As a GLP-1 agonist, semaglutide is known for its various benefits, such as weight loss, improved quality of life, and a lower likelihood of diabetes. However, like any other medicine, it also comes with a few side effects that are generally short-lived and mild.
Most of the side effects associated with semaglutide subside as your body adjusts to the medication. However, in the meantime, there are a few tips and tricks you can undertake to mitigate these effects. Below, eighteen side effects of semaglutide and their remedies are covered.
1. Nausea and vomiting
Nausea is the most common side effect associated with semaglutide. Up to 20% of people receiving Ozempic or semaglutide for Type- 2 diabetes reported nausea during clinical trials. Nausea is more common with Wegovy for weight loss. Vomiting tends to be less common than nausea.
You are more likely to experience nausea and vomiting with higher doses of semaglutide. That is why your prescriber will increase your dose slowly over a few months to minimize these effects. For most people, side effects such as nausea should improve over time.
In the meantime, here are tips for managing nausea from semaglutide:
- Eat smaller, more frequent meals.
- Eat slowly and stop eating when you start to feel full.
- Avoid or minimize high-fat foods.
- Remain upright after you eat.
- Stay hydrated since dehydration can worsen nausea.
- Opt for low-fat, bland foods that are easy on your stomach.
- Try a home remedy, such as ginger.
If these changes do not help, talk to your healthcare team about medication options. They may recommend an over-the-counter (OTC) or prescription nausea medication for relief.
If your nausea is accompanied by severe pain in your upper and middle abdomen, seek medical attention. This could be a sign of pancreatitis, which has been reported with semaglutide.
2. Diarrhea
Diarrhea is another side effect associated with semaglutide. Around 9% of people using it for Type 2 diabetes and 30% of people using it for weight loss reported diarrhea during clinical trials.
Similar to nausea and vomiting, you are more likely to experience diarrhea with higher semaglutide doses. As mentioned above, your prescriber will slowly increase your dose over time to minimize this side effect. It should also improve over time.
A few tips for managing diarrhea from semaglutide include:
- Avoid or minimize foods that can worsen diarrhea, such as fatty or fried foods, milk, and caffeinated drinks.
- Minimize foods and drinks that can cause gas, such as beans, dairy products, and carbonated beverages.
- Avoid alcoholic beverages, since they can irritate the digestive tract.
- Drink enough fluids to replace what you are losing.
Consult your health care provider if your diarrhea is persistent or affecting your daily activities. He or she can determine the subsequent steps, which may include lowering your dose or extending the time between dose increases.
3. Constipation
Along with diarrhea, constipation can also take place with semaglutide. Some individuals may experience both side effects. Similar to other side effects, constipation tends to improve over time.
If you are feeling constipated, a few small adjustments to your daily routine may help provide relief. Examples of these include:
- Drink enough water.
- Engage in regular physical activity.
- Slowly incorporate more fiber-rich foods into your diet.
- Try a toilet stool softener to make it easier for bowel movement.
- Establish a regular bathroom routine.
Your healthcare team may recommend an OTC laxative if these lifestyle changes do not suffice.
4. Gas and bloating
You may experience gas and bloating from semaglutide. Similar to other gastrointestinal (GI) side effects, dietary and lifestyle changes may help. Examples include eating smaller meals and foods that are lower in fat. Adding fiber can help. However, adding it over a short period of time can worsen gas and bloating. Two additional servings a day is a good place to start.
If needed, your healthcare team may recommend an OTC anti-gas remedy, such as simethicone (Gas-X) for bloating relief. You can try an enzyme such as alpha galactosidase (Beano) to prevent bloating from certain gas-producing foods.
5. Stomach pain
Mild stomach pain is another common GI semaglutide side effect. Similar to nausea, vomiting, and diarrhea, this should subside over time. Using the tips listed above can help minimize this side effect.
Severe stomach pain can be a sign of more serious problems, such as pancreatitis or gallbladder issues (such as gallstones). Contact your health care provider if these complications develop.
