Key Points

• Most side effects of Ozempic (semaglutide) are short-term, and resolve with time or when you stop taking the medication.
• Ozempic has the potential to cause certain long-term problems that may last months or years after stopping it.
• Some examples of long-term side effects you may experience from Ozempic include pancreatitis, vision problems, kidney injury, and skin changes (e.g., Ozempic face).

What Are Common Ozempic Side Effects?

Ozempic (semaglutide) is associated with a range of side effects, most of which are mild to moderate and often improve over time. The most commonly reported side effects include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain or discomfort
• Fatigue
• Loss of appetite
• Indigestion or heartburn
• Bloating
• Burping
• Dizziness
• Injection site reactions (redness, swelling, or itching)

These symptoms are most likely to occur when first starting Ozempic or after a dose increase. They are generally temporary and may subside as your body adjusts to the medication. For most people, this means Ozempic side effects after 3 months improve.

Can Ozempic Cause Long-Term Effects?

Yes, Ozempic has been associated with certain long-term side effects. Clinical trials studied Ozempic for 30 weeks for type 2 diabetes, 104 weeks for cardiovascular outcomes (SUSTAIN trials), and 41 months in adults with type 2 diabetes and chronic kidney disease. Below are some of the reported long-term effects. Please note that these are not all possible side effects from Ozempic. Review the full product information and discuss your risk for side effects with your healthcare provider.

Pancreatitis

Although rare, pancreatitis (inflammation of the pancreas) has been reported by some people who took Ozempic during clinical trials. However, it is unclear if Ozempic causes pancreatitis.

In one 2-year study, 8 people taking Ozempic experienced pancreatitis compared to 10 people taking a placebo (no active medication). A more recent meta-analysis that included about 35,000 patients found that semaglutide is not associated with a higher risk of pancreatitis compared to placebo.

While more evidence is coming out showing no association between Ozempic and pancreatitis, there continue to be cases of people who are taking the medication reporting it. Watch out for signs and symptoms of pancreatitis, which may include:

• Severe upper stomach pain that may radiate to the back
• Nausea or vomiting
• Rapid heartbeat
• Fever
• Diarrhea

Pancreatitis usually goes away within 2 weeks, but it can last longer. There was one report of chronic (long-term) pancreatitis in one patient taking Ozempic during clinical trials.

Vision problems

Ozempic may worsen an eye condition called diabetic retinopathy as blood sugar levels improve rapidly. In a 2-year study:

• 3% of Ozempic users experienced complications vs. 1.8% taking a placebo

Ozempic might also cause an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION), which is when the optic nerve doesn’t get enough blood supply.

Research suggests a drop in blood sugar can trigger changes in the eye that can lead to damage in people who have high blood sugar. It is not fully clear how Ozempic may cause NAION, which could lead to vision loss.

Contact your prescriber or eye provider if you experience any of the following symptoms:

• Blurry vision
• Floating spots in your vision
• Loss of vision
• Distorted colors
• Light sensitivity

Acute kidney injury

Vomiting and diarrhea—common Ozempic side effects—may lead to dehydration and subsequent kidney injury. In most cases, kidney function improves with treatment, but some cases may result in permanent damage. Your risk is higher if you already have kidney problems.

Your healthcare provider may monitor your kidney health through blood tests when you start Ozempic and when your dose is raised. Seek medical attention if you have severe vomiting, diarrhea, or are urinating less than usual.

Gallbladder problems

Ozempic may increase the risk of gallstones and gallbladder disease. In clinical trials:

• 1.5% of people taking Ozempic developed gallstones vs. 0.4% on placebo.

Contact your healthcare provider if you notice symptoms of gallstones or gallbladder problems, such as:

• Nausea and vomiting
• Sudden, severe abdominal pain
• Fever
• Chills
• Light-colored stools
• Yellowing of the skin or whites of your eyes

Intestinal obstruction

Post-market reports of ileus (intestinal blockage) led the FDA to update Ozempic’s label. This condition can be life-threatening if untreated. A blockage can cause serious infections or rupture of your intestine.

Tell your healthcare provider if you experience symptoms of intestinal blockage, including:

• Stomach pain or swelling
• Loss of appetite
• Constipation
• Nausea or vomiting

Many of the symptoms caused by ileus are similar to side effects of Ozempic. See your healthcare provider regularly so they can make sure this medication continues to be safe for you to take.

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Risk of thyroid tumors

Animal studies have linked semaglutide to thyroid C-cell tumors, though the risk in humans is unknown. Warning signs of thyroid tumors include:

• Lump or swelling in your neck
• Hoarse voice
• Difficulty swallowing
• Shortness of breath

Contact your healthcare provider right away if you notice any of the symptoms listed above.

Ozempic Feet, Ozempic Butt, and Ozempic Face

While not listed in the official prescribing information, many patients have reported experiencing unpleasant changes in the appearance of their face, butt, or face - known as Ozempic feet, Ozempic butt, and Ozempic face. These cosmetic effects are caused by saggy skin that sometimes occurs due to rapid weight loss.

