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Wegovy (semaglutide 2.4 mg) is a once-weekly subcutaneous injection licensed by the MHRA for weight management in adults and adolescents with obesity. Understanding proper injection technique, including how to use the Wegovy injection site thigh correctly, is essential for optimal drug absorption and patient safety. The thigh is one of three recommended injection sites alongside the abdomen and upper arm, chosen specifically for adequate subcutaneous fatty tissue. This article provides comprehensive guidance on thigh injection technique, site rotation strategies, managing injection site reactions, and recognising when to seek medical advice.
Quick Answer: The thigh is a recommended Wegovy injection site because it contains adequate subcutaneous fatty tissue for proper drug absorption and offers a large, easily accessible surface area for safe self-administration.
Wegovy (semaglutide 2.4 mg) is a once-weekly subcutaneous injection licensed by the MHRA for weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with weight-related comorbidities, as well as in adolescents aged 12 years and above with obesity. The medication belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class and works by mimicking a naturally occurring hormone that regulates appetite and food intake. Understanding the correct injection technique, including appropriate site selection, is essential for optimal drug absorption and patient safety.
The thigh is one of three recommended injection sites for Wegovy, alongside the abdomen and upper arm. These areas are specifically chosen because they contain adequate subcutaneous fatty tissue, which allows for proper absorption of the medication into the bloodstream. The thigh offers several practical advantages: it provides a large surface area for site rotation, is easily accessible for self-injection, and typically has sufficient subcutaneous fat even in individuals with lower body weight.
Why subcutaneous injection matters: Wegovy must be administered into the subcutaneous tissue (the layer between skin and muscle) rather than intramuscularly or intravenously. Subcutaneous injection ensures the medication is absorbed at the intended rate, maintaining consistent blood levels of semaglutide throughout the week. According to the Wegovy SmPC, the choice of injection site (abdomen, thigh, or upper arm) does not have a clinically relevant effect on the exposure of semaglutide.
The front and outer areas of the thigh are particularly suitable because they are easy to reach and allow clear visualisation during injection. This practical consideration helps with accurate administration and proper technique, which are important for ensuring the medication's effectiveness and minimising discomfort.
Proper injection technique is crucial for ensuring Wegovy's effectiveness and minimising injection site reactions. Before beginning, gather all necessary supplies: your Wegovy pre-filled pen (which is a single-use device), an alcohol wipe, and a sharps disposal container. Always check the medication's appearance through the pen window—it should be clear and colourless. Never use Wegovy if it appears cloudy, discoloured, or contains particles.
Preparation steps:
Wash your hands thoroughly with soap and water
Remove the Wegovy pen from the refrigerator and allow it to reach room temperature, which reduces injection discomfort
Select an injection site on the front or outer thigh, at least 2.5 cm away from any previous injection site
Clean the chosen area with an alcohol wipe using a circular motion, then allow the skin to dry completely (this prevents stinging)
Injection technique: Sit comfortably with your thigh relaxed. Pinch a fold of skin gently between your thumb and forefinger to lift the subcutaneous tissue away from the underlying muscle. Hold the pen at a 90-degree angle to your skin and press the injection button firmly. Keep the pen pressed against your skin and hold until the yellow bar in the indicator window has stopped moving and/or you hear the second click. This ensures the full dose is delivered.
After the completion signal, withdraw the pen straight out and release the skin fold. Do not rub the injection site, as this may affect absorption. A small amount of bleeding or a drop of medication at the site is normal. Apply gentle pressure with a clean tissue if needed. Immediately dispose of the used pen in a sharps container—the needle is hidden within the device for safety. Record the injection site and date to help with rotation planning for your next dose.
Important: Never inject into a vein or muscle. Always use a new pen for each injection, as Wegovy pens are designed for single use only.
Systematic rotation of injection sites is a fundamental aspect of Wegovy administration that helps prevent lipodystrophy (abnormal fat distribution), reduces the risk of injection site reactions, and maintains consistent drug absorption. The three approved sites—thigh, abdomen, and upper arm—each offer distinct advantages, and rotating between them is recommended.
The rotation strategy: Whilst you may inject Wegovy on any day of the week, maintaining the same day each week ensures consistent medication levels. When rotating sites, use a different spot each time, at least 2.5 cm away from your previous injection site. You can rotate within the same anatomical area (e.g., different parts of the thigh) or between different areas (thigh, abdomen, upper arm) according to your preference and comfort.
Site-specific considerations: Thigh: Offers a large surface area and is ideal for self-injection. Use the front and outer portions of the thigh. Many patients find this area comfortable and easy to access.
Abdomen: Inject at least 5 cm away from the navel (belly button). The abdomen provides a good amount of subcutaneous tissue for most people and is easily accessible for self-injection.
Upper arm: Use the outer back portion of the upper arm where there is adequate subcutaneous tissue. This site may be more challenging for self-injection and some patients find it easier to have a family member or carer assist with upper arm injections.
Keeping a simple diary or using a body map diagram can help track your rotation pattern. Never inject into areas with skin changes, bruising, scarring, or active skin conditions. If you have questions about site rotation or experience difficulties finding suitable injection sites, discuss this with your healthcare provider.