6. Fatigue
Fatigue is a common side effect of Wegovy, reported by 11% of people using it in clinical trials. Fatigue was reported in less than 5% of people using Ozempic, and it was not reported with Rybelsus.
There are a few reasons why you might be fatigued after starting semaglutide. These can include dips in your blood glucose levels, less energy from reduced food intake, and dehydration from the GI side effects.
Feelings of fatigue should be temporary, but here are a few tips for boosting your energy in the meantime:
- Ensure you are getting enough rest by maintaining a regular sleep schedule.
- Stay hydrated since dehydration can worsen fatigue.
- Eat a well-balanced, nutrient-dense diet.
- Incorporate more movement into your routine.
- Ensure your blood glucose levels are not dropping drastically.
Consult your health care provider if your fatigue is not improving or is getting worse. He or she may need to adjust your medications or check for an underlying cause.
7. Burping
Some people experience acid reflux symptoms while taking semaglutide, which can include burping or belching. In fact, this has been referred to as the “Ozempic burp” since it can have a distinct smell and taste.
If you are’re experiencing burps or other acid reflux symptoms from semaglutide, here are a few tips that may help:
- Avoid or minimize foods and drinks that can trigger heartburn, such as greasy, spicy, and fried foods.
- Avoid caffeine and alcohol.
- Stay upright after eating.
- Sleep with the head of your bed raised about 6 inches.
- Wear loose-fitting clothes to avoid placing pressure on your stomach.
For fast relief, your health care provider may suggest an OTC antacid. Let him or her know if your symptoms get worse or do not subside.
8. Changes to your face (Ozempic face)
Some people taking semaglutide may notice less fullness in their face. This phenomenon has been referred to as “Ozempic face.”
Even though Ozempic was not initially approved for weight loss, many overweight individuals use to it reduce their BMI. Facial fat loss is one potential effect of fast and significant weight loss. This can also result in looser skin and wrinkles which are more noticeable. You can contact a weight loss clinic to improve your health if you are overweight.
Keep in mind that the benefits of semaglutide on your health outweigh these aforementioned side effects. If you are concerned about possible changes to your appearance, talk to your health care provider. He or she can recommend treatments for mitigating the appearance of wrinkles and increasing the fullness in your face.
9. Headache
Semaglutide is not known to cause headaches directly. Certain semaglutide side effects, such as dehydration, can result in headaches. It is a good idea to keep hydrated, especially if you are experiencing diarrhea or vomiting during treatment.
If you have been prescribed semaglutide for Type- 2 diabetes, it is possible that your blood glucose may drop a bit too low. This can result in headaches and other symptoms, such as shakiness and sweating.
10. Rebound weight gain
Semaglutide treatment has been associated with weight loss. Wegovy, in particular, is approved to help people manage their long-term body weight. As long as you maintain the semaglutide regimen, you will sustain your weight loss. If you stop using it, you may regain some (or all) of the weight. This is called rebound weight gain.
If you want to stop semaglutide and are concerned about rebound weight gain, talk to your health care provider. He or she can help you come up with a plan, which may include tapering off the medication. Make sure that you have a sustainable exercise routine since this has been shown to help lessen rebound weight gain.
11. Low blood glucose
Low blood glucose (hypoglycemia) is not very common with semaglutide on its own. The reason is because this medication works by telling your body to release insulin in response to a meal specifically.
Combining semaglutide with other blood glucose-lowering medications, such as insulin and sulfonylureas, raises the risk of hypoglycemia. Your prescriber may need to change the dose of these medications when starting semaglutide.
If you have Type- 2 diabetes, checking your blood glucose levels regularly can help you detect and address hypoglycemia quickly. Not everyone may experience symptoms associated with hypoglycemia, A few common ones to watch for include headache, shakiness, and sweating.
12. Hair loss
Losing weight quickly may sometimes result in hair loss. This may be a reason why some people using Wegovy or Ozempic are reporting hair loss during treatment. During clinical trials associated with Wegovy, 3% of people receiving the medication reported this side effect.
This type of hair loss, called telogen effluvium, is usually temporary. Hair loss you may be experiencing from Wegovy or Ozempic should subside as your body adjusts. Keep in mind this may take several months.
