Does Ozempic (semaglutide) cause pancreatitis?

From the Guidelines

Ozempic (semaglutide) has been associated with a small risk of pancreatitis, though this is considered a rare side effect. According to the most recent evidence from 2023, GLP-1 receptor agonists like Ozempic may increase the risk of pancreatitis in some patients 1. The exact mechanism involves the medication's effect on pancreatic enzyme secretion and possibly increased intraductal pressure. Patients taking Ozempic should be aware of pancreatitis symptoms including severe abdominal pain that may radiate to the back, nausea, vomiting, and fever. Those with a history of pancreatitis, gallstones, heavy alcohol use, or very high triglyceride levels may have a higher risk. If symptoms of pancreatitis develop while taking Ozempic, patients should seek immediate medical attention and discontinue the medication until pancreatitis has been ruled out.

Some key points to consider:

• The risk of pancreatitis is considered rare, but it is essential to monitor patients for symptoms and discontinue the medication if pancreatitis is suspected.
• Healthcare providers should evaluate the benefits versus risks when prescribing Ozempic, especially for patients with previous pancreatic conditions.
• The medication's label warns about the risk of pancreatitis, and patients should be informed about the potential risks and benefits of Ozempic 1.
• Other studies have also reported a potential increased risk of pancreatitis with GLP-1 receptor agonists, although the evidence is not conclusive 1.
• The American Gastroenterological Association recommends using semaglutide 2.4 mg with lifestyle modifications for the long-term treatment of obesity, but also notes the potential risk of pancreatitis 1.

Overall, while the risk of pancreatitis associated with Ozempic is considered rare, it is crucial to monitor patients closely and weigh the benefits and risks of the medication, especially for those with a history of pancreatic conditions.

From the FDA Drug Label

In glycemic control trials, acute pancreatitis was confirmed by adjudication in 7 OZEMPIC-treated patients (0.3 cases per 100 patient years) versus 3 in comparator-treated patients (0. 2 cases per 100 patient years). One case of chronic pancreatitis was confirmed in an OZEMPIC-treated patient. After initiation of OZEMPIC, observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting) If pancreatitis is suspected, OZEMPIC should be discontinued and appropriate management initiated; if confirmed, OZEMPIC should not be restarted.

Ozempic may cause pancreatitis. The incidence of acute pancreatitis was higher in OZEMPIC-treated patients (0.3 cases per 100 patient years) compared to comparator-treated patients (0.2 cases per 100 patient years) 2. Patients should be monitored for signs and symptoms of pancreatitis, and the medication should be discontinued if pancreatitis is suspected.

From the Research

Ozempic and Pancreatitis

• Ozempic, also known as semaglutide, is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) used to manage type 2 diabetes and obesity.
• There have been reports of acute pancreatitis in patients taking semaglutide, but the evidence is mixed.
• A case report published in Cureus in 2023 found a patient who developed acute pancreatitis after starting semaglutide for type 2 diabetes 3.
• Another case report published in Cureus in 2024 found a patient who developed acute pancreatitis after starting semaglutide for weight loss 4.
• However, a meta-analysis published in Endocrinologia, diabetes y nutricion in 2024 found that semaglutide was not associated with an increased risk of acute pancreatitis compared to placebo 5.
• A retrospective cohort study published in Diabetes & metabolic syndrome in 2024 found that semaglutide and tirzepatide were associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity with a history of acute pancreatitis 6.
• A study published in Pharmacoepidemiology and drug safety in 2015 found that dipeptidyl peptidase-4 (DPP-4) inhibitors, which are a different class of diabetes medications, were associated with a decreased risk of acute pancreatitis compared to sulfonylureas, but the study did not investigate GLP-1 RAs like semaglutide 7.

Key Findings

• Semaglutide may be associated with a risk of acute pancreatitis in some patients, but the evidence is not consistent.
• GLP-1 RAs like semaglutide may be associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity with a history of acute pancreatitis.
• More research is needed to fully understand the relationship between semaglutide and pancreatitis.