From the Guidelines
Semaglutide is not recommended for patients with chronic pancreatitis due to the potential risk of worsening their condition. According to the study published in Obesity Reviews in 2023 1, semaglutide is contraindicated in patients with a history of pancreatitis. The study highlights the importance of caution when using semaglutide in patients with a history of pancreatitis, as it may exacerbate inflammation and damage to the pancreas.
The mechanism of action of semaglutide, a GLP-1 analog, stimulates the pancreas to produce insulin, which may increase stress on an already compromised organ. Key points to consider when evaluating the use of semaglutide in patients with chronic pancreatitis include:
- Contraindications: chronic pancreatitis, personal or family history of medullary thyroid cancer or MEN2, pregnancy, and breastfeeding
- Cautions: use caution in patients with a history of pancreatitis or cholelithiasis
- Common side effects: nausea, vomiting, diarrhea, constipation, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, gastroenteritis, and gastroesophageal reflux disease
Alternative approaches for weight management or diabetes management in patients with chronic pancreatitis should be considered, such as metformin, insulin therapy, or other classes of diabetes medications that don't directly stimulate the pancreas. Any patient with chronic pancreatitis who is considering semaglutide should have a thorough discussion with their healthcare provider about the potential risks versus benefits, as individual circumstances may vary 1.
From the FDA Drug Label
• Has not been studied in patients with a history of pancreatitis. Consider another antidiabetic therapy (1,5.2). • Pancreatitis: Has been reported in clinical trials. Discontinue promptly if pancreatitis is suspected. Do not restart if pancreatitis is confirmed (5. 2).
Semaglutide is not recommended for use in patients with a history of pancreatitis, including chronic pancreatitis. The drug label explicitly states that it has not been studied in patients with a history of pancreatitis and recommends considering another antidiabetic therapy. Additionally, if pancreatitis is suspected, the medication should be discontinued promptly and not restarted if pancreatitis is confirmed 2.
From the Research
Semaglutide and Chronic Pancreatitis
- The use of semaglutide in patients with chronic pancreatitis is a topic of interest, with several studies investigating its safety and efficacy in this population.
- A study published in 2023 3 reported a case of acute pancreatitis in a patient taking semaglutide, highlighting the potential risk of pancreatic inflammation with GLP-1 receptor agonists.
- However, a review of the safety of semaglutide published in 2021 4 found that the established safety profile for semaglutide is similar to that of other GLP-1RAs, with no unexpected safety issues arising to date.
- A propensity score-matched analysis published in 2025 5 found that the use of GLP-1RAs, including semaglutide, did not increase the risk of pancreatitis in a comorbidity-free subgroup of patients with type 2 diabetes mellitus.
- An updated meta-analysis published in 2024 6 found that semaglutide therapy was not associated with an increased risk of acute pancreatitis, with similar results across different administration regimens.
- A retrospective cohort study published in 2024 7 found that semaglutide and tirzepatide were associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity with a history of acute pancreatitis.
Key Findings
- Semaglutide may not increase the risk of acute pancreatitis in patients with type 2 diabetes mellitus 5, 6.
- GLP-1RAs, including semaglutide, may be associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity with a history of acute pancreatitis 7.
- The safety profile of semaglutide is similar to that of other GLP-1RAs, with no unexpected safety issues arising to date 4.