Since these medications can also affect your appetite, be sure you are getting enough vitamins, minerals, and protein. If you are not, this can also contribute to hair loss. Your healthcare team can help you ensure you are obtaining adequate nutrition during treatment.
13. Pancreatitis
Although rare, pancreatitis has been reported with semaglutide. It is unclear whether this complication is from semaglutide or another cause.
Pancreatitis can be life-threatening if left untreated. Seek immediate medical attention if you develop severe abdominal pain, nausea and vomiting, and/or jaundice (yellowing of skin and eyes).
Before starting semaglutide, tell your health care provider if you have a history of acute pancreatitis. He or she may recommend a different medication for you.
14. Gallbladder disease
Gallbladder disease, including gallstones, has been reported with semaglutide,albeit uncommon. This complication has been reported in clinical trials in less than 2% of participants taking semaglutide.
Symptoms of gallbladder complications include: upper stomach pain, fever, and jaundice. You may also notice clay-colored stools. Tell your prescriber right away if these issues develop.
Talk to your health care provider regarding ways you can avoid gallbladder problems while taking semaglutide. This may include dietary changes and routine physical activity.
15. Kidney damage
Research has shown that semaglutide may benefit the kidneys. In rare cases, acute kidney damage has been reported. This seems to be primarily related to severe GI side effects which lead to dehydration. Taking medications that may lead to dehydration, such as diuretics (water pills), may also increase your risk.
Here are a few tips for lowering your risk of kidney damage from semaglutide:
- Drink plenty of water throughout the day, especially if you have side effects such as diarrhea.
- Tell your healthcare team if any GI side effects are persistent or severe.
- Be cautious with medications that can affect kidney function, such as nonsteroidal anti-inflammatory drugs.
- Attend all follow-up appointments, since your healthcare team may want to monitor your kidney function during treatment.
Tell your healthcare team right away if you are not urinating very much or at all, or notice swelling in your arms or legs.
17. Allergic reactions
Severe allergic reactions to semaglutide, such as anaphylaxis, are rare, but still possible. Call 911 or get immediate medical attention if you have swelling of the face, tongue, or throat, or shortness of breath after your dose.
Mild allergic reactions can include itching, rash, or redness at the injection site. Stopping semaglutide is not always necessary with mild reactions. Make sure to tell your healthcare team about your reaction.
Do not use oral or injectable semaglutide if you are allergic to any of their ingredients. there is a chance you could have an allergic reaction to semaglutide if you have had a reaction to a medication in the same class.
18. Thyroid tumors
Semaglutide has a boxed warning from the FDA about a risk of thyroid C-cell tumors. This is because animal studies found that rodents developed thyroid tumors when exposed to GLP-1 receptor agonists. However, human studies have yet to confirm this risk.
You should not use semaglutide if you or your family have a history of medullary thyroid cancer, or if you have multiple endocrine neoplasia (MEN) type 2. Contact your healthcare team immediately if you notice signs or symptoms of thyroid cancer. These include a lump in your neck and neck or jaw pain.
Does semaglutide cause long-term side effects?
Ozempic, Rybelsus, and Wegovy have been on the market for less than 10 years. Researchers are still studying their potential long-term side effects, such as how they might affect the thyroid and GI tract. The FDA continues to review side effects that are reported with these medications while they are on the market.
Currently, the longest semaglutide trial followed individuals receiving Wegovy for up to 5 years. During this time, people who received a placebo (an injection without medication) reported serious side effects at a higher rate than those who received semaglutide.
When should you contact your prescriber about side effects from semaglutide?
Many semaglutide side effects may improve on their own with continued treatment. If mild GI side effects do not subside over the course of a few weeks, contact your prescriber. If they are severe at any point, seek medical attention. This may be a sign of something more serious.
Hypoglycemia is not common with semaglutide. It is important to know the indicators of low blood glucose and how to treat them. Contact your health care provider if you are finding that your blood glucose levels are dropping drastically with semaglutide. He or she may need to adjust your dose accordingly.