Is Rhinorrhea a Side Effect of Ozempic?
No, rhinorrhea (runny nose) is not a recognized or documented side effect of Ozempic (semaglutide). Based on comprehensive safety data from the SUSTAIN clinical trial program and FDA labeling, rhinorrhea does not appear among the adverse effects associated with semaglutide therapy.
Established Side Effect Profile of Semaglutide
The documented adverse effects of Ozempic are predominantly gastrointestinal in nature, not respiratory 1, 2, 3. The most common side effects include:
- Nausea, vomiting, and diarrhea are the most frequently reported adverse effects, occurring in a dose-dependent manner and typically being mild-to-moderate and transient 1, 2
- Constipation and abdominal pain are also common gastrointestinal complaints 1
- These gastrointestinal symptoms usually improve over time with continued treatment 2, 3
Serious Adverse Events (Not Including Rhinorrhea)
When serious adverse events occur with semaglutide, they include 1, 2:
- Pancreatitis and gallbladder disease (cholelithiasis and cholecystitis) 1, 2
- Diabetic retinopathy complications in patients with pre-existing retinopathy 2
- Injection-site reactions (for subcutaneous formulations) 2
- Acute kidney injury (particularly from dehydration secondary to severe gastrointestinal effects) 1
A comprehensive meta-analysis of 23 studies involving 57,911 participants confirmed that gastrointestinal adverse events are the primary safety concern, with no mention of respiratory symptoms like rhinorrhea 3.
Why Rhinorrhea Is Not Associated with Ozempic
Rhinorrhea is a symptom typically associated with:
- Allergic rhinitis caused by IgE-mediated responses to airborne allergens 4, 5
- Viral upper respiratory infections (common cold) 4, 5
- Non-allergic rhinitis triggered by irritants, temperature changes, or vasomotor instability 4, 5
- Medication-induced rhinitis from drugs like ACE inhibitors, alpha-blockers, or phosphodiesterase-5 inhibitors 4
Semaglutide does not appear on any list of medications known to cause drug-induced rhinitis 4. The mechanism of action of GLP-1 receptor agonists—enhancing glucose-dependent insulin secretion, suppressing glucagon, and delaying gastric emptying—has no known effect on nasal mucosa or respiratory secretions 1, 2.
Clinical Recommendation
If a patient on Ozempic develops rhinorrhea, alternative causes should be investigated rather than attributing it to the medication 4, 5. Consider:
- Concurrent viral upper respiratory infection (most common cause) 5
- Seasonal or perennial allergic rhinitis (evaluate for allergen exposure, family history, and associated symptoms like sneezing, nasal itching, or ocular symptoms) 4, 5
- Other medications the patient may be taking that are known to cause rhinorrhea 4
- Environmental irritants or non-allergic triggers 4, 5
The safety profile of semaglutide has been extensively studied, and no unexpected safety issues related to respiratory symptoms have emerged 2, 3. The medication has an overall favorable risk/benefit profile, with adverse effects being predictable and manageable 2, 3.