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Key takeaways
Semaglutide is an FDA-approved medication that healthcare providers use to treat individuals with type 2 diabetes mellitus. A specific branded formulation may also be used for weight loss.
The most common side effects of semaglutide injections are nausea, vomiting, diarrhea, stomach pain, and constipation.
Most side effects of semaglutide are short-term and should resolve within a few weeks.
Certain medical conditions, as well as a family history of certain conditions, are potential contraindications of semaglutide that can increase the risk of side effects.
To lower the potential risk of possible side effects of Ozempic, stay on the lowest dosage that your healthcare provider recommends, avoid overeating, don’t drink alcohol, and stay hydrated.
Semaglutide, is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to improve blood glucose control in type 2 diabetes mellitus (sold under the brand names Ozempic as an injectable formulation, and Rybelsus as an oral tablet) or for weight management (sold under the brand name Wegovy as an injectable formulation). The branded formulation Ozempic recently also became FDA approved to reduce the risks of major cardiovascular outcomes in adults with type 2 diabetes mellitus with known heart disease, and to reduce the risk of kidney damage and cardiovascular related deaths in adults with type 2 diabetes mellitus and chronic kidney disease (CKD).It works by enhancing insulin release, reducing glucagon production, and slowing stomach emptying, which can reduce appetite, increase feelings of fullness, and encourage weight loss. Like any prescription medicine, taking semaglutide may cause some unpleasant side effects.
Side effects of semaglutide
According to one study, the most common side effects of semaglutide reported from clinical trials include nausea, vomiting, diarrhea, stomach pain, and constipation. These gastrointestinal problems are assumed to be caused by the drug activating GLP-1 receptors (GLP-1Rs)—proteins responsible for regulating blood sugar levels and other bodily functions—and delaying gastric or stomach emptying.
Other potential gastrointestinal side effects of semaglutide can include the following:
- Eructation (belching or burping)
- Decreased appetite
- Abdominal distension
- Dyspepsia (indigestion)
- Flatulence (gas)
- Gastritis (inflammation of the stomach lining)
“Most patients will experience at least one side effect, but these effects are generally minimal if the dosing is gradual and appropriate,” says Jessica Marren, APRN, CRNA, the owner, CEO, and lead injector at Bella Bar Medspa in Brownsville, Texas. “Proper titration (slow increasing the dose of a medication by very small amounts) and monitoring significantly reduce the intensity of these symptoms, allowing most patients to tolerate the medication well.”
How soon do semaglutide side effects start?
According to Megan Horsham, MD, a board-certified physician in emergency medicine at Sanctuary Wellness Institute in Lakeland, Florida, when and if semaglutide side effects begin varies person by person. “Some people may experience no side effects ever if they follow their doctor’s suggestions and slowly titrate the dosage of medication properly,” she explains. “Some people tend to be more sensitive to medications and may have subtle side effects that could start as soon as the first injection. Most side effects, if any, are minimal and temporary.”
How long do semaglutide side effects last?
Marren says that symptoms like nausea, vomiting, diarrhea, bloating, and heartburn are short-term and typically resolve within a few weeks once your body adjusts to the use of this injectable medicine. “Rare side effects, such as gallbladder issues or pancreatitis, may require discontinuation of the medication,” she explains. “These long-term effects are uncommon but require close monitoring.”
How to prevent semaglutide side effects
There are several semaglutide contraindications or interactions—medications, procedures, or surgeries that should be avoided because they may be harmful to your health—that can lead to an increased risk of unwanted side effects.
According to Dr. Horsham and Marren, semaglutide should be avoided for the following medical conditions or situations:
- Type 1 diabetes mellitus
- A history of medullary thyroid cancer (MTC)
- Chronic abdominal pain
- Chronic vomiting
- A medical history of pancreatitis
- A family history of multiple endocrine neoplasia type 2 (MEN 2)
- Hypersensitivity to the drug or its components
- Severe gastrointestinal diseases, such as gastroparesis
- Are pregnant or breastfeeding
“I also warn patients with a history of gallstones or gallbladder disease that still have a gallbladder that losing weight (and not necessarily the medication itself) can worsen these conditions,” Dr. Horsham explains.
If you want to lower your risk of experiencing semaglutide side effects, Marren and Dr. Horsham recommend the following steps:
- Follow your healthcare provider’s instructions: “Once you begin semaglutide, listen to your doctor about a conservative or slow titration schedule of the medication to keep you on the lowest dose that is working and not causing side effects,” Dr. Horsham says. “If you’re vomiting, your dose is too high.”
- Don’t overeat: “Eat slowly and pay attention to your body,” Dr. Horsham says. “You will fill up very quickly, so overeating on this medication could cause stomach upset.”
- Avoid alcohol: To reduce gastrointestinal issues, such as nausea and vomiting, Dr. Horsham advises that you avoid consuming alcoholic beverages.
- Stay hydrated: According to Marren, you should aim to drink at least half a gallon of water per day to maintain adequate hydration.
How to treat side effects of semaglutide
If you experience side effects from semaglutide injections, dosage adjustments may relieve symptoms. “You can lower the dose or continue the same dose until side effects have subsided before increasing the dose,” Dr. Horsham says.
For gastrointestinal issues, Marren recommends changing eating habits and taking over-the-counter medications to help side effects subside from this diabetes medication. “[For constipation], increase fiber intake with green leafy vegetables, maintain adequate water consumption, and use a stool softener only if needed,” she says. “[Diarrhea] will more than likely resolve within a couple of days. Stick to a bland diet, such as BRAT (bananas, rice, applesauce, and toast), and ensure adequate electrolyte intake.”
If you’re experiencing severe side effects of semaglutide, it’s best to seek medical attention from your healthcare provider or visit your nearest emergency room if you’re having severe complications.
Serious adverse effects of semaglutide can include the following:
- Thyroid tumors
- Hypersensitivity or serious allergic reactions
- Acute kidney injury
- Cholelithiasis (gallstones)
- Cholecystitis (gallbladder inflammation)
- Angiodemia (tissue swelling of your face, eyes, and lips)
- Syncope (fainting and loss of consciousness)
- Pancreatitis (pancreas inflammation)
- Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system, Frontiers in Public Health (2022)
- Jessica Marren, APRN, CRNA, of Bella Bar Medspa
- Megan Horsham, MD of Sanctuary Wellness Institute