Can Wegovy (semaglutide) cause dizziness?

Dizziness as a Side Effect of Wegovy (Semaglutide)

Yes, dizziness is a known adverse effect of Wegovy (semaglutide). According to the American College of Cardiology's expert consensus, dizziness is specifically listed among the adverse effects to monitor in patients taking GLP-1 receptor agonists like semaglutide 1.

Mechanism and Prevalence

Dizziness with Wegovy may occur through several mechanisms:

1. Blood pressure changes: GLP-1 receptor agonists can decrease blood pressure, which may lead to orthostatic hypotension and dizziness in some patients.

2. Gastrointestinal effects: The common gastrointestinal side effects (nausea, vomiting) may contribute to dehydration and subsequent dizziness.

3. Rapid weight loss: The significant weight reduction associated with semaglutide (14.9% at 68 weeks with 2.4 mg weekly dosing) 2 may cause hemodynamic changes that contribute to dizziness.

Risk Factors for Dizziness with Wegovy

Certain patients may be at higher risk for experiencing dizziness while taking Wegovy:

• Elderly patients
• Patients with pre-existing cardiovascular disease
• Those taking concurrent medications that can lower blood pressure
• Patients with dehydration or electrolyte imbalances
• Those taking medications for diabetes (particularly insulin, sulfonylureas, or glinides) due to increased hypoglycemia risk 1

Management of Dizziness

If a patient experiences dizziness while taking Wegovy, consider the following approach:

1. Evaluate for hypoglycemia, especially if the patient is also taking insulin, sulfonylureas, or glinides 1

2. Check for orthostatic hypotension by measuring blood pressure lying down and standing

3. Ensure adequate hydration, particularly if the patient is experiencing gastrointestinal side effects

4. Consider dose adjustment - slower titration may reduce side effects including dizziness

5. Monitor for other neurological symptoms that may accompany dizziness, as GLP-1 receptor agonists have been associated with other neurological effects in rare cases 3

Titration Recommendations to Minimize Side Effects

The American Heart Association and American College of Cardiology recommend:

• Slow titration to reduce nausea, vomiting, and potentially dizziness 1
• Starting at lower doses and gradually increasing based on tolerance
• Following the manufacturer's recommended titration schedule

When to Consider Discontinuation

Consider discontinuing Wegovy if:

• Dizziness is severe or persistent despite management attempts
• Patient experiences syncope or near-syncope episodes
• Significant impact on quality of life or daily functioning
• Development of other concerning neurological symptoms

Important Considerations

1. Dizziness may be transient: Like other gastrointestinal side effects of GLP-1 receptor agonists, dizziness may improve over time with continued treatment 1.

2. Monitoring is essential: Regular follow-up to assess for side effects, including dizziness, is recommended, especially during dose titration periods 4.

3. Medication interactions: Be cautious when combining Wegovy with other medications that may cause dizziness or hypotension, as this could exacerbate symptoms 1.

4. Patient education: Advise patients about the potential for dizziness, particularly when changing positions quickly, and recommend appropriate precautions to prevent falls.

By recognizing dizziness as a potential side effect of Wegovy and implementing appropriate management strategies, healthcare providers can help patients maintain treatment while minimizing adverse effects.