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Use different sites within the recommended areas (abdomen, thigh, upper arm) and maintain at least 23 cm distance from previous injection sites Ensure proper needle insertion inject at a 90-degree angle into subcutaneous tissue, not intramuscularly or intradermally Allow the medication to reach room temperature remove the pen from the refrigerator approximately 30 minutes before injection, but follow the storage instructions in the Patient Information Leaflet (PIL) and do not exceed recommended storage temperatures Clean the injection site with an alcohol wipe and allow it to dry completely before injecting Do not inject into areas with active skin conditions avoid sites with rashes, bruises, scars, or inflammation Skin preparation and aftercare: Maintain good skin hydration regular use of emollients can improve skin barrier function and potentially reduce irritation Avoid tight clothing over fresh injection sites for several hours Do not massage the injection site immediately after administration, as this may increase local irritation Patient education and monitoring: Keep a symptom diary noting injection sites, any reactions, and their duration Report persistent or worsening reactions to your healthcare provider promptly Ensure you have received proper training in injection technique from a healthcare professional Be aware of the signs of serious allergic reactions and have an action plan If you have previously experienced a serious hypersensitivity reaction to semaglutide, you should not be re-exposed to the medication

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a third pathologist performed adjudication if consensus could not be reached between the two pathologists

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