Gambit

Ozempic®

Ozempic®

Used for weight management and weight loss; this new treatment has everyone talking.

Dosage options: 0.25mg – 1mg per week. 2mg or 4mg per injectable pen

The Weight Burner

Ozempic

$312$1161

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*You will only be charged for the applicable doctor consult and fees. The medication will not be charged until the doctor has deemed that the treatment is applicable to you.
*A member of our Allied Health Team will reach out to advise you of your eligibility and next steps.
*To start the process for weight management, payment must be completed for all doctor consults, lab requisition fees and service fees.
*Includes 1 year prescription if approved
*Access to our clinicians for 1 year
*100% refundable if you are declined the prescription after a medical review

What is Ozempic®?

Ozempic (generic name: semaglutide) is a medication typically used for the treatment of type 2 diabetes. It is a glucagon-like peptide-1 (GLP-1) receptor agonist, which means it mimics the effects of the hormone GLP-1 in the body. GLP-1 is naturally produced in the gut and helps regulate glucose levels. By mimicking the effects of GLP-1, Ozempic can help lower blood sugar levels and promote weight loss. Ozempic is typically taken once a week as an injection.

Ozempic® for Weight Management

Because a common side effect of Ozempic is weight loss, it can be used to slow down weight gain, or increase weight loss. In conjunction with a healthy diet and regular exercise, Gambit can provide you a personalized treatment regime for your weight management goals

Does it work if I’m not diabetic?

Yes! Even though Ozempic was developed as a medication ot treat Type 2 diabetes, non-diabetics can use Ozempic safely. Ozempic should be avoided in those who have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome.

Important Safety Information

What Sildenafil does:

SILDENAFIL belongs to a class of medicine called phosphodiesterase type 5 (PDE5) inhibitors. Following sexual stimulation, SILDENAFIL works by helping to relax the blood vessels in your penis by allowing blood to flow into your penis. This results in improved erectile function.

When Sildenafil should not be used:

  • If you are taking any medicines containing nitrates in any form (oral, sublingual [under the tongue], skin patch, or by inhalation [spray]). Although SILDENAFIL is used occasionally, nitrates must never be used. Nitrates are found in many prescription medicines that are used in the treatment of angina pectoris (chest pain due to heart disease), such as nitroglycerin, isosorbide mononitrate, or isosorbide dinitrate. If you do not understand what nitrates are, or are unsure about whether a medication you are taking is a “nitrate”, ask your doctor or pharmacist.

If you take SILDENAFIL with nitrate containing medicines or any other nitrates (e.g., amyl nitrite “poppers”), your blood pressure could suddenly drop to a life-threatening level. You could get dizzy, faint, or even have a heart attack or stroke.

  • If you have ever had an allergic reaction to sildenafil citrate or the nonmedicinal ingredients in SILDENAFIL.
  • SILDENAFIL is not to be used in men for whom sexual activity is inadvisable.

This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours.

BEFORE you use SILDENAFIL talk to your doctor or pharmacist if you:

  • have heart problems (irregular heartbeats, angina, chest pain or had a heart attack). If you have heart problems, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. If you have chest pain, dizziness or nausea during sex, stop exerting yourself. You should not use nitrates, but you should seek immediate medical assistance.
  • are 65 years of age or over
  • have had a stroke
  • have low blood pressure or uncontrolled high blood pressure
  • have liver or kidney problems
  • have sickle cell anemia (abnormality of the red blood cells), multiple myeloma (cancer of the bone marrow) or leukemia (cancer of the white blood cells)
  • are allergic to sildenafil or any of the other ingredients of SILDENAFIL tablets
  • have a deformed penis or Peyronie’s disease
  • have ever had an erection that lasted more than 4 hours
  • have stomach ulcers or other bleeding problems.
  • have a rare inherited eye disease called retinitis pigmentosa
  • Ever had temporary, decrease, or permanent loss of vision, including a condition called Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION). The specific type of vision decrease or loss, called non-arteritic anterior ischemic optic neuropathy (NAION), seems to occur rarely when blood flow to the optic nerve is reduced or blocked. Vision decrease or loss may be partial or complete, in one or very occasionally both eyes. While in some cases the condition may improve over time, it can also be irreversible. Rare cases of central serous chorioretinopathy (serous detachment of the macula layers of the retina) have been reported.
  • Rare but serious skin reactions of Stevens-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) have been reported during the post-marketing period.

SILDENAFIL is not recommended for use in children under 18 years of age and in women.

SILDENAFIL does not protect against sexually transmitted diseases (STD), including Human Immunodeficiency Virus (HIV).

Alcohol consumption may decrease the ability to get an erection. Patients should know how to react to the drug before operating a motor vehicle or any machinery. If you are taking SILDENAFIL and experience temporary, decrease, or permanent loss of vision, stop taking SILDENAFIL and call your doctor.

