What should I do if I experience lightheadedness, hypotension, and weight loss while taking Ozempic (semaglutide)?

From the Guidelines

If you experience lightheadedness, hypotension, and weight loss while taking Ozempic (semaglutide), you should contact your healthcare provider immediately to assess the need for dose adjustment or management of side effects. These symptoms could be indicative of dehydration, excessive weight loss, or other side effects that require medical attention. It is crucial not to stop taking Ozempic suddenly without medical guidance. In the meantime, ensuring you stay well-hydrated, eat regular meals despite reduced appetite, and avoid standing up too quickly can help minimize lightheadedness. The medication's effect on slowing gastric emptying and reducing food intake can lead to dehydration and excessive weight loss, and its impact on blood glucose levels can contribute to lightheadedness, especially if you're taking other diabetes medications 1. Your doctor might recommend reducing your Ozempic dose, adjusting other medications, or implementing dietary changes to manage these side effects while maintaining the medication's benefits for blood glucose control or weight management. It's also important to note that GLP-1 receptor agonists like semaglutide have been associated with gastrointestinal side effects, which are usually transient and can be mitigated by slow up-titration of the medication 1. Given the potential benefits of semaglutide in weight management and cardiovascular risk reduction, as evidenced by recent studies 1, working closely with your healthcare provider to manage side effects and adjust treatment as necessary is key to maximizing the therapeutic benefits of Ozempic while minimizing its risks. Key considerations include monitoring for signs of dehydration, managing dietary intake to prevent excessive weight loss, and regular follow-up with your healthcare provider to adjust the treatment plan as needed.

From the FDA Drug Label

Signs and symptoms of low blood sugar may include: o dizziness or light-headedness o blurred vision o anxiety, irritability, or mood changes o sweating o slurred speech o hunger o confusion or drowsiness o shakiness o weakness o headache o fast heartbeat o feeling jittery

If you experience lightheadedness, hypotension, and weight loss while taking Ozempic (semaglutide), it may be related to low blood sugar (hypoglycemia), which is a possible side effect of Ozempic.

• Dizziness or lightheadedness is a symptom of low blood sugar.
• You should talk to your healthcare provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia).
• Your healthcare provider may need to adjust your dose of Ozempic or other diabetes medicines due to weight loss.
• It is essential to follow your healthcare provider's instructions and attend regular check-ups to monitor your condition 2.

From the Research

Lightheadedness and Soft Blood Pressure with Weight Loss on Ozempic

• Lightheadedness and hypotension (low blood pressure) are potential side effects of Ozempic (semaglutide), especially when combined with weight loss 3, 4.
• Studies have shown that semaglutide can lead to significant weight loss, with a mean reduction in weight of 10.2% at 208 weeks 3.
• The SELECT trial found that semaglutide was associated with lower rates of serious adverse events, including those related to blood pressure, compared to placebo 3.
• Another study found that low-dose semaglutide was effective and safe for short-term weight loss in non-diabetic people, with no severe adverse reactions, such as hypoglycemia and hypotension, observed 4.
• A systematic review and network meta-analysis of randomized controlled trials found that semaglutide, a GLP-1 receptor agonist, was one of the most effective drugs for weight loss, with a mean difference in percentage body weight change of -11.40% compared to lifestyle modification alone 5.
• Semaglutide has also been shown to improve cardiometabolic risk factors, including blood pressure, in adults with overweight or obesity without diabetes 6.
• A meta-analysis of randomized controlled trials found that semaglutide significantly reduced systolic blood pressure in patients with type-2 diabetes, with a weighted mean difference of -2.31 mmHg compared to placebo or other antihyperglycemic agents 7.

Management of Lightheadedness and Hypotension

• If you experience lightheadedness or hypotension while taking Ozempic, it is essential to consult your healthcare provider for guidance on managing these side effects 3, 4.
• Your healthcare provider may recommend monitoring your blood pressure regularly and adjusting your medication or lifestyle habits as needed 6, 7.
• It is also crucial to maintain adequate hydration and electrolyte balance to prevent dehydration and electrolyte imbalances, which can exacerbate lightheadedness and hypotension 4, 6.