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The following strategies are recommended to minimise discomfort and reduce the risk of reactions: Injection technique optimisation: Allow the medication to reach room temperature before injectingremove the pen from the refrigerator 30 minutes prior to use Rotate injection sites systematically , using a different area each week (e.g., alternating between abdomen, thighs, and upper arms) Avoid injecting into areas with visible skin changes, bruises, scars, or stretch marks Use proper injection technique : place the pen at a 90-degree angle against the skin, press and hold until the injection completes, and hold for the full 10 seconds (or until you hear the second click) Ensure the skin is clean and dry before injectionuse an alcohol wipe and allow it to dry completely Upper arm injections should be given by a caregiver or another person [1] [4] Symptomatic relief measures: Apply a cold compress to the injection site for 1015 minutes after injection to reduce swelling and discomfort Avoid rubbing or massaging the injection site immediately after administration Over-the-counter antihistamines (such as cetirizine or loratadine) may help relieve itching if bothersome, though this should be discussed with a pharmacist or GP first Topical hydrocortisone cream (1%) may be applied sparingly for up to 7 days to reduce inflammation and itching

Starting at 0.25 mg semaglutide is not a reflection of your prior medication strength it is a standard safety measure to allow your body to adjust to the different mechanism and minimize GI side effects
However, this risk increases when combined with other glucose-lowering medications, particularly sulfonylureas or insulin