In case of chest pain occurring during or after sexual activity you should not use nitrates, but you should seek immediate medical assistance. Sudden decrease or loss of hearing has been reported in a few number of post-marketing and clinical trial cases with the use of PDE5 inhibitors, including sildenafil citrate. It has not been established whether these are related directly to the use of these medications or to other factors. If you experience these symptoms, stop taking SILDENAFIL and call your doctor.

Drugs that may interact with SILDENAFIL include:

  • any drugs that contain nitrates in any form (oral, sublingual [under the tongue], skin patch or by inhalation [spray]). Nitrates are found in many prescriptions that are used to treat angina pectoris (Chest pain due to heart disease). You should not take SILDENAFIL if you are taking these drugs.
  • alpha-blockers (drugs used to treat prostate problems or high blood pressure)
  • ketoconazole or itraconazole (drugs used to treat fungal infections)
  • erythromycin (a drug used to treat bacterial infections) ritonavir, saquinavir or other drugs for the treatment of HIV
  • cimetidine (a drug generally used to treat duodenal or gastric problems)

Grapefruit juice may increase the levels of SILDENAFIL in your blood.

SIDE EFFECTS AND WHAT TO DO ABOUT THEM

As with most drugs, SILDENAFIL can cause some side effects. These effects are usually mild to moderate in nature and do not last for a long time.

The most common side effects are headache and facial flushing. Less commonly reported side effects are indigestion, dizziness, stuffy nose, effects on vision (including color tinge, increased brightness of light and blurred vision), seizure, seizure recurrence, sudden decrease or loss of hearing and transient global amnesia (temporary memory loss).

In extremely rare instances, a man may have an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours.

Reports of sudden loss of vision have occurred rarely with the use of oral erectile dysfunction medications (PDE5 inhibitors). It has not been established whether these are related directly to the use of these medications or to other factors. There may be an increased risk to patients who have already experienced a condition called Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION). You should stop taking SILDENAFIL and consult your doctor if you experience a decrease in, or loss of, vision in one or both eyes.

Reports of serious skin reactions characterized by rash, blisters, peeling skin and pain, which require immediate medical attention, have also occurred rarely. You should stop taking SILDENAFIL and consult your doctor if you experience such reactions.

If you notice any side effects not mentioned above, or any of the above-mentioned side effects persist or become bothersome, please contact your doctor or pharmacist.

Source: Mint Pharmaceuticals Inc. Product Monograph

Important Safety Information

Read More

What is OZEMPIC® used for?

  • OZEMPIC® contains the active substance semaglutide. It is used to lower blood sugar (glucose) in adults with type 2 diabetes.
  • OZEMPIC® is used on its own if your blood sugar level is not properly controlled by diet and exercise alone and you cannot use metformin.
  • OZEMPIC® is used in combination with one or more other medicines for diabetes when they are not enough to control your blood sugar levels. These other medicines may include: oral antidiabetics (such as metformin, sulfonylurea, or sodium glucose co-transporter 2 inhibitor medicines) or insulin.
  • It is important that you keep following any diet and lifestyle advice from your doctor, pharmacist or nurse while using OZEMPIC®.
  • OZEMPIC® is not a substitute for insulin. OZEMPIC® should not be used in patients with Type 1 diabetes mellitus (formerly known as insulin-dependent diabetes mellitus or IDDM), or for treatment of diabetic ketoacidosis.

How does OZEMPIC® work?

OZEMPIC® belongs to a class of medicines called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists). OZEMPIC® helps your body make more insulin when your blood sugar is high.

What are the ingredients in OZEMPIC®?

Medicinal ingredients: semaglutide. One mL solution for injection contains 1.34 mg or 2.68 mg semaglutide.

Non-medicinal ingredients: disodium phosphate dihydrate, propylene glycol, phenol, and water for injections.

OZEMPIC® comes in the following dosage forms:

OZEMPIC® is supplied as a clear and colourless solution for injection in a pre-filled pen.

OZEMPIC® is available in a carton of 1 disposable, pre-filled, multi-dose pen delivering doses of 0.25 mg or 0.5 mg, including 6 NovoFine® Plus needles. This pack size is intended to be used for dose escalation and maintenance treatment at the 0.5 mg dose. The pen contains 1.5 mL solution.

OZEMPIC® is available in a carton of 1 disposable, pre-filled, multi-dose pen delivering only doses of 1 mg, including 4 NovoFine® Plus needles. This pack size is intended to be used for maintenance treatment at the 1 mg dose only. The pen contains 3 mL solution.

Ozempic® is available in a carton of 1 disposable, pre-filled, multi-dose pen delivering only doses of 2 mg, including 4 NovoFine® Plus needles. This pack size is intended to be used for maintenance treatment at the 2 mg dose only. The pen contains 3 mL solution.

