The Saxenda pen is a prefilled, disposable injection device that you use once daily to deliver a dose just under the skin. The process is straightforward once you’ve done it a few times: attach a new needle, prime the pen if it’s new, dial your dose, inject, and dispose of the needle. Here’s how each step works in detail.
Know the Parts of Your Pen
Before your first injection, take a moment to identify five key parts. The pen cap covers the medication cartridge and should always be replaced after use to protect the liquid from light. The dose selector is a dial you turn to set your dose. The dose counter displays the selected number, and the dose pointer (an arrow on the pen body) lines up with it to confirm your selection. Finally, the dose button at the end of the pen is what you press and hold to deliver the medication.
Preparing a New Pen
Remove the pen cap and pull the paper tab off a new, unused needle. Screw or push the needle straight onto the tip of the pen until it’s secure. Remove both the outer and inner needle caps, keeping the outer cap nearby for later removal of the used needle.
Every new pen needs a one-time flow check before your first injection. Turn the dose selector until the flow check symbol lines up with the dose pointer (it sits just past the zero mark). Hold the pen with the needle pointing up and press the dose button until the counter returns to zero. You should see a small drop of liquid appear at the needle tip. If no drop appears, repeat the process up to six times. If you still don’t see a drop, the pen may be defective and shouldn’t be used. You only need to do this flow check once per new pen, not before every injection.
Dialing Your Dose
Saxenda uses a gradual dose increase over five weeks so your body can adjust. You start at 0.6 mg daily for the first week, then increase by 0.6 mg each week: 1.2 mg in week two, 1.8 mg in week three, 2.4 mg in week four, and finally 3.0 mg from week five onward. This slow ramp-up significantly reduces nausea and other stomach-related side effects.
To set your dose, turn the dose selector until the correct number appears in the dose counter window, lined up with the dose pointer. If you accidentally dial past your dose, you can turn the selector back. The pen will not let you select a dose larger than the amount of medication remaining in the cartridge.
Injecting the Medication
You have three approved injection sites: the abdomen (stomach area), the front of the upper thigh, or the upper arm. Rotate where you inject each day to avoid skin irritation, but you can stay within the same general region. For example, you might alternate between the left and right sides of your abdomen. Clean the skin with an alcohol swab if your provider recommends it.
Insert the needle into the skin at a straight angle. Press the dose button and hold it down. Keep the needle in your skin until the dose counter reads zero, then slowly count to six before pulling the needle out. This pause ensures the full dose is delivered and prevents medication from leaking back out. If the counter does not return to zero, the pen did not contain enough medication for your full dose, and you’ll need to use a new pen for the remainder.
The injection goes under the skin, not into a vein or muscle. If you’re pinching a fold of skin (which many people find easier for abdominal injections), release the fold after pulling the needle out.
Removing and Disposing of Needles
After every injection, carefully guide the outer needle cap back onto the needle. Unscrew or pull the capped needle off the pen and place it directly into a sharps disposal container. Never throw loose needles into regular household trash. Use a new needle for every single injection, as reusing needles can cause contamination, infection, or blocked tips that affect your dose accuracy.
When your sharps container is about three-quarters full, seal it and dispose of it through your local program. Options vary by community but commonly include drop-off boxes at pharmacies, hospitals, or fire stations, household hazardous waste collection sites, and mail-back programs. Your local health department or trash service can tell you what’s available in your area.
Storage Rules
Unopened Saxenda pens belong in the refrigerator between 36°F and 46°F (2°C to 8°C) until their printed expiration date. Once you start using a pen, you can keep it in the refrigerator or at room temperature, as long as the temperature stays below 86°F (30°C). Do not freeze the pen, and don’t use it if it has been frozen.
The critical rule: throw away your in-use pen after 30 days, even if there’s medication left inside. Write the date you first used the pen on a label or in your phone so you don’t lose track. Always replace the pen cap after each injection to shield the liquid from light, which can degrade the medication.
Handling Air Bubbles
Small air bubbles in the liquid are common and harmless. Because Saxenda is injected under the skin rather than into a vein, tiny bubbles pose no safety risk. Trying to tap or purge them out can waste medication or damage the pen mechanism, so leave them alone. If you notice a large bubble that takes up a significant portion of the cartridge, or if the pen won’t deliver medication properly, contact your pharmacy.
Timing and Managing Nausea
You can inject Saxenda at any time of day, with or without food. The most practical approach is to pick a consistent time that’s easy to remember and stick with it. If you miss a dose by more than 12 hours, skip it and take your next dose at the usual time the following day. Do not double up.
Nausea is the most common side effect, especially during the first few weeks as your dose increases. A few strategies help: eat smaller, more frequent meals instead of three large ones, avoid greasy, fried, or heavily spiced foods, steer clear of strong smells, and take small sips of water or suck on ice chips throughout the day. For most people, nausea fades as the body adjusts to each new dose level, which is exactly why the five-week ramp-up schedule exists.