From the Guidelines
Semaglutide commonly causes gastrointestinal side effects, including nausea, vomiting, diarrhea, abdominal pain, and constipation, especially when starting treatment or increasing doses, as reported in the most recent study 1.
Side Effects of Semaglutide
The side effects of semaglutide can be managed by following the prescribed dosing schedule, which typically involves gradual dose escalation over several weeks.
- Starting with a low dose (like 0.25mg weekly for injectable forms) and slowly increasing allows the body to adapt.
- Staying well-hydrated, eating smaller meals, and avoiding fatty or spicy foods can help manage gastrointestinal symptoms.
- Patients should promptly report severe or persistent side effects to their healthcare provider, as dose adjustments or supportive treatments may be needed.
Serious Side Effects
More serious but less common side effects of semaglutide include:
- Pancreatitis
- Gallbladder problems
- Kidney injury
- Allergic reactions
- Diabetic retinopathy complications
- Rare reports of thyroid tumors, though this risk is primarily based on animal studies, as noted in 1 and 1.
Mechanism of Action
These side effects occur because semaglutide mimics GLP-1, a hormone that slows gastric emptying and affects the brain's appetite center, which explains both its weight loss effects and digestive side effects, as discussed in 1.
Clinical Considerations
It is essential for patients to be aware of the potential side effects of semaglutide and to discuss any concerns with their healthcare provider, as emphasized in 1 and 1.
Management of Side Effects
The management of side effects, such as nausea, vomiting, and diarrhea, can be achieved through slow titration of the dose, as recommended in 1.
Comparison with Other Studies
The findings of the most recent study 1 are consistent with previous studies, including 1, 1, and 1, which also reported gastrointestinal side effects as the most common adverse effects of semaglutide.
From the Research
Side Effects of Semaglutide
The side effects of semaglutide, a glucagon-like peptide-1 receptor agonist, have been studied in various clinical trials and reviews. Some of the common side effects associated with semaglutide include:
- Gastrointestinal side effects such as nausea, vomiting, diarrhea, and constipation 2, 3, 4, 5
- Increased risk of biliary disease, including cholelithiasis 2, 5
- Gallbladder disorders 5
- Diabetic retinopathy complications, particularly in patients with pre-existing diabetic retinopathy 2, 3, 4
- Injection-site and allergic reactions 2
- Acute pancreatitis, acute kidney injury, and acute gallbladder injury 4
- Nonarteritic anterior ischemic optic neuropathy 4
Serious Adverse Events
While semaglutide has been associated with some serious adverse events, the overall risk of these events is considered low. Some of the serious adverse events reported in clinical trials include:
- Cardiovascular events, such as myocardial infarction and stroke 3, 6
- Serious adverse events, such as acute kidney injury and diabetic retinopathy complications 3, 4
- However, a systematic review and meta-analysis found that the risk of serious adverse events was not statistically significant in patients with overweight or obesity without diabetes mellitus 5
Patient Populations
The side effects of semaglutide may vary depending on the patient population. For example:
- Patients with type 2 diabetes may be at risk for hypoglycemia, particularly when semaglutide is used in combination with other glucose-lowering medications 2, 3
- Patients with overweight or obesity without diabetes mellitus may experience gastrointestinal side effects, such as nausea and vomiting, but the risk of serious adverse events is considered low 5
- Patients with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should not use semaglutide due to the potential risk of thyroid cancer 4