What are the side effects of Rybelsus (Semaglutide)?

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Last updated: March 28, 2025View editorial policy

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From the Guidelines

Rybelsus (semaglutide) is associated with a range of side effects, most commonly gastrointestinal issues such as nausea, vomiting, diarrhea, and constipation, which affect a significant proportion of patients, as evidenced by the most recent study 1. The most frequent side effects of Rybelsus include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Headache
  • Fatigue
  • Dizziness
  • Abdominal distension
  • Eructation
  • Gastroenteritis
  • Gastroesophageal reflux disease These side effects are often tolerable and may decrease over time as the body adjusts to the medication 1. It is essential to note that Rybelsus may also warning signs of more serious side effects, such as:
  • Pancreatitis
  • Diabetic retinopathy complications
  • Allergic reactions
  • Potential thyroid tumors (based on animal studies)
  • Kidney problems, especially in patients with pre-existing kidney disease or dehydration
  • Suicidal ideation and behavior
  • Injection site reactions To minimize side effects, it is recommended to start with the lowest dose and gradually increase as tolerated by the patient, and to take the medication first thing in the morning with no more than 4 ounces of water and waiting 30 minutes before eating or taking other medications 1. The use of Rybelsus should be cautious in patients with a history of pancreatitis, cholelithiasis, or medullary thyroid cancer, and in pregnant or breastfeeding women 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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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