Which site is next

The FDA-label rule

Section 2.3 of every injectable GLP-1 label, Important Administration Instructions, says essentially the same thing — Saxenda[5], Mounjaro[4], Zepbound[3], Ozempic[2] and Wegovy[1] alike:

Inject [drug] subcutaneously in the abdomen, thigh, or upper arm. Rotate injection sites with each [weekly/daily] dose.

No minimum distance between sites appears on the label itself. The patient instructions packed with each pen fill that in: leave 2 inches between one site and the next, keep 2 inches clear of the navel, and pass over any skin that is tender, bruised, reddened, hardened, scarred or marked with stretch marks.

Why rotate

• Lipohypertrophy. Inject the same spot often enough and fatty lumps build up beneath the skin. They change how the drug is absorbed there, and a dose can end up doing less than it should. Rotating is how that is prevented.
• Reactions at the site. Redness, itching and hardening usually settle within a few days on their own. Moving around stops a fresh one landing on skin that has not recovered from the last.
• Steadier absorption. Clinically the three regions take the drug up at much the same rate. Rotating still helps, by keeping site-to-site variation from accumulating across months of injections.

The 3 regions and their landmarks

• Abdomen — anywhere across it, except the 2 inches (about 5 cm) immediately around the navel. Most patient instructions treat the areas to either side of the navel as the default place to start.
• Thigh — the upper outer part, toward the front and side. Stay off the inner thigh, where the femoral vessels run.
• Upper arm — the back of it, over the triceps. In practice this one usually needs someone else to do it; the angle is awkward to manage alone.

The rotation algorithm this tracker uses

It looks at the last 3 doses you logged, works out which regions those used, and applies two rules in order:

1. Favor a region that has not appeared in the last 3 doses.
2. Having chosen a region, take the opposite side from the last dose given there — or, if you have never used that region, the opposite side from your most recent dose anywhere.

The result is a 6-site cycle (3 regions × 2 sides) that typically rotates through all 6 in 6 doses on a weekly schedule, then repeats.

How to use the printable rotation card

The print / save / copy panel below the result bundles your drug, your most recent 6 logged doses, the next suggested site, and the FDA-label rotation rule into a one-page card you can stick on the fridge or save to your phone’s files. When you do this week’s injection, come back, log it, and reprint.

Related tools and research

• Where to inject — site-by-site guide
• Step-by-step injection technique
• GLP-1 missed-dose guide
• GLP-1 titration schedule planner
• GLP-1 pre-op stop-date calendar

Important disclaimer

Educational only. What governs is §2.3 of the label and the patient instructions that came in the box with your pen — this page sits behind both. Lumps under the skin, reactions that will not settle, or anything else about a site is a question for your prescriber or your pharmacist.