Arm Injection Area
Exact Location:
Inject in the back (outer) part of the upper arm, about halfway between the shoulder and elbow. This area is difficult to reach yourself—most people need help from another person.
- ✓ Consistent absorption rates
- ✓ Good if abdomen/thigh unavailable
- ✓ Discreet injection site
- ✓ Less affected by body position
- ✗ Usually requires another person to help
- • Smaller surface area limits rotation options
- • More painful if you have less arm fat
- • Difficult to see the injection site
If you're injecting yourself, stick with abdomen or thigh. Upper arm is hard to reach properly and you can't see what you're doing. Save this site for when someone can help you.
Proper Injection Technique (Step-by-Step)
Before You Start:
- 1.Wash your hands thoroughly with soap and water
- 2.Let medication warm to room temperature for 30 minutes (cold injections hurt more)
- 3.Gather supplies: Semaglutide pen or vial, alcohol wipes, sharps container, cotton ball or gauze
- 4.Check the medication: Should be clear and colorless. Don't use if cloudy or discolored
Injection Steps:
- Clean the injection site: Use an alcohol wipe to clean the area. Let it air dry completely (30 seconds). Don't blow on it or fan it—this adds bacteria.
- Pinch the skin: Using your thumb and forefinger, gently pinch up a fold of skin at the injection site. This creates a subcutaneous space for the medication.
- Insert the needle: Hold the pen or syringe at a 90-degree angle to your skin. Push the needle straight in with a quick, smooth motion. (If you're very lean, a 45-degree angle may work better—ask your provider.)
- Inject the medication: For Wegovy/Ozempic pens, press the button and hold for the full time (usually 6 seconds). For syringes, slowly push the plunger down. Don't rush.
- Remove the needle: Pull the needle straight out at the same angle you inserted it. Don't twist or angle it.
- Apply pressure: Press a cotton ball or gauze over the injection site for a few seconds. Don't rub—this can irritate the site and affect absorption.
- Dispose of the needle: Immediately place the needle or pen needle in a sharps container. Never recap needles—this causes needle stick injuries.
Site Rotation: Why It Matters
Rotating injection sites isn't optional—it's essential. Repeated injections in the same spot can cause:
- Lipohypertrophy: Buildup of fatty tissue that creates lumps under the skin
- Lipoatrophy: Loss of fatty tissue creating dents or indentations
- Reduced absorption: Scar tissue prevents proper medication absorption
- Pain and bruising: Overused sites become tender and bruise easily
- Inconsistent results: Medication doesn't work as predictably
Rotation Schedule:
Recommended Rotation Pattern:
- • Week 1: Abdomen, lower left quadrant
- • Week 2: Abdomen, upper left quadrant
- • Week 3: Abdomen, upper right quadrant
- • Week 4: Abdomen, lower right quadrant
- • Week 5: Repeat starting with lower left
- • Week 1: Abdomen (left side)
- • Week 2: Right thigh
- • Week 3: Abdomen (right side)
- • Week 4: Left thigh
- • Week 5: Repeat
Golden rule: Wait at least 4 weeks before reusing the exact same spot. Move your injection at least 1 inch from the previous week's site.
