What are the side effects of Ozempic (semaglutide)?

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Last updated: April 26, 2025View editorial policy

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From the Guidelines

Ozempic (semaglutide) is associated with a range of side effects, most commonly gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation, as well as other effects like headache, fatigue, and injection site reactions, as reported in the most recent study 1.

Common Side Effects

The most frequently observed side effects of Ozempic include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Headache
  • Fatigue
  • Dizziness
  • Injection site reactions These side effects are often more pronounced when initiating treatment or increasing the dose, but they tend to diminish over time as the body adapts to the medication 1.

Serious but Less Common Side Effects

More serious, though less common, side effects of Ozempic include:

  • Pancreatitis, characterized by severe abdominal pain that may radiate to the back
  • Gallbladder problems, including cholelithiasis and gallstone-related complications
  • Kidney issues, with a potential risk of acute kidney injury, particularly in individuals with pre-existing kidney disease
  • Allergic reactions
  • Hypoglycemia, especially when used in conjunction with other diabetes medications
  • Thyroid tumors, although this is a rare occurrence 1.

Management of Side Effects

To minimize the side effects of Ozempic, it is recommended to:

  • Start with a lower dose, typically 0.25mg weekly, and gradually increase to the target dose, usually 0.5mg or 1mg weekly
  • Stay well-hydrated
  • Eat smaller, more frequent meals to help manage gastrointestinal symptoms
  • Monitor for signs of serious side effects and seek medical attention if they occur 1.

Important Considerations

Ozempic is contraindicated in individuals who are or may become pregnant, and individuals of reproductive potential must be counseled on the use of reliable contraception methods 1. The medication works by mimicking the hormone GLP-1, which regulates blood sugar and slows stomach emptying, explaining many of its side effects. Given the potential for serious side effects, careful consideration and monitoring are necessary when prescribing Ozempic.

From the FDA Drug Label

OZEMPIC may cause serious side effects, including: • inflammation of your pancreas (pancreatitis). • changes in vision. • low blood sugar (hypoglycemia). • kidney problems (kidney failure) • serious allergic reactions The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation.

The possible side effects of OZEMPIC include:

  • Serious side effects:
    • Inflammation of the pancreas (pancreatitis)
    • Changes in vision
    • Low blood sugar (hypoglycemia)
    • Kidney problems (kidney failure)
    • Serious allergic reactions
  • Common side effects:
    • Nausea
    • Vomiting
    • Diarrhea
    • Stomach (abdominal) pain
    • Constipation 2 2

From the Research

Side Effects of Ozempic (Semaglutide)

The side effects of Ozempic (semaglutide) can be categorized into common and less common adverse drug reactions (ADRs).

  • Common ADRs include:
    • Nausea
    • Vomiting
    • Abdominal pain
    • Constipation
    • Diarrhea These ADRs are often dose-dependent in nature 3.
  • Less common ADRs that may result in more significant concerns include:
    • Development of acute pancreatitis
    • Gallbladder and biliary tract diseases
    • Acute kidney injury
    • Ileus These ADRs are highlighted in the literature as potential risks associated with semaglutide 3, 4.

Specific Safety Concerns

Specific safety concerns associated with semaglutide include:

  • Hypoglycemia: patients at risk for deterioration of existing diabetic retinopathy should be carefully monitored if treated with semaglutide, particularly if also treated with insulin 4.
  • Gastrointestinal side effects: semaglutide induces mostly mild-to-moderate and transient gastrointestinal disturbances 4.
  • Pancreatic safety: no unexpected safety issues have arisen to date, and the established safety profile for semaglutide is similar to that of other GLP-1RAs, where definitive conclusions for pancreatic and thyroid cancer cannot be drawn at this point due to low incidence of these conditions 4.
  • Cardiovascular aspects: semaglutide has beneficial metabolic and cardiovascular actions, and the low risk for severe adverse events 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Safety of Semaglutide.

Frontiers in endocrinology, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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