Can Semaglutide (Ozempic) cause gastritis?

From the Guidelines

Ozempic (semaglutide) can potentially cause or worsen gastritis in some patients, as evidenced by gastrointestinal side effects such as nausea, vomiting, diarrhea, and stomach discomfort, which may contribute to gastric inflammation, as reported in a 2024 study 1. As a GLP-1 receptor agonist, Ozempic's mechanism of action slows gastric emptying and increases acid exposure time in the stomach, potentially irritating the gastric mucosa. Some key points to consider:

• Patients with pre-existing gastritis or risk factors for gastric inflammation should monitor their symptoms closely when starting Ozempic.
• The standard starting dose is 0.25 mg once weekly for four weeks, then increasing to 0.5 mg weekly, with potential further increases to 1 mg or 2 mg weekly as needed for glycemic control, as outlined in a 2023 study 1.
• If you develop persistent upper abdominal pain, burning sensation, or other symptoms of gastritis while taking Ozempic, contact your healthcare provider, who may recommend taking the medication with food, using acid-reducing medications, or adjusting your dosage to help manage these effects, as suggested in a 2024 study 1. It is essential to weigh the potential benefits of Ozempic against the risks of gastritis and other gastrointestinal side effects, and to closely monitor patients for any adverse effects, as recommended in a 2023 study 1. Additionally, a 2024 study 1 highlights the importance of slow titration to increase gastrointestinal tolerability and minimize the risk of adverse effects. Overall, while Ozempic may pose a risk of gastritis, its potential benefits in managing type 2 diabetes and obesity make it a valuable treatment option for many patients, as supported by the evidence from a 2024 study 1.

From the FDA Drug Label

The most common adverse reactions, reported in ≥5% of patients treated with OZEMPIC are: nausea, vomiting, diarrhea, abdominal pain and constipation (6.1). The FDA drug label does not explicitly mention gastritis as an adverse reaction. However, it does mention abdominal pain, which can be a symptom of gastritis.

• Abdominal pain is reported in ≥5% of patients treated with OZEMPIC.
• There is no direct information on gastritis in the drug label 2.

From the Research

Ozempic and Gastritis

• Ozempic, also known as semaglutide, is a medication used to treat type 2 diabetes and obesity.
• The relationship between Ozempic and gastritis is complex, with some studies suggesting a potential link between the two.
• A study published in 2022 3 found that semaglutide was associated with gastrointestinal adverse events, including gastritis, with a reporting odds ratio (ROR) of 1.01-42.03.
• Another study published in 2021 4 found that semaglutide induces mostly mild-to-moderate and transient gastrointestinal disturbances, but did not specifically mention gastritis as a common side effect.
• A study published in 2022 5 found that semaglutide exposure was not statistically significantly different between subjects with and without upper GI disease, including gastritis.

Gastrointestinal Adverse Events

• Gastrointestinal adverse events, including gastritis, are a common side effect of many medications, including semaglutide.
• A study published in 2006 6 found that current use of H(2) antagonists and proton pump inhibitors (PPIs) was associated with an increased risk of acute pancreatitis, but did not specifically mention gastritis.
• A study published in 2024 7 found that semaglutide therapy was not associated with an increased risk of acute pancreatitis, but did not specifically mention gastritis.

Mechanisms and Risk Factors

• The exact mechanisms by which semaglutide may cause gastritis are not fully understood, but may be related to its effects on gastrointestinal motility and secretion.
• Patient age and body weight may be associated with an increased risk of gastrointestinal adverse events, including gastritis, according to a study published in 2022 3.
• Further research is needed to fully understand the relationship between Ozempic and gastritis, and to identify potential risk factors and mechanisms.