From the Guidelines
If you're experiencing abdominal pain after an Ozempic (semaglutide) dose increase, you should have several key labs checked, including lipase and amylase to assess for pancreatitis, as this is a rare but serious side effect of GLP-1 medications like Ozempic, as noted in the 2025 standards of care in diabetes 1. When considering the management of abdominal pain following a dose increase of Ozempic, it's crucial to prioritize the assessment for potential serious side effects. The most recent and highest quality evidence from the 2025 standards of care in diabetes suggests that GLP-1 RAs, such as semaglutide, have a potential risk for pancreatitis, although causality has not been established 1. Given this, the following labs should be considered:
- Lipase and amylase to assess for pancreatitis
- Liver function tests (ALT, AST, bilirubin) to check for liver issues
- A complete blood count to evaluate for infection or inflammation
- A comprehensive metabolic panel to assess kidney function and electrolyte balance Abdominal ultrasound might also be warranted depending on symptom severity. It's essential to contact your healthcare provider immediately, as abdominal pain could indicate pancreatitis, and symptoms typically include severe pain radiating to the back, nausea, and vomiting, as suggested by the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1. While mild digestive symptoms are common with Ozempic, especially after dose increases, persistent or severe pain requires prompt medical attention, and your provider might recommend temporarily stopping Ozempic while determining the cause of your symptoms.
From the FDA Drug Label
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.
The labs to check with abdominal pain after an Ozempic dose increase include:
- Amylase and lipase levels to evaluate for pancreatitis, as increases in these enzymes have been observed in patients treated with OZEMPIC 2
- Blood glucose levels to assess for hypoglycemia, which may occur with concomitant use of insulin secretagogues or insulin 2 It is essential to monitor patients carefully for signs and symptoms of pancreatitis and hypoglycemia after initiating or escalating OZEMPIC doses.
From the Research
Laboratory Tests for Abdominal Pain after Ozempic Dose Increase
- Laboratory tests may be ordered to narrow the differential diagnosis of abdominal pain, as discussed in 3
- In patients taking semaglutide (Ozempic), laboratory tests such as lipase levels may be relevant, as acute pancreatitis has been reported as a potential side effect, as seen in 4 and 5
- Other laboratory tests that may be considered include:
- It is essential to note that the safety profile of semaglutide has been extensively studied, and while it has been associated with some adverse events, such as gastrointestinal disturbances and an increased risk of biliary disease, the overall risk/benefit profile is considered favorable, as discussed in 7
Potential Causes of Abdominal Pain after Ozempic Dose Increase
- Acute pancreatitis, as reported in 4 and 5
- Gastrointestinal side effects, such as nausea, vomiting, and diarrhea, which are common adverse events associated with semaglutide, as discussed in 7
- Other potential causes of abdominal pain, such as gallbladder disease or liver dysfunction, which may be evaluated through laboratory tests, as discussed in 3 and 6