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The high price and side effects of Ozempic, the blockbuster diabetes drug also used off label for weight loss, has led people to stretch out their supply by taking the medication in smaller, micro doses.
But the efficacy of micro dosing Ozempic has yet to be determined by clinical trials, says Northeastern professor Mansoor Amiji.
A micro dose could amount to one-10th the amount of the standard prescription, says Amiji, university distinguished professor of pharmaceutical sciences and chemical engineering.
“Nobody has done any clinical studies with one-tenth of the dose to show whether it is working or not working,” he says.
Ozempic, the trade name for semaglutide, is a once-a-week injectable medication in the class of GLP-1 receptor agonists used to lower blood sugar levels in people with type 2 diabetes.
Doses start at 0.25 milligrams weekly and may eventually be increased to 2 milligrams weekly, according to GoodRx.
Ozempic is also prescribed for weight loss, which is considered an off-label treatment rarely covered by insurance.
The out-of-pocket cost for an injectable pen with a full dose of Ozempic can cost over $1,000 — providing an incentive for people to stretch out their treatments by micro dosing.
Published reports say the cost has led to patients taking the popular drug in smaller amounts to make it last longer.
And it’s not just Ozempic — other blockbuster GLP-1 drugs such as Wegovy, Mounjaro and Zepbound are part of the micro dosing trend, according to Healthline.
“I can certainly understand these drugs are expensive,” Amiji says. He says people think, “’If I could spread the drug over a longer period of time, it’s better from a cost perspective.’”
“But micro dosing is not, in my opinion, a solution to that,” Amiji says.
Another reason people might micro dose is to dodge side effects that can include nausea, diarrhea, vomiting and muscle loss.
“But,” Amiji asks, “is it still efficacious?”
Reports of microdosing helping people remain in the realm of “anecdotal,” he says. “There’s no evidence.”
It’s easy to see why people might be tempted to take Ozempic since it is being touted as beneficial not only for weight loss but also for improved cardiovascular health, reducing depression and even lowering the risk of an opioid overdose.
“Right now we’re seeing a lot of preclinical evidence in terms of benefits in other disease conditions,” Amiji says.
He calls the studies promising but is hoping for the day when “clinical data that is done in a scientifically rigorous way” can bear out the claims.
Current claims are not based on placebo-controlled trials, Amiji says. “It is primarily anecdotal evidence. It’s not a standardized trial that allows you to look at the data and make comparisons.”
Amiji says he’d like to see the cost of GLP-1s reduced so more people can benefit from the already proven benefits.
And he says whether people are using a full or micro dose, they should always be sure to use a clean needle to avoid contamination issues.