From the Guidelines
Nausea and vomiting caused by Ozempic (semaglutide) should be managed by starting with non-pharmacological approaches, such as eating smaller, more frequent meals, avoiding fatty or spicy foods, and staying well-hydrated, as these side effects typically improve within 4-8 weeks as the body adjusts to the medication 1. To further manage these symptoms, anti-nausea medications such as ondansetron 4-8 mg as needed or metoclopramide 5-10 mg before meals can provide relief. Some key points to consider when managing nausea and vomiting caused by Ozempic include:
- The nausea occurs because Ozempic slows gastric emptying and affects the brain's chemoreceptor trigger zone 1.
- If severe symptoms continue, the healthcare provider might consider temporarily reducing the Ozempic dose or slowing down the dose escalation schedule 1.
- It's essential to document these symptoms in the medical record with the appropriate ICD-10 code (R11.2 for nausea with vomiting) and note the association with Ozempic 1.
- Contact the healthcare provider immediately if experiencing severe abdominal pain, persistent vomiting, or signs of dehydration, as these may require more urgent intervention 1. The management of nausea and vomiting caused by Ozempic is crucial to improve the patient's quality of life and minimize the risk of dehydration and other complications. According to the study published in Anaesthesia 1, the most common adverse effects of GLP-1 receptor agonists, such as Ozempic, are nausea, vomiting, and diarrhea, which are dose-dependent and more frequent with short-acting drugs. Slow titration is helpful in increasing gastrointestinal tolerability 1. In addition, the study published in Kidney International 1 highlights the importance of managing nausea and vomiting caused by GLP-1 receptor agonists, such as Ozempic, in patients with chronic kidney disease. Overall, the management of nausea and vomiting caused by Ozempic requires a comprehensive approach that includes non-pharmacological and pharmacological interventions, as well as close monitoring of the patient's symptoms and adjustment of the treatment plan as needed.
From the FDA Drug Label
The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation. Nausea and vomiting are listed as common side effects of OZEMPIC.
- Key points:
- Nausea and vomiting are potential side effects of OZEMPIC.
- Patients should talk to their healthcare provider about any side effect that bothers them or does not go away. 2
From the Research
Nausea and Vomiting Caused by Ozempic (Semaglutide)
- Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist used for the management of type 2 diabetes 3, 4, 5, 6, 7.
- Common adverse effects of semaglutide include gastrointestinal side effects, such as nausea and vomiting 4, 5, 6.
- Studies have shown that semaglutide is associated with an increased incidence of nausea, vomiting, and diarrhea compared to placebo 6.
- The tolerability profile of oral semaglutide is consistent with that seen for injectable GLP-1RAs, with gastrointestinal side effects seen most frequently, and most are transient and tend to occur during dose escalation 4.
- Semaglutide has been proved to be safe in adults and elderly patients with renal or hepatic disorders demanding no dose modification, but gastrointestinal adverse effects are common 3.
Management of Nausea and Vomiting
- Patients experiencing nausea and vomiting while taking semaglutide should be monitored closely and managed accordingly 5.
- The beneficial metabolic and cardiovascular actions of semaglutide, and the low risk for severe adverse events, suggest that semaglutide has an overall favorable risk/benefit profile for patients with type 2 diabetes 5.
- However, patients at risk for deterioration of existing diabetic retinopathy should be carefully monitored if treated with semaglutide, particularly if also treated with insulin 5.