What should I do if I experience abdominal pain while taking Ozempic (semaglutide)?

What to Do If You Experience Abdominal Pain While Taking Ozempic

Stop taking Ozempic immediately and contact your healthcare provider right away if you have severe abdominal pain that will not go away, with or without vomiting, as this may indicate pancreatitis—a serious and potentially life-threatening condition. 1

Distinguishing Between Common and Serious Abdominal Pain

Mild, Transient Abdominal Discomfort (Common Side Effect)

• Mild abdominal pain is one of the most common side effects of Ozempic, occurring in the majority of patients, and is typically dose-dependent and more pronounced during initial treatment or dose escalation. 2
• This type of discomfort is usually manageable and often improves with continued use or dose adjustment. 2
• If your abdominal pain is mild, intermittent, and not worsening, you may continue the medication while implementing management strategies (see below). 2

Warning Signs Requiring Immediate Medical Attention

You must stop Ozempic and seek emergency care if you experience: 1

• Severe, persistent abdominal pain that does not resolve
• Pain radiating from your abdomen to your back
• Abdominal pain accompanied by persistent vomiting
• Fever along with abdominal pain
• Inability to keep fluids down

These symptoms may indicate pancreatitis, which has been reported in clinical trials and requires immediate discontinuation of the medication. 2, 1

Management Strategies for Mild Abdominal Pain

Dietary Modifications

• Reduce meal size to help manage nausea and abdominal discomfort. 2
• Avoid high-fat diets, which can worsen gastrointestinal symptoms. 2
• Limit alcohol and carbonated drinks to reduce reflux symptoms and abdominal discomfort. 2

Hydration and Dehydration Prevention

• Drink adequate fluids to prevent dehydration, which is crucial because gastrointestinal side effects (including abdominal pain with nausea, vomiting, or diarrhea) can lead to fluid loss and worsen kidney function. 1
• This is especially important if you have pre-existing kidney disease. 2

Dose Adjustment Considerations

• If abdominal pain is bothersome but not severe, discuss with your provider whether staying at your current dose (rather than escalating) might be appropriate, as slow dose titration minimizes gastrointestinal side effects. 2
• If you tolerate a submaximal dose well and achieve adequate response, continuing that dose long-term is acceptable rather than escalating. 2

When to Consider Discontinuation

Absolute Indications to Stop Ozempic

Discontinue Ozempic immediately if: 2, 1

• You develop signs of pancreatitis (severe, persistent abdominal pain)
• You experience symptoms of gallbladder disease (sudden severe right upper abdominal pain, especially after eating fatty meals)
• Abdominal pain is accompanied by severe, uncontrollable vomiting leading to dehydration

Monitoring for Serious Complications

Your healthcare provider should monitor you for: 2

• Signs of pancreatitis (persistent severe abdominal pain)
• Gallbladder disease (cholelithiasis and cholecystitis occur at increased rates with semaglutide)
• Kidney function, especially if severe gastrointestinal symptoms could lead to dehydration
• Acute kidney injury, which can result from dehydration secondary to severe gastrointestinal effects

Common Pitfalls to Avoid

• Do not ignore persistent or worsening abdominal pain, assuming it will resolve on its own—pancreatitis requires immediate medical attention. 1
• Do not continue escalating your dose if you're experiencing significant abdominal discomfort—staying at a lower, tolerable dose is preferable. 2
• Do not become dehydrated—aggressive fluid intake is essential when experiencing any gastrointestinal symptoms. 1
• Do not assume all abdominal pain is benign—while mild discomfort is common, severe pain warrants immediate evaluation. 2, 1

Follow-Up and Reassessment

• Contact your healthcare provider within 24-48 hours if mild abdominal pain persists despite dietary modifications and adequate hydration. 2
• Your provider may need to adjust your dose, slow your titration schedule, or consider alternative medications if gastrointestinal side effects remain intolerable. 2
• Regular monitoring of gastrointestinal symptoms is advised, particularly during dose escalation periods. 2