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Local injection site reactions are relatively common with Wegovy. Understanding what to expect can help distinguish normal reactions from those requiring medical attention. According to the Wegovy SmPC, injection site reactions are classified as 'common' side effects (affecting up to 1 in 10 people).
Expected local reactions:
Redness or erythema: A small area of pinkness around the injection site is normal and usually fades within 24–48 hours
Swelling: Minor localised swelling or a small raised area immediately after injection typically resolves within hours
Tenderness or bruising: Light bruising may occur if a small blood vessel is inadvertently punctured. This is harmless and will resolve naturally
Itching: Mild, temporary itching at the site affects some patients and usually subsides without intervention
Rash: Some patients may develop a mild rash at the injection site
Factors influencing injection site reactions: Cold medication injected directly from the refrigerator may increase discomfort and local reactions. Allowing the pen to reach room temperature before injection can help. Using proper technique—including allowing the alcohol to dry completely before injection—may also reduce reaction frequency.
Managing minor reactions: For mild discomfort, applying a cool (not ice-cold) compress for 10–15 minutes can provide relief. Avoid applying heat, which may increase inflammation. Over-the-counter oral antihistamines may help with itching, though this should be discussed with your GP or pharmacist first. If bruising occurs, it requires no specific treatment but can be minimised in future by applying gentle pressure (without rubbing) immediately after injection.
Persistent or concerning reactions: Whilst most injection site reactions are benign, persistent redness lasting beyond 72 hours, increasing pain, warmth, or swelling may indicate infection or an inflammatory response requiring medical assessment. Similarly, if you develop recurrent reactions at multiple sites or notice skin changes such as lumps, depressions, or thickening, contact your healthcare provider for evaluation.
You can report any suspected side effects to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or search for 'MHRA Yellow Card' in the Google Play or Apple App Store.
Patient safety is paramount when using Wegovy, and understanding when injection site issues require professional medical advice is essential. Whilst the medication has a well-established safety profile, certain situations warrant prompt evaluation by your GP or healthcare team.
Immediate medical attention required: Seek urgent medical advice if you experience:
Signs of infection: Increasing redness spreading beyond the injection site, significant warmth, pus or discharge, fever, or red streaks extending from the site
Severe allergic reaction: Difficulty breathing, facial or throat swelling, rapid heartbeat, severe rash, or dizziness (these symptoms suggest anaphylaxis, which requires emergency treatment via 999)
Severe persistent pain: Pain that worsens over 24–48 hours or prevents normal movement of the leg
Severe, persistent abdominal pain: Especially if accompanied by vomiting, as this may indicate pancreatitis, a rare but serious side effect
Symptoms of gallbladder problems: Sudden pain in your upper abdomen, particularly on the right side, that may spread to your shoulder or back, nausea, vomiting, or yellowing of the skin or eyes
Non-urgent concerns to discuss with your GP: Arrange a routine appointment if you notice:
Recurrent injection site reactions despite proper technique
Development of lipodystrophy (lumps, depressions, or thickened areas at injection sites)
Persistent bruising or bleeding at injection sites
Difficulty finding suitable injection sites due to scarring or skin changes
Special populations and precautions: Patients taking anticoagulants (blood thinners) may experience increased bruising and should apply gentle pressure for longer after injection. Those with diabetes should be aware that Wegovy may affect blood glucose levels, potentially requiring adjustment of other diabetes medications. There is an increased risk of hypoglycaemia when Wegovy is used with insulin or sulfonylureas, so blood glucose monitoring and dose adjustments may be necessary. If you have any skin conditions affecting potential injection sites, discuss alternative site options with your prescriber.
General safety reminders: Never share Wegovy pens, even if the needle is changed, as this poses infection risks. Store unopened pens in the refrigerator (2–8°C) and protect from light. Do not freeze. Unopened pens may be kept at temperatures below 30°C for up to 28 days. Always check the expiry date before use and dispose of used pens appropriately through pharmacy take-back schemes or sharps containers. If you miss a dose and it has been 5 days or less since the missed dose, take it as soon as possible. If more than 5 days have passed, skip the missed dose and take the next dose on your usual scheduled day.
Inject Wegovy into the front or outer portions of your thigh, where there is adequate subcutaneous fatty tissue. Choose a site at least 2.5 cm away from any previous injection site to allow proper rotation and prevent skin reactions.
Rotate between the three approved sites—thigh, abdomen, and upper arm—or within different areas of the same site each week. Maintain at least 2.5 cm distance from previous injection sites and keep a simple diary to track your rotation pattern.
Mild redness and swelling are common and typically resolve within 24–48 hours. Apply a cool compress for relief if needed. However, seek medical advice if redness persists beyond 72 hours, spreads, or is accompanied by increasing pain, warmth, or signs of infection.
All medical content on this blog is created based on reputable, evidence-based sources and reviewed regularly for accuracy and relevance. While we strive to keep content up to date with the latest research and clinical guidelines, it is intended for general informational purposes only.
DisclaimerThis content is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any medical questions or concerns. Use of the information is at your own risk, and we are not responsible for any consequences resulting from its use.
