Can Wegovy Cause Palpitations?
Yes, palpitations can occur with Wegovy (semaglutide), though they are not among the most common side effects. The primary cardiovascular effect documented with GLP-1 receptor agonists like semaglutide is increased heart rate rather than palpitations specifically, but cardiac arrhythmias and tachycardia have been reported and may manifest as palpitations 1, 2.
Cardiovascular Effects of Semaglutide
Documented Heart Rate Changes
- GLP-1 receptor agonists as a class are associated with increased heart rate as a cardiovascular side effect 1
- Cardiac arrhythmia and tachycardia may occur with semaglutide, and if symptomatic, monitoring and consideration of beta blockers may be necessary 2
- Elevated heart rate is a common side effect requiring monitoring in patients taking semaglutide 2
Clinical Context and Severity
- While palpitations are mentioned in the safety profile, they are not listed among the most frequent adverse events (which are predominantly gastrointestinal: nausea, vomiting, diarrhea, constipation occurring in 30-40% of patients) 3, 2
- The cardiovascular safety profile of semaglutide is generally favorable, with studies showing reduced major cardiovascular events (6.5% vs 8% with placebo) in patients with obesity and cardiovascular disease 3, 4
Important Clinical Considerations
When to Be Concerned
- Symptomatic tachycardia or arrhythmias warrant clinical evaluation and may require beta-blocker therapy 2
- Patients with pre-existing cardiovascular disease should be monitored, though semaglutide has demonstrated cardiovascular benefits even in this population 5, 4
- In patients with heart failure, semaglutide actually showed improved outcomes without increased cardiac adverse events 6, 5
Common Pitfalls
- Do not confuse palpitations with the more serious adverse events that require immediate attention: chest pain suggesting acute myocardial infarction, which has been reported in clinical trials 2
- Palpitations may be related to dehydration from gastrointestinal side effects rather than direct cardiac effects, so assess volume status 2
- Consider that anxiety about starting a new medication or media attention surrounding weight loss drugs may contribute to perceived palpitations 7
Management Approach
If Palpitations Occur
- Assess for symptomatic tachycardia or arrhythmia requiring monitoring 2
- Evaluate for dehydration secondary to gastrointestinal side effects (nausea, vomiting, diarrhea) 2
- Consider beta-blocker therapy if symptoms are significant and persistent 2
- Rule out other causes of palpitations unrelated to semaglutide