Do not use OZEMPIC® if:

  • You are allergic to semaglutide or any of the other ingredients of this medicine.
  • You or a member of your family has ever had medullary thyroid cancer (MTC).
  • You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • You are pregnant or breastfeeding.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take OZEMPIC®. Talk about any health conditions or problems you may have, including if you:

  • or a member of your family has or has had medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • Have type 1 diabetes.
  • Have ever had diabetic ketoacidosis (increased ketones in the blood or urine).
  • Have ever had an allergic reaction to OZEMPIC®.
  • Have a high heart rate (fast pulse).
  • Have ever had pancreatitis.
  • Are breastfeeding or plan to breastfeed.
  • Are pregnant or plan to become pregnant.
  • Have end stage renal disease.
  • Have gastrointestinal (digestive) problems, including severe vomiting, diarrhea and/or dehydration.
  • Have hepatic (liver) disease.
  • Have diabetic retinopathy.

Other warnings you should know about:

Children and adolescents

OZEMPIC® is not recommended in children and adolescents under 18 years as the safety and efficacy in this age group have not yet been established.

Pregnancy and breastfeeding

Tell your doctor if you are pregnant, think you might be pregnant, or are planning to become pregnant. OZEMPIC® should not be used during pregnancy and for at least two months before a planned pregnancy because it is not known if it may affect your unborn child.

If you could become pregnant while using OZEMPIC®, it is recommended to use contraception.

Do not use this medicine if you are breast-feeding. This is because it is not known if OZEMPIC® passes into breast milk.

Driving and using machines

Low blood sugar (hypoglycemia) may affect your ability to concentrate. Avoid driving or using machines if you get any signs of low blood sugar. See What are possible side effects from using OZEMPIC® for the warning signs of low blood sugar. Talk to your doctor for further information.

Severe and on-going stomach pain which could be due to acute pancreatitis

If you have severe and on-going pain in the stomach area – see a doctor straight away as this could be a sign of acute pancreatitis (inflamed pancreas).

Dehydration

During treatment with OZEMPIC®, you may experience feeling sick (nausea) or being sick (vomiting), and diarrhea. These side effects can cause dehydration (loss of fluids). It is therefore important to drink plenty of fluids to prevent dehydration. Talk to your doctor if you have any questions or concerns.

Diabetic eye disease (retinopathy)

Fast improvements in blood sugar control may lead to a temporary worsening of diabetic eye disease. This may require treatment or lead to a loss of vision. You should inform your doctor if you have diabetic eye disease (retinopathy) or if you experience eye problems during treatment with OZEMPIC®.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

In particular, tell your doctor, pharmacist or nurse if you are using medicines containing any of the following:

  • Sulfonylurea
  • Insulin

Combining these medicines with OZEMPIC® might increase the risk of getting low blood sugar (hypoglycemia). Please see What are possible side effects from using OZEMPIC® for the warning signs of low blood sugar. Your doctor may tell you to lower your regular dose levels of these drugs when adding OZEMPIC® treatment.

The following may interact with OZEMPIC®:

The following list includes some, but not all, of the drugs that may increase your heart rate. You should check with your doctor or pharmacist before taking any other medication with OZEMPIC®:

  • Drugs to treat hypertension.
  • Drugs to treat heart failure.
  • Drugs to treat HIV infection.
  • Drugs to treat attention deficit-hyperactivity disorder.
  • Drugs to suppress appetite/cause weight loss.
  • Decongestants.
  • Drugs to treat asthma.

How to take OZEMPIC®:
OZEMPIC® is given as an injection under the skin (subcutaneous injection). Do not inject it into a vein or muscle. The best places to give the injection are the front of your thighs, the front of your waist (abdomen), or your upper arm.

Before you use the pen for the first time, your doctor or Diabetes Nurse Educator will show you how to use it.

Detailed instructions for use are on the other side of this leaflet.

Always use this medicine exactly as your doctor has told you. Check with your doctor,

pharmacist or nurse if you are not sure.

You should use OZEMPIC® once a week on the same day each week if possible. You can give yourself the injection at any time of the day – regardless of meals. To help you remember to inject OZEMPIC® once a week only, it is recommended to note the chosen weekday (e.g.

Wednesday) on the carton. You can also write the date on the carton every time you have injected OZEMPIC®.

If necessary you can change the day of your weekly injection of OZEMPIC® as long as it has been at least 2 days since your last injection of OZEMPIC®.

Do not stop using OZEMPIC® without talking to your doctor. If you stop using it, your blood sugar levels may increase.

