From the Guidelines
Ozempic (semaglutide) has been associated with a small increased risk of pancreatitis in some patients, and therefore, it is crucial to monitor patients for this potential side effect, especially those with a history of pancreatitis or other risk factors 1.
Overview of Ozempic and Pancreatitis Risk
The medication Ozempic, also known as semaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the treatment of type 2 diabetes and weight management. While it offers significant benefits in terms of glucose control and weight loss, there have been concerns regarding its safety profile, particularly regarding the risk of pancreatitis.
Clinical Evidence and Guidelines
According to the most recent guidelines and studies, including those published in 2025 in the journal Diabetes Care 1, GLP-1 receptor agonists like semaglutide have been reported to have a potential risk of acute pancreatitis, although the causality has not been fully established. The guidelines recommend not initiating these medications in patients at high risk for pancreatitis and discontinuing them if pancreatitis is suspected.
Risk Factors and Mechanism
The risk of pancreatitis appears to be higher in patients with a history of pancreatitis or other risk factors such as gallstones, high triglycerides, or excessive alcohol consumption. The mechanism likely involves the medication's effects on pancreatic enzyme secretion and potential direct effects on pancreatic tissue.
Clinical Recommendations
If a patient is taking Ozempic and experiences severe abdominal pain, especially if radiating to the back and accompanied by nausea or vomiting, they should seek immediate medical attention as these could be symptoms of pancreatitis. Healthcare providers should monitor patients on this medication closely and consider their medical history, including any history of pancreatic issues, before starting treatment.
Balancing Risks and Benefits
While the risk of pancreatitis is a concern, the overall benefit of Ozempic for diabetes management and weight loss is considered to outweigh this risk for most patients. However, awareness of this potential side effect is crucial, and patients should be educated on the signs and symptoms of pancreatitis and the importance of prompt medical attention if they occur.
Key points to consider:
- Ozempic is associated with a small increased risk of pancreatitis.
- Patients with a history of pancreatitis or other risk factors are at higher risk.
- Monitoring and prompt medical attention are crucial if symptoms of pancreatitis occur.
- The benefits of Ozempic for diabetes and weight management generally outweigh the risks for most patients, but individual risk assessment is necessary.
From the FDA Drug Label
In glycemic control trials, acute pancreatitis was confirmed by adjudication in 7 OZEMPIC-treated patients (0.3 cases per 100 patient years) versus 3 in comparator-treated patients (0. 2 cases per 100 patient years). One case of chronic pancreatitis was confirmed in an OZEMPIC-treated patient. After initiation of OZEMPIC, observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting) If pancreatitis is suspected, OZEMPIC should be discontinued and appropriate management initiated; if confirmed, OZEMPIC should not be restarted.
Ozempic (semaglutide) may cause pancreatitis. The drug label reports cases of acute and chronic pancreatitis in patients treated with Ozempic. Patients should be carefully monitored for signs and symptoms of pancreatitis after initiation of Ozempic, and the medication should be discontinued if pancreatitis is suspected or confirmed 2.
From the Research
Ozempic (Semaglutide) and Pancreatitis
- Ozempic (semaglutide) is a glucagon-like peptide-1 receptor agonist (GLP-1RA) used to treat type 2 diabetes and obesity.
- There have been reports of acute pancreatitis associated with the use of GLP-1RAs, including semaglutide 3, 4, 5.
- A case study reported a patient who experienced multiple episodes of pancreatitis after repeated exposure to semaglutide, with another episode occurring 15 weeks after discontinuation of the medication 3.
- Another case study reported a patient who developed severe acute pancreatitis leading to death after four years of semaglutide use, with a dose increase occurring four weeks prior to admission 4.
- The prescribing information for semaglutide notes that GLP-1RA agents can cause changes in the pancreas that may lead to pancreatitis 6.
Mechanism and Risk Factors
- The exact mechanism by which semaglutide may cause pancreatitis is not fully understood, but it is thought to be related to the drug's effects on the pancreas and the incretin hormone system 3, 4.
- Risk factors for pancreatitis associated with semaglutide use are not well established, but may include a history of pancreatitis, alcohol consumption, and dose increases 3, 4, 7.
Monitoring and Precautions
- Patients taking semaglutide should be monitored for signs and symptoms of pancreatitis, including abdominal pain, nausea, and vomiting 3, 4, 5.
- The prescribing information for semaglutide recommends gradual dose escalation to minimize the risk of gastrointestinal adverse events, and notes that the medication is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 6.
- Patients with a history of pancreatitis or suspected pancreatitis should not be started on semaglutide, and those with exocrine pancreatic insufficiency should be closely monitored while taking the medication 6, 7.