How to use a GLP-1 pen: flow check, hold time and what to do if no drop appears

Flow check, hold time and needles for each GLP-1 pen

Ozempic and Wegovy FlexTouch pens need a flow check only on a new pen. The Mounjaro and Zepbound KwikPen needs priming every week. Single-dose autoinjectors need neither, but they set their own hold time. The table puts each US pen's Instructions for Use side by side.

How do you use an Ozempic or Wegovy FlexTouch pen for the first time?

On a new Ozempic or Wegovy FlexTouch pen, attach a new needle, turn the dose selector to the flow check symbol, hold the pen needle up and press until the counter shows 0. A drop should appear at the tip^1–2. After that first time, skip the flow check and go straight to setting your dose^1–2.

1. 1
   Check the pen

   Wash your hands. Check the name and colored label, and that the medicine is clear and colorless. Don't use it if it's cloudy^1–2.
2. 2
   Attach a new needle and take off both caps

   Push the needle straight on and turn it until tight. Pull off the outer cap and keep it, then pull off the inner cap and throw it away. If you forget the inner cap, no medicine goes in^1–2.
3. 3
   New pen only: do the flow check

   Turn the dose selector to the flow check symbol. Hold the pen needle up and press and hold the dose button until the counter shows 0. A drop will appear at the needle tip^1–2. A drop that appears before this step doesn't count. The label says you must still do the check¹.
4. 4
   Set your dose by the counter, not the clicks

   Turn the dose selector until your dose lines up with the dose pointer. The labels say not to set the dose by counting clicks^1–2. If the counter stops before your dose, there isn't enough left for a full dose. Use a new pen^1–2.
5. 5
   Inject and count to 6

   Insert the needle, keep your fingers off the counter, and press and hold the button until it shows 0. Keep pressing with the needle in and count 6 seconds. Then take the needle out and let go of the button^1–2.
6. 6
   Take the needle off

   Unscrew the needle without putting the caps back on, and put it straight into a sharps container. Put the pen cap back on. Don't store the pen with a needle attached^1–2.

An in-use Ozempic pen is thrown away 56 days after first use, even if there's medicine left¹. The Wegovy FlexTouch also gets 56 days after first use². More on that in how long pens can stay out of the fridge.

How do you prime a Mounjaro or Zepbound KwikPen?

Prime the KwikPen before every weekly dose: turn the knob 2 clicks to the prime position, hold the pen needle up, tap out air, then push the knob in and slowly count to 5. A drop of medicine should come out^3–4. Priming clears air from the cartridge and checks the pen works^3–4.

1. 1
   Wipe the seal and attach a new pen needle

   Wipe the red inner seal with an alcohol swab. Twist on a new pen needle, keep the outer shield, and throw the inner shield away^3–4.
2. 2
   Prime: 2 clicks, tap, push, count to 5

   Turn the knob slowly until you hear 2 clicks and see the extended line. Hold the pen needle up and tap the cartridge holder. Push the knob in until it stops and slowly count to 5. Push it into the air, not into your body^3–4.
3. 3
   Dial your dose all the way

   Turn the knob all the way until it stops and the dose icon shows in the window. Don't count clicks^3–4.
4. 4
   Inject and count to 5

   Insert the needle, push the knob in until it stops, then slowly count to 5 before you pull out. The icon must show in the window^3–4.
5. 5
   Check the icon

   If the icon shows, you got the full dose. If not, put the needle back in and finish the injection. Don't redial, and don't start over or repeat the injection^3–4.

After 4 doses the pen won't let you dial a full dose, and the instructions say not to inject the leftover medicine⁴. The UK pen works the same way. See Mounjaro pen doses in the UK.

How long do you hold a Zepbound, Mounjaro or Wegovy single-dose pen?

Press and hold a Zepbound or Mounjaro single-dose pen for up to 10 seconds. The first click means the injection has started and the second means it's done^3–4. Hold a Wegovy single-dose pen firmly against the skin until the yellow bar stops moving, which takes about 5 to 10 seconds².

• Zepbound and Mounjaro: pull off the gray base cap, place the clear base flat on your skin, unlock, then press the purple button. You know it's finished when the gray plunger is visible^3–4. Some people hear a soft click right before the second loud one. Don't lift the pen until that second loud click⁴.
• Wegovy and Wegovy HD: the injection starts when you press the needle cover firmly against your skin. You'll hear 2 clicks, but the yellow bar is the signal to watch. Lift the pen slowly once it stops². Lifting early, or not pressing firmly the whole time, can leave medicine on the skin and give you less than the full dose².

Air bubbles in the window are normal in both pens^2,4. The Zepbound pen doesn't need warming to room temperature first⁴.

What if no drop appears during the flow check?

No drop usually means a blocked or damaged needle, and the labels warn that you'd inject nothing even though the counter moves^1–2. Each pen has a limit on how many times to retry before you change the needle, and then before you stop.

A different sign of the same problem: on an Ozempic or Wegovy FlexTouch pen, if the counter doesn't reach 0 while you hold the button, the needle may be blocked and no medicine went in^1–2. Ozempic says to change the needle and start again from step 1¹. If a pen was dropped, attach a new needle and do the flow check again before injecting^1–2.

Are UK GLP-1 pens used the same way?

The UK Mounjaro KwikPen instructions match the US ones: prime before each injection, no more than 2 extra primes, then a new needle and one more, and count to 5 for both priming and injecting⁵. Pen needles aren't included⁵.

UK Ozempic and Wegovy FlexTouch pens come with NovoFine Plus needles in the box^6–7. Unlike the US, the UK Wegovy FlexTouch comes in five strengths, from 0.25 mg to 2.4 mg, and each pen holds 4 doses⁷. The UK leaflets aren't covered line by line here, so follow the Instructions for Use in your own box.