GLP-1 Injection Site Rotation Chart: 8-Week Belly and Thigh Plan

1. Choose your medicine. Mounjaro and Zepbound keep the back of the upper arm for another person to inject, so the arms appear only if someone else gives your shot.
2. Tap where your last shots went, up to three. If this is your first shot or you don’t remember, choose where to start this week.
3. Set the date of your next shot. The calculator names the site for that date and the seven weeks after it, following the order in the table below, and flags a zone you used twice.
4. Rest any zone that is bruised, lumpy or tender and the plan skips it. Print the plan for the fridge, add it to your calendar with the site in each reminder, or keep the link.

Belly only or thighs only leaves four zones, so each one comes round every 4 weeks and the eight-week list shows it twice.

The planner moves through the zones in a fixed order, finishing the belly before the thighs. The table shows the order when you start at the first zone.

Dividing an area into quadrants, using one each week and moving in the same direction every time is the scheme the UK injection technique recommendations describe for insulin (FIT UK recommendations, section 3.6). The same document places thigh injections on the upper third of the front and outer side of each thigh, the area the planner’s four thigh zones stand for.

The four US labels agree that the spot should change every week, but they word it differently. The table quotes section 2 of the Ozempic, Wegovy, Mounjaro and Zepbound prescribing information.

The UK wording is close. The Mounjaro SmPC says injection sites should be rotated with each dose and keeps the back of the upper arm for another person (Mounjaro SmPC, section 4.2). The Ozempic and Wegovy SmPCs say the injection site can be changed (Ozempic SmPC, section 4.2; Wegovy SmPC, section 4.2).

The Zepbound vial instructions give the reason. They say to rotate within the area you choose "to reduce your risk of getting lipodystrophy (pits in skin or thickened skin) and localized cutaneous amyloidosis (skin with lumps)" (Zepbound single-dose vial Instructions for Use). The same instructions say not to inject where the skin has pits, is thickened or has lumps, or is tender, bruised, scaly or hard. What each reaction means is explained in bruising and lumps at the injection site.

The belly and thighs are the two areas every weekly GLP‑1 label lets you inject yourself. The Mounjaro and Zepbound labels keep the back of the upper arm for another person to inject. The Ozempic and Wegovy pens allow it, but their prefilled-syringe instructions also say the back of the upper arm needs someone else’s help (Ozempic Instructions for Use). All four labels report similar exposure from the abdomen, thigh and upper arm, so leaving the arm out makes no difference to your exposure to the drug (Zepbound prescribing information, section 12.3). If someone else gives your shot, the back of each upper arm adds two more zones.

On the belly, keep at least 2 inches (5 cm) from your belly button, as the Wegovy pen instructions say (Wegovy Instructions for Use); the Ozempic prefilled syringe and the Mounjaro and Zepbound KwikPen instructions give the same 2 inches. Where to inject Ozempic, Wegovy, Mounjaro and Zepbound sets out each site and device in full.

No weekly GLP‑1 label gives a distance between injections; they ask only for a different site or spot. The nearest published figure comes from insulin guidance. The FIT UK recommendations space injections at least 1 cm apart to avoid repeated trauma to the same tissue. They also say to use a single injection site no more often than every 4 weeks when that is feasible (FIT UK recommendations, summary section 2 and section 3.6).

A weekly plan meets the 4-week figure with four zones or more, because each zone then comes round every 4 weeks at the soonest. Within a zone, move each shot at least 1 cm (half an inch) from the last one, the distance FIT UK gives in its therapeutic education section.

The FITTER recommendations, written by 183 diabetes experts from 54 countries, cover insulin injection. They call lipohypertrophy a frequent complication of therapy that distorts insulin absorption (Frid et al., Mayo Clinic Proceedings 2016). They advise not injecting into those lumps and say correct rotation helps prevent them.

A weekly GLP‑1 is 52 injections a year, against 365 for one insulin injection a day, so lump rates seen with insulin do not tell you the rate for a weekly shot.

Site rotation is free in Pensday: it records the site with each shot you log, suggests the next one on a body map, and warns you when a spot is used twice in a row or three times in 14 days. Injection site tracker apps compares other ways to keep the log.