How Long Do Ozempic Side Effects Last?

For most people, common side effects such as nausea, diarrhea, and constipation are short-term and improve within a few days to weeks after starting Ozempic or increasing the dose. However, individual experiences can vary:

• Mild side effects (nausea, bloating, fatigue): Often resolve within several weeks.
• Digestive issues: May persist longer, but typically lessen over time.
• Serious side effects (pancreatitis, gallbladder problems): Require immediate medical attention and may not resolve without stopping the medication.

If side effects persist beyond a few weeks or interfere with daily life, consult your healthcare provider for guidance.

Are Any Ozempic Side Effects Permanent or Irreversible?

Most Ozempic side effects are not permanent and resolve after discontinuing the medication. However, rare but serious complications can have lasting effects:

• Pancreatitis: Can cause permanent damage to the pancreas.
• Acute kidney injury: May lead to long-term kidney problems if not treated promptly.
• Gallbladder disease: In rare cases, may require surgery.
• Diabetic retinopathy complications: Worsening vision may be irreversible in some cases.

Prompt recognition and medical intervention are crucial to reduce the risk of permanent harm and long term side effects of Ozempic.

Ozempic Side Effects in Females vs. Ozempic Side Effects in Males

Both males and females experience similar side effects while taking Ozempic. But some studies and user reports suggest that women may experience gastrointestinal side effects more frequently, while men may report different tolerability patterns. Hormonal factors and body composition may play a role, but more research is needed to understand Ozempic side effects in females long-term compared to males.

How to Manage or Reduce Ozempic Side Effects

Managing Ozempic side effects can help improve comfort and adherence to treatment. Consider the following tips to help you feel better.

Dietary Adjustments

• Eat smaller, more frequent meals to reduce nausea.
• Avoid high-fat, greasy, or spicy foods.
• Stay hydrated, especially if experiencing vomiting or diarrhea.
• Include fiber-rich foods to minimize constipation.

Dose Changes

• Gradual dose increases, as recommended by your doctor, can help your body adjust.
• Do not change your dose without consulting your healthcare provider.

Lifestyle Tips

• Engage in light physical activity to support digestion.
• Monitor your blood sugar regularly, especially if taking other diabetes medications.
• Keep track of side effects and discuss them at follow-up appointments.

When to Seek Help

Severe abdominal pain, persistent vomiting, signs of dehydration, vision changes, or symptoms of an allergic reaction require immediate medical attention.

What Happens After Stopping Ozempic?

What about Ozempic side effects after stopping? After discontinuing Ozempic:

• Most side effects resolve within days to weeks as the medication leaves your system.
• Blood sugar levels may rise if you have diabetes, so alternative treatments may be needed.
• Weight loss may plateau or reverse if Ozempic was used for weight management.
• Serious complications (such as pancreatitis or kidney injury) may require ongoing care.

Always consult your healthcare provider before stopping Ozempic to ensure a safe transition and to discuss alternative options.

This is not all the information you need to know about Ozempic (semaglutide) for safe and effective use and does not take the place of your healthcare provider’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.

References

Guo, C., et. al. 2023. HIF-1α accumulation in response to transient hypoglycemia may worsen diabetic eye disease. In: Cell Reports. DOI: https://doi.org/10.1016/j.celrep.2022.111976

Hazanchuk, V., et. al. 2024. Can Ozempic Affect Eye Health? Here’s What Ophthalmologists Want You to Know. Accessed 10/13/24 at https://www.aao.org/eye-health/news/can-ozempic-affect-eye-health-here-s-what-ophthalm

Lu, J., et. al. 2023. A potentially serious adverse effect of GLP-1 receptor agonists. In: Acta Pharmaceutica Sinica B. DOI: https://doi.org/10.1016%2Fj.apsb.2023.02.020

Masson, W., et. al. 2024. Acute pancreatitis due to different semaglutide regimens: An updated meta-analysis. In: Endocrinologia, diabetes y nutricion. DOI: https://doi.org/10.1016/j.endien.2024.03.012

National Eye Institute. 2024. Diabetic Retinopathy. Accessed 10/15/24 at https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

National Institute of Diabetes and Digestive and Kidney Diseases. 2017. Symptoms & Causes of Pancreatitis. Accessed 10/15/24 at https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes

National Library of Medicine. 2021. Acute pancreatitis: Learn More – How is acute pancreatitis treated? In: InformedHealth.org [Internet]. Accessed 10/15/24 at https://www.ncbi.nlm.nih.gov/books/NBK298835/

Ozempic [package insert]. Updated September 2023. Novo Nordisk. Accessed 10/15/24 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79

Rentzeperi, E., et. al. 2022. Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care. Journal of personalized medicine, 12(3), 454. https://doi.org/10.3390/jpm12030454

Smits, M. M., et. al. 2021. Safety of Semaglutide. In: Frontiers in Endocrinology. DOI: https://doi.org/10.3389%2Ffendo.2021.645563

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