What are the known adverse reactions to Ozempic (semaglutide)?

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Last updated: February 27, 2025View editorial policy

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From the Guidelines

Ozempic (semaglutide) is associated with several adverse reactions, including nausea, vomiting, diarrhea, abdominal pain, and constipation, as well as more serious reactions such as pancreatitis and thyroid C-cell tumors, and patients should be closely monitored for these potential side effects. The most common side effects of Ozempic include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Constipation
  • Headache
  • Fatigue
  • Dyspepsia
  • Dizziness
  • Abdominal distension
  • Eructation
  • Gastroenteritis
  • Gastroesophageal reflux disease These side effects are typically mild to moderate in severity and may improve over time as the body adjusts to the medication 1. More serious adverse reactions associated with Ozempic include:
  • Pancreatitis, characterized by severe abdominal pain that may radiate to the back
  • Thyroid C-cell tumors, including medullary thyroid carcinoma, which is a boxed warning for the medication
  • Kidney problems
  • Diabetic retinopathy complications
  • Allergic reactions
  • Injection site reactions
  • Gallbladder problems, including cholelithiasis and cholecystitis
  • Suicidal ideation and behavior According to a recent study, semaglutide was associated with a 38% higher risk of serious adverse events (SAEs) compared to placebo, including abdominal pain, constipation, diarrhea, nausea, vomiting, pancreatitis, and suicidal ideation 1. It is essential for patients to be aware of these potential side effects and to contact their healthcare provider immediately if they experience any severe or persistent symptoms. The medication should be used with caution in patients with a history of pancreatitis, cholelithiasis, or thyroid C-cell tumors, and patients should be counseled on the importance of reliable contraception due to the potential risks associated with the medication 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 known adverse reactions to Ozempic (semaglutide) include:

  • Gastrointestinal reactions:
    • Nausea
    • Vomiting
    • Diarrhea
    • Abdominal pain
    • Constipation Other serious adverse reactions include:
  • Pancreatitis
  • Diabetic Retinopathy Complications
  • Hypoglycemia with concomitant use of insulin secretagogues or insulin
  • Acute Kidney Injury
  • Hypersensitivity reactions, including anaphylaxis and angioedema
  • Risk of Thyroid C-cell Tumors 2

From the Research

Adverse Reactions to Ozempic (Semaglutide)

The following are known adverse reactions to Ozempic (semaglutide):

  • Gastrointestinal side effects, including nausea, vomiting, and abdominal pain 3, 4, 5, 6
  • Increased risk of biliary disease (cholelithiasis) 3
  • Pancreatitis 5, 6
  • Diabetic retinopathy complications 3, 5, 6
  • Severe allergic reactions 6
  • Acute kidney injury 5
  • Acute gallbladder injury 5
  • Nonarteritic anterior ischemic optic neuropathy 5
  • Injection-site and allergic reactions 3

Specific Patient Groups

In patients with advanced chronic kidney disease (CKD), semaglutide appears to be tolerated, despite associated gastrointestinal side effects, and leads to an improvement of glycemic control and insulin discontinuation in patients with type 2 diabetes mellitus 4. In patients with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, semaglutide is contraindicated 5. In pregnant patients, semaglutide is contraindicated 5.

Drug Interactions

Semaglutide may interact with other drugs used in diabetes treatment, such as metformin, as well as anti-psychotics, due to anti-psychotics associated weight gain 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Safety of Semaglutide.

Frontiers in endocrinology, 2021

Research

The Use of Semaglutide in Patients With Renal Failure-A Retrospective Cohort Study.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2024

Research

Semaglutide: Double-edged Sword with Risks and Benefits.

Archives of internal medicine research, 2025

Research

Semaglutide: a new drug for the treatment of obesity.

Drug and therapeutics bulletin, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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