What are the side effects of Ozempic (semaglutide)?

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Last updated: March 24, 2025View editorial policy

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From the Guidelines

Ozempic (semaglutide) is associated with several side effects, most commonly gastrointestinal issues such as nausea, vomiting, diarrhea, abdominal pain, and constipation, as well as other effects like decreased appetite, weight loss, headache, fatigue, dizziness, and injection site reactions. These side effects are often most pronounced when starting treatment or increasing doses, but they typically improve over time as the body adjusts to the medication 1. Other potential side effects include pancreatitis, gallbladder problems, kidney issues, allergic reactions, and hypoglycemia, particularly when used with other diabetes medications 1. It's also important to note that Ozempic may increase the risk of diabetic retinopathy complications in some patients with pre-existing eye conditions and can cause changes in taste perception or acid reflux 1. The medication works by mimicking a hormone called GLP-1 that regulates blood sugar and appetite, which explains many of these effects 1. To minimize side effects, patients should start at a low dose and gradually increase to therapeutic doses, stay well-hydrated, and eat smaller, more frequent meals if experiencing digestive issues 1. Given the potential for serious side effects, it's crucial for patients to be closely monitored by their healthcare provider, especially those with a history of pancreatitis, cholelithiasis, or other conditions that may be exacerbated by semaglutide 1. The most recent and highest quality study available, from 2023, supports these findings and emphasizes the importance of careful patient selection and monitoring 1.

Some key points to consider when prescribing Ozempic include:

  • Starting with a low dose (typically 0.25 mg once weekly) and gradually increasing as needed and tolerated by the patient 1
  • Monitoring for signs of pancreatitis, gallbladder disease, and other serious side effects 1
  • Counseling patients on the potential for decreased appetite, weight loss, and other effects, and advising them to stay hydrated and manage digestive issues through dietary changes 1
  • Being aware of the potential for increased risk of diabetic retinopathy complications in patients with pre-existing eye conditions 1
  • Considering the potential for suicidal ideation and behavior, as well as other psychiatric effects, and monitoring patients closely for these symptoms 1

From the FDA Drug Label

OZEMPIC may cause serious side effects, including: • inflammation of your pancreas (pancreatitis). • changes in vision. • low blood sugar (hypoglycemia). • kidney problems (kidney failure) • serious allergic reactions The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation.

The side effects of Ozempic (semaglutide) include:

  • Serious side effects:
    • Inflammation of the pancreas (pancreatitis)
    • Changes in vision
    • Low blood sugar (hypoglycemia)
    • Kidney problems (kidney failure)
    • Serious allergic reactions
  • Common side effects:
    • Nausea
    • Vomiting
    • Diarrhea
    • Stomach (abdominal) pain
    • Constipation 2 2

From the Research

Side Effects of Ozempic (Semaglutide)

The side effects of Ozempic (semaglutide) include:

  • Gastrointestinal side effects such as nausea, vomiting, abdominal pain, and discomfort in the abdomen 3, 4, 5, 6
  • Increased risk of biliary disease (cholelithiasis) 4
  • Gastroparesis, a condition where the stomach takes too long to empty its contents 3
  • Appendicitis, a condition where the appendix becomes inflamed 5
  • Acute pancreatitis, a condition where the pancreas becomes inflamed 7
  • Acute kidney injury, a condition where the kidneys suddenly stop working properly 7
  • Acute gallbladder injury, a condition where the gallbladder becomes inflamed 7
  • Nonarteritic anterior ischemic optic neuropathy, a condition where the blood flow to the optic nerve is blocked 7
  • Diabetic retinopathy, a condition where the blood vessels in the retina become damaged 4, 7
  • Injection-site and allergic reactions 4
  • Anesthetic risks like pulmonary aspiration or residual gastric content 7
  • Delayed gastric emptying and constipation, which can affect surgical outcomes and complications 7

Administration Errors

Administration errors of semaglutide can occur due to incorrect labeling, dispensing, and counseling practices, leading to adverse drug events such as:

  • Nausea, vomiting, and abdominal pain 6
  • Headache, anorexia, weakness, and fatigue 6
  • Large overdoses (e.g., 10-fold dosing errors) due to the use of vials without safety features and syringes not intended for semaglutide 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Safety of Semaglutide.

Frontiers in endocrinology, 2021

Research

Appendicitis: A Hidden Danger of GLP-1 Receptor Agonists?

The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians, 2024

Research

Administration errors of compounded semaglutide reported to a poison control center-Case series.

Journal of the American Pharmacists Association : JAPhA, 2023

Research

Semaglutide: Double-edged Sword with Risks and Benefits.

Archives of internal medicine research, 2025

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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