Does semaglutide (Ozempic) increase heart rate?

In this article:

• Semaglutide (Ozempic) and increased heart rate
• What to do if you experience an increased heart rate after taking semaglutide

In this article

• Semaglutide (Ozempic) and increased heart rate
• What to do if you experience an increased heart rate after taking semaglutide

Semaglutide, sold as brand names Ozempic, Wegovy, and Rybelsus, is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to improve blood glucose control in type 2 diabetes mellitus or for weight management. It works by enhancing insulin secretion, which slows gastric emptying, leading to decreased appetite and weight loss. According to medical experts, Ozempic can cause your heart rate to increase following administration, but it’s a rare side effect. 

Semaglutide (Ozempic) and increased heart rate

Semaglutide, a GLP-1 receptor agonist, can increase heart rate due to its direct effects on the sinus node. The sinus node, or the sinoatrial (SA) node, is your heart’s natural pacemaker—a cluster of cells in the right atrium that generates electrical impulses that set the heart’s rhythm and rate. Ozempic can stimulate this area of the heart, leading to a temporary increase in resting heart rate.

In addition to increased heart rate, semaglutide’s effects on cardiovascular function can reduce the risk of cardiac events. “Semaglutide and other GLP-1 agonist drugs have consistently demonstrated improvement in cardiovascular functions,” says Craig D. Robison, MD, a board-certified cardiologist at Tri-City Cardiology Consultants in Mesa, Arizona. “These drugs are associated with a decreased risk of stroke, heart attacks, and the development of heart failure.”

A study involving patients with preexisting cardiovascular disease and overweight or obesity without diabetes found that a weekly semaglutide dose of 2.4 milligrams (mg) reduced the risk of death from cardiac events, nonfatal myocardial infarction, or nonfatal stroke.

It’s crucial to note that increased heart rate is not a common side effect of semaglutide. “According to the SURE (SemaglUtide Real-World Evidence) program analysis, about 16% of people experience an increased heart rate after two years on Ozempic, compared to 11% of people who were not on Ozempic in the same time frame,” says Erika Gray, PharmD, founder of MytoolBox Genomics in San Francisco, California. “According to the SUSTAIN 6 trial, the average increase in heart rate is between 2.75-3.2 beats per minute (bpm), which is clinically insignificant.”

While the average heart rate increase is between two and three beats per minute, some individuals have experienced an increase of up to 10 bpm in resting heart rate after administering a 1.5 mg dose of semaglutide.

Risk factors and considerations

Because semaglutide may increase resting heart rate, it may be an unsafe drug for some individuals. “Patients with pre-existing heart failure who experience an increased heart rate with semaglutide and other GLP-1 agonist drugs are potentially at risk of their heart failure worsening,” Dr. Robison explains. “These increases in heart rate are more pronounced in the longer-acting GLP-1 agonists such as semaglutide and tirzepatide.”

Aside from heart conditions, you should also avoid semaglutide if you have any of the following conditions or situations:

• Type 1 diabetes mellitus
• A history of medullary thyroid carcinoma (MTC)
• Chronic stomach problems
• Eye disease or vision problems
• Medical history of pancreatitis
• Hypersensitivity to the drugs or its active ingredients
• Severe gastrointestinal diseases
• Kidney disease
• Are pregnant or breastfeeding

If you have a pre-existing heart condition, please notify your healthcare provider so that they can decide whether semaglutide is a safe medication for you.

In addition to pre-existing conditions, certain lifestyle choices could exacerbate your risk of an increased heart rate while taking semaglutide. 

Some lifestyle factors that could further contribute to increased heart rate with the injectable medication include: 

• Stress 
• Physical inactivity
• Excessive alcohol consumption or withdrawal
• Too much caffeine
• Smoking or nicotine use
• Use of illegal drugs, such as cocaine or methamphetamine

While increased heart rate is a very rare side effect of semaglutide, other potential side effects are more likely to occur while taking this injectable medicine.

The most common side effects of semaglutide include:

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Eructation (burping or belching)
• Abdominal pain
• Stomach pain
• Headache
• Decreased appetite
• Dyspepsia (indigestion)
• Abdominal distension
• Flatulence
• Gastritis (inflammation of the stomach lining)
• Gastroesophageal reflux disease (GERD)
• Diabetic retinopathy
• Hypoglycemia (low blood sugar)
• Increased amylase
• Increased lipase
• Injection site reactions

Should you be worried?

Based on clinical trials and insights from medical experts, it’s highly unlikely that you’ll experience an elevated heart rate from taking Ozempic or other semaglutide medications. However, if you have any underlying medical conditions, are constantly stressed, or have some unhealthy lifestyle habits, you may have an increased risk of experiencing this rare symptom. 

“People in relatively good health should not be concerned about increased heart rate on Ozempic, as it is uncommon and rarely noticeable when it occurs,” Dr. Gray says. However, don’t hesitate to consult your healthcare provider if you believe you’re experiencing an elevated heart rate or other symptoms.

To stay on top of your heart health while taking semaglutide, you can start monitoring your heart rate daily to keep track of your bpm and identify any changes early on.

Here’s a step-by-step guide for monitoring your heart rate:

1. Use the pads/tips of your index finger and middle finger and gently press them against the side of your neck. You can also press on the inside of your wrist, just below the base of your thumb.
2. Count the number of beats you feel for 15 seconds. You can use a stopwatch or other timing device to track the seconds accurately.
3. Multiply the number of beats by four to get your heart rate.

So, for example, if you count 20 beats in 15 seconds, multiply 20 by four, for a total of 80 bpm. According to the American Heart Association, most adults should have a heart rate between 60 to 100 beats per minute. Factors such as age, physical fitness, and other medications will affect an individual’s heart rate.

If you don’t want to check your heart rate the old-fashioned way, consider a wearable device. “Wearables, such as an Apple Watch, can monitor your resting heart rate and notify you if there are any long-term changes in heart rate trends,” Dr. Robison says.

RELATED: How long can you take semaglutide?

What to do if you experience an increased heart rate after taking semaglutide

If you take semaglutide and your heart starts to beat rapidly, please contact your healthcare provider as soon as possible. “They can help you determine if the increased heart rate is from Ozempic or from a new condition,” Dr. Gray says. “You and your doctor can determine the best course of action with Ozempic.”

They may recommend stopping the medication or adjusting the dose. They may also suggest other ways to mitigate side effects, such as switching to an alternative medication or making lifestyle changes, such as stopping or limiting caffeine consumption, engaging in smoking cessation, or adopting stress management techniques.