Some users of Ozempic (semaglutide) and Wegovy are deliberately adjusting their dosages by a technique called “click counting,” or microdosing. This involves manipulating the injection pen to deliver fractions of the standard dose, a practice not officially endorsed by drug manufacturers but reportedly used under medical supervision in some cases. The same medication is sold in single-use pens as Wegovy for weight loss.
The practice has emerged for several key reasons: to cope with past medication shortages, save money, manage side effects, or maintain weight loss after reaching initial goals. Some doctors, like Beverly Tchang of NewYork-Presbyterian, instruct patients to microdose to balance effectiveness with tolerability.
How Click Counting Works
Ozempic and Wegovy pens use a rotating dial with audible “clicks” to measure dosage. Users have determined that approximately 74 clicks equate to a 1 milligram injection. By turning the dial to fewer clicks, they can administer sub-approved doses—for example, 26 clicks for 0.35 mg. These custom amounts are not FDA-approved, but some patients find them effective.
Social media platforms like YouTube, TikTok, Facebook, and Reddit host discussions and “click charts” detailing how many clicks correspond to specific doses. Some advice even comes from doctors and pharmacists.
Why People Are Doing This
Shortages: When shortages occurred, microdosing allowed patients to stretch their supply and avoid restarting treatment.
Cost: Some patients fill prescriptions for high-capacity pens and use click counting to administer smaller, cheaper doses. However, this may conflict with the drug’s official shelf life of 56 days after first use.
Side Effects: Microdosing allows for gradual dose increases, minimizing gastrointestinal distress like nausea and diarrhea, which can be severe at higher doses. It may also help patients avoid skipping doses before important events.
Weight Maintenance: Some users attempt to reduce their dose after weight loss to save money or prevent weight regain. Experts warn against this without medical guidance, as sudden reductions can lead to rebound weight gain.
The Risks
Microdosing is an experimental technique with inherent risks. Incorrect click calculations can lead to overdosing or underdosing, depending on the pen type (1 mg vs. 8 mg). This practice should only be done under a doctor’s supervision. Some experts worry that unsupervised microdosing could encourage unsafe experimentation with off-label uses, such as for addiction or longevity.
The Bottom Line
While some patients and doctors use microdosing to navigate shortages, save money, or manage side effects, it remains an unapproved technique with potential dangers. If considering this approach, consult a healthcare provider to ensure safety and effectiveness. The FDA has now resolved the shortage of semaglutide injection products, and has also approved a pill version of Wegovy (a once-daily oral semaglutide 25 mg) that’s now available for adults living with obesity or weight-related medical problems.