Tips to Make Injections Less Painful
Before Injection:
- ✓ Let medication warm to room temperature
- ✓ Use a fresh needle (never reuse)
- ✓ Apply ice to numb area (5 minutes before)
- ✓ Relax muscles at injection site
- ✓ Take a deep breath before inserting needle
During Injection:
- ✓ Insert needle quickly (hesitation hurts more)
- ✓ Inject medication slowly (5-10 seconds)
- ✓ Keep skin pinched until needle is out
- ✓ Don't inject into muscle (use fatty tissue)
- ✓ Remove needle at same angle inserted
After Injection:
- ✓ Don't rub the injection site
- ✓ Apply gentle pressure if bleeding
- ✓ Watch for unusual reactions
- ✓ Dispose of needle immediately
- ✓ Record site location for rotation tracking
General Tips:
- ✓ Inject same day/time each week
- ✓ Avoid areas with moles or scars
- ✓ Use shorter needles if anxious (ask provider)
- ✓ Practice on an orange first if nervous
- ✓ Consider vibration device to distract nerves
Common Injection Site Reactions (Normal vs. Concerning)
Normal Reactions:
- Small red bump: Lasts a few hours, no treatment needed
- Minor bruising: Small bruise that fades in 3-7 days
- Slight tenderness: Mild soreness at site for 1-2 days
- Small drop of blood: Tiny blood spot that stops quickly
- Itching: Mild, temporary itching without rash
When to Call Your Doctor:
- !Severe pain at injection site that doesn't improve
- !Large, spreading redness or warmth around injection site
- !Swelling that increases over 24 hours
- !Pus or drainage from injection site
- !Fever after injection (could indicate infection)
- !Hard lumps under skin that don't go away
- !Allergic reaction: Hives, difficulty breathing, swelling of face/throat (call 911)
Wegovy Pens vs Ozempic Pens vs Compounded Semaglutide
| Aspect | Wegovy/Ozempic Pens | Compounded Vials |
|---|---|---|
| Ease of Use | Very easy, pre-measured doses | Requires drawing up dose each time |
| Needle Visibility | Hidden (better for needle anxiety) | Visible during entire process |
| Cost | Higher ($300-1,400/mo without insurance) | Lower ($79-299/mo) |
| Portability | Compact, discreet | Bulkier with multiple supplies |
| Dose Flexibility | Fixed doses only | Can adjust dose precisely |
| Injection Sites | All three sites work well | All three sites work well |
Injection site choice is the same regardless of which delivery method you use. Brand-name pens (Wegovy, Ozempic) and compounded vials both go in the same body locations: abdomen, thigh, or upper arm.
Frequently Asked Questions
Can I inject semaglutide in the same spot every week?
No. Rotating injection sites is essential to prevent lipohypertrophy (fat buildup), lipoatrophy (fat loss), and scar tissue formation. Wait at least 4 weeks before reusing the same spot, and move at least 1 inch from previous injection sites.
Does the injection site affect how well semaglutide works?
All three FDA-approved sites (abdomen, thigh, upper arm) have similar absorption rates and effectiveness. The abdomen may have slightly faster absorption due to better blood flow, but STEP clinical trials showed no significant difference in weight loss results between injection sites.
Which site is least painful?
The abdomen is generally least painful because it has more fatty tissue. Thigh can be comfortable if you have adequate subcutaneous fat. Upper arm tends to be more painful, especially for people with less arm fat. Pain also depends on injection technique—slower injection hurts less.
Can I switch between injection sites each week?
Yes, you can alternate between body areas (abdomen one week, thigh the next) or stay within one area and rotate within it (abdomen left side one week, right side next week). Either rotation method works as long as you're not reusing the exact same spot within 4 weeks.
What if I get a bruise at the injection site?
Small bruises are normal and harmless. They occur when the needle nicks a small blood vessel. Apply gentle pressure after injection to minimize bruising. Avoid aspirin or NSAIDs before injection (they increase bruising). If you get large bruises regularly, you may be injecting into muscle instead of fatty tissue—pinch more skin before injecting.
Should I massage the injection site after injecting?
No. Don't rub or massage the injection site—this can affect medication absorption and irritate the area. Simply apply gentle pressure with a cotton ball or gauze for a few seconds if there's any bleeding, then leave it alone.
Is there a difference between Wegovy and Ozempic injection sites?
No difference. Both Wegovy (for weight loss) and Ozempic (for diabetes) contain semaglutide and use the same three injection sites: abdomen, thigh, or upper arm. The injection technique is identical.
The Bottom Line: Best Injection Site for You
Our Recommendation:
For most people self-injecting semaglutide, the abdomen is the best starting point:
- ✓Easy to access and see what you're doing
- ✓Large surface area for proper rotation
- ✓Generally least painful with good fatty tissue
- ✓Most studied site in STEP clinical trials
Use the thigh as an alternative if your abdomen becomes tender, has scarring, or you simply prefer it. Reserve upper arm for when you have someone to help you.
Most important: Rotate consistently and use proper injection technique. The "best" site is whichever you can access comfortably while maintaining a 4-week rotation schedule.
Getting Started with Semaglutide?
Learn about online providers offering compounded semaglutide with physician oversight and injection training.