From the Guidelines
Ozempic (semaglutide) carries several notable risks, including nausea, vomiting, diarrhea, and constipation, as well as more serious risks such as pancreatitis, gallbladder problems, and cardiac arrhythmia/tachycardia, which patients should be aware of before starting treatment. The most common side effects of Ozempic are dose-dependent and include gastrointestinal issues, which typically occur during dose escalation and may diminish over time 1. More serious risks include acute pancreatitis, a rare adverse effect that has been linked to the use of exenatide in reports submitted to the US Food and Drug Administration Adverse event reporting system and in observational studies 1.
To manage these risks, it is recommended to start Ozempic at a low dose and titrate upward slowly, and to avoid the medication in patients with a history of gastroparesis or pancreatitis 1. Additionally, patients with cardiac arrhythmia/tachycardia should be monitored and considered for beta blockers if symptomatic 1. The medication has also been shown to have cardiovascular benefits, including a reduction in major adverse cardiovascular events (MACE) in patients with type 2 diabetes 1.
It is essential to weigh the benefits and risks of Ozempic and to closely monitor patients, especially those with a history of diabetic retinopathy or severe gastrointestinal disease, as the medication may worsen these conditions 1. Overall, Ozempic can be a valuable treatment option for patients with type 2 diabetes, but it is crucial to be aware of the potential risks and to take steps to minimize them.
Key points to consider when prescribing Ozempic include:
- Starting at a low dose and titrating upward slowly to minimize gastrointestinal side effects
- Avoiding the medication in patients with a history of gastroparesis or pancreatitis
- Monitoring patients with cardiac arrhythmia/tachycardia and considering beta blockers if symptomatic
- Closely monitoring patients with a history of diabetic retinopathy or severe gastrointestinal disease
- Weighing the benefits and risks of Ozempic and considering alternative treatment options if necessary 1.
From the Research
Risks of Ozempic (Semaglutide)
The risks associated with Ozempic (semaglutide), a GLP-1 receptor agonist, include:
- Gastrointestinal disorders 2
- Hypotension 2
- Syncope 2
- Arthritic disorders 2
- Nephrolithiasis 2
- Interstitial nephritis 2
- Drug-induced pancreatitis 2
- Contraindication in patients with a history of medullary thyroid cancer 3
- Used with caution in patients with a history of pancreatitis of a known cause 3
Comparison of Risks with Other Treatments
Compared to other treatments, such as sulfonylureas, DPP4 inhibitors, and SGLT2 inhibitors, GLP-1 receptor agonists like semaglutide have a unique risk profile 2. While they may have a lower risk of certain conditions, such as substance use and psychotic disorders, seizures, and neurocognitive disorders, they may have a higher risk of gastrointestinal disorders and other conditions listed above.
Considerations for Use
When considering the use of Ozempic (semaglutide), it is essential to weigh the potential benefits against the potential risks. Patients with a history of certain conditions, such as medullary thyroid cancer or pancreatitis, may need to avoid or use the medication with caution 3. Additionally, patients with established cardiovascular disease or at high risk of cardiovascular disease may benefit from the use of GLP-1 receptor agonists like semaglutide 3.