Usual dose:

When you first start using OZEMPIC®, the starting dose is 0.25 mg once a week for four weeks. After four weeks you should increase your dose to 0.5 mg once a week. Talk to your doctor before increasing your dose.

Your doctor may increase your dose to 1 mg once a week if your blood sugar is not controlled well enough with a dose of 0.5 mg.

Your doctor may increase your dose to 2 mg once a week if your blood sugar is not controlled well enough with a dose of 1 mg.

Do not change your dose unless your doctor has told you to.

Overdose:

If you use more OZEMPIC® than you should, talk to your doctor straight away. You may get side effects such as feeling sick (nausea) or being sick (vomiting), or diarrhea.

Missed Dose:

If you forgot to inject a dose and:

    • It is 5 days or less since you should have used OZEMPIC®, use it as soon as you remember. Then inject your next dose as usual on your scheduled day.
    • It is more than 5 days since you should have used OZEMPIC®, skip the missed dose. Then inject your next dose as usual on your scheduled day.

Do not take an extra dose or increase the dose to make up for a missed dose.

What are possible side effects from using OZEMPIC®?

These are not all the possible side effects you may feel when taking OZEMPIC®. If you experience any side effects not listed here, contact your healthcare professional.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Very common: may affect more than 1 in 10 people

    • Feeling sick (nausea) – this usually goes away over time
    • Diarrhea – this usually goes away over time
    • Low blood sugar (hypoglycemia) when OZEMPIC® is used with a sulfonylurea or insulin.

The warning signs of low blood sugar may come on suddenly. They can include: cold sweat, cool pale skin, headache, fast heartbeat, feeling sick (nausea) or very hungry, changes in vision, feeling sleepy or weak, feeling nervous, anxious or confused, difficulty concentrating or shaking.

Your doctor will tell you how to treat low blood sugar and what to do if you notice these warning signs.

Common: may affect up to 1 in 10 people

    • Being sick (vomiting)
    • Low blood sugar (hypoglycemia) when OZEMPIC® is used with an oral antidiabetic other than a sulfonylurea
    • Indigestion
    • Inflamed stomach (‘gastritis’) – the signs also include stomach ache, feeling sick (nausea), or being sick (vomiting)
    • Reflux or heartburn – also called ‘gastro-esophageal reflux disease’ (GERD)
    • Stomach pain
    • Bloating of the stomach
    • Constipation
    • Burping
    • Gall stones
    • Feeling dizzy
    • Feeling tired
    • Weight loss
    • Less appetite
    • Gas (flatulence)
    • Increase of pancreatic enzymes (such as lipase and amylase)
    • Complications of diabetic eye disease (retinopathy)

Uncommon: may affect up to 1 in 100 people

    • Change in the way food or drink tastes
    • Fast pulse
    • Injection site reactions – such as bruising, pain, irritation, itching and rash
    • Allergic reactions like rash, itching or hives

Rare: may affect up to 1 in 1,000 people
Severe allergic reactions (anaphylactic reactions, angioedema). You should seek immediate medical help and inform your doctor straight away if you get symptoms such as breathing problems, swelling of face, lips, tongue and/or throat with difficulty swallowing and a fast heartbeat.

Serious side effects and what to do about them
Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases

COMMON

Diabetic retinopathy complications – complications of diabetic eye disease/diabetic eye problems

 check 

UNCOMMON

Pancreatitis (severe and ongoing pain in the stomach area which could be a sign of inflamed pancreas)

 checkcheck

Severe hypoglycemia* (low blood sugar) symptoms: feeling confused, fits and passing out

 checkcheck

RARE

Severe allergic reaction (anaphylactic reaction, angioedema) symptoms: breathing problems, swelling of face, lips, tongue and/or throat with difficulty swallowing and a fast heartbeat

 checkcheck

*The risk of severe hypoglycemia may be higher when you also take other diabetes medications.

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional.

Storage:

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the pen label and carton after

ʻEXP’. The expiry date refers to the last day of that month.

Before opening:

Store in a refrigerator (2°C – 8°C). Do not freeze. Keep away from the cooling element.

During use:

  • You can keep the pen for 8 weeks when stored at a temperature below 30°C or in a refrigerator (2°C – 8°C). Do not freeze.
  • When you are not using the pen, keep the pen cap on in order to protect it from light.

Do not use this medicine if the solution is not clear and colourless.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

If you want more information about OZEMPIC®:

    • Talk to your healthcare professional
    • Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug- products/drug-product-database.html); the manufacturer’s website (www.novonordisk.ca), or by calling 1-800-465-4334.

This leaflet was prepared by Novo Nordisk Canada Inc. Last Revised 2022

OZEMPIC®, NovoFine® and NovoTwist® are trademarks of Novo Nordisk A/S and used under license by Novo Nordisk Canada Inc.

© 2022

Novo Nordisk Canada Inc