From the Guidelines
Wegovy (semaglutide) carries a small but serious risk of pancreatitis, with symptoms including severe abdominal pain that may radiate to the back, nausea, and vomiting. The estimated risk is approximately not explicitly stated in the most recent and highest quality study, but pancreatitis has been reported in clinical trials, and causality has not been established 1. Patients with a history of pancreatitis, gallstones, or heavy alcohol use face higher risks and should discuss these factors with their healthcare provider before starting treatment. If symptoms of pancreatitis develop, patients should stop taking Wegovy immediately and seek urgent medical attention. The mechanism behind this adverse effect likely involves GLP-1 receptor stimulation, which increases pancreatic enzyme production and may cause inflammation in susceptible individuals. Healthcare providers typically monitor patients during the initial treatment period and may order baseline pancreatic enzyme tests in high-risk individuals. While this risk is important to recognize, most patients tolerate Wegovy without developing pancreatitis, and the overall benefit-risk profile remains favorable for appropriate candidates. Some key considerations for the use of Wegovy include:
- Contraindications such as personal or family history of medullary thyroid cancer or MEN2, and pregnancy or breastfeeding 1
- Common side effects including nausea, vomiting, diarrhea, constipation, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, gastroenteritis, and gastroesophageal reflux disease 1
- Potential safety concerns such as pancreatitis, acute gallbladder disease, suicidal ideation and behavior, and injection site reactions 1
From the FDA Drug Label
Acute Pancreatitis Inform patients of the potential risk for acute pancreatitis and its symptoms: severe abdominal pain that may radiate to the back, and which may or may not be accompanied by vomiting. Instruct patients to discontinue WEGOVY promptly and contact their physician if pancreatitis is suspected [see Warnings and Precautions (5. 2)].
The following adverse reactions have been reported during post-approval use of semaglutide, the active ingredient of WEGOVY. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure Gastrointestinal Disorders: acute pancreatitis and necrotizing pancreatitis, sometimes resulting in death;
Risks of Pancreatitis with Wegovy (semaglutide):
- The FDA drug label warns of the potential risk for acute pancreatitis and its symptoms.
- Patients should be instructed to discontinue Wegovy promptly and contact their physician if pancreatitis is suspected.
- Postmarketing reports have included cases of acute pancreatitis and necrotizing pancreatitis, sometimes resulting in death. 2 2 2
From the Research
Risks of Pancreatitis Associated with Wegovy (Semaglutide)
The use of Wegovy (semaglutide) has been linked to an increased risk of pancreatitis in several case reports. Some key points to consider include:
- Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that has been shown to be effective in managing type 2 diabetes mellitus and obesity 3, 4, 5.
- There have been reports of acute pancreatitis in patients taking semaglutide, with some cases being severe and even fatal 4.
- The exact mechanism by which semaglutide causes pancreatitis is not fully understood, but it is thought to be related to changes in the pancreas that may lead to inflammation and damage 3, 5.
- Patients who have taken semaglutide and experienced pancreatitis have reported symptoms such as severe epigastric pain, nausea, and constipation 3, 4, 5.
- In some cases, pancreatitis has occurred after long-term use of semaglutide, and even after the medication has been discontinued 5.
Case Reports
Some notable case reports include:
- A 36-year-old female who developed acute pancreatitis after starting semaglutide for weight loss, with symptoms resolving after the medication was stopped 3.
- A 74-year-old male who died from severe pancreatitis after four years of taking semaglutide for type 2 diabetes, with a dose increase occurring four weeks prior to admission 4.
- A 53-year-old female who experienced multiple episodes of pancreatitis after taking semaglutide for type 2 diabetes, with another episode occurring 15 weeks after discontinuation of the medication 5.
Important Considerations
It is essential for patients taking semaglutide to be aware of the potential risk of pancreatitis and to seek medical attention immediately if they experience any symptoms such as severe abdominal pain, nausea, or vomiting 3, 4, 5. Clinicians should also be mindful of this potential complication when prescribing semaglutide, particularly in patients with comorbidities that may increase the risk of pancreatitis 6.