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Semaglutide Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 21, 2023.

Applies to semaglutide: oral tablet.

Other dosage forms:

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Warning: Risk of Thyroid C-Cell Tumors. In rodents, semaglutide causes thyroid C-cell tumors.

It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.Semaglutide is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. Do not use this medicine for at least 2 months before you plan to become pregnant.

It is very important to carefully follow any instructions from your health care team about:

This medicine may increase the risk of having thyroid tumors. Tell your doctor right away if you have a lump or swelling in your neck or throat, trouble swallowing or breathing, or if your voice gets hoarse.

Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

Check with your doctor right away if you have blurred vision or any other changes in vision. These may be symptoms of diabetic retinopathy.

This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use semaglutide with other medicines, such as insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.

This medicine may cause serious kidney problems, including acute kidney injury. Check with your doctor right away if you have a bloody urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These can be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of semaglutide

Along with its needed effects, semaglutide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking semaglutide:

More common side effects

  • anxiety
  • bloating
  • blurred vision
  • chills
  • cold sweats
  • confusion
  • constipation
  • cool, pale skin
  • cough
  • darkened urine
  • depression
  • diarrhea
  • difficulty swallowing
  • dizziness
  • fast heartbeat
  • fever
  • headache
  • increased hunger
  • indigestion
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • nausea
  • nervousness
  • nightmare
  • pain in the stomach, side, or abdomen, possibly radiating to the back
  • seizures
  • skin rash
  • slurred speech
  • tightness in the chest
  • trouble breathing
  • unusual tiredness or weakness
  • vomiting
  • yellow eyes or skin

Other side effects of semaglutide

Some side effects of semaglutide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common side effects

  • acid or sour stomach
  • belching
  • excess air or gas in stomach
  • feeling pressure in the stomach
  • heartburn
  • passing gas
  • stomach discomfort, swelling, tenderness, or upset

For healthcare professionals

Applies to semaglutide: oral tablet, subcutaneous solution.

General adverse events

The most commonly reported adverse reactions have included nausea, vomiting, diarrhea, abdominal pain, and constipation.[Ref]

Oncologic

GLP- 1 Receptor Agonist:

Cases of Medullary thyroid cancer (MTC) have been reported in patients treated with liraglutide in the postmarketing period; the data in these reports is insufficient to establish or exclude a causal relationship between MTC and GLP-1 receptor agonist use in humans.

Gastrointestinal

In clinical trials for type 2 diabetes, acute pancreatitis was confirmed by adjudication in 7 (0.3 cases per 100 patient years) and 8 patients (0.27 per 100 patient years) in 2 separate trials (compared to 3 and 10 placebo treated patients, respectively). One case of chronic pancreatitis was confirmed. In clinical trials for weight loss, 4 cases of acute pancreatitis were confirmed by adjudication (vs 1 placebo case). In weight loss trials, nausea, diarrhea, vomiting, constipation, and abdominal pain were reported more frequently than in clinical trials for type 2 diabetes.

Hypersensitivity

Ocular

In a 2-year trial among patients with type 2 diabetes and high cardiovascular risk, patients treated with this drug experienced a great incidence of diabetic retinopathy complications (3% vs 1.8%). The absolute risk was greater in patients with a history of diabetic retinopathy at baseline (8.2%[drug] vs 5.2%[placebo]) than those without (0.7%[drug] vs 0.4%[placebo]).

Metabolic

In the weight loss clinical trials, patients without type 2 diabetes experienced episodes of hypoglycemia.

Local

Immunologic

As with other protein and peptide pharmaceuticals, patients receiving this drug have developed anti-semaglutide antibodies. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay, as well as other factor in handling of the sample. For these reasons, the incidence of antibodies cannot be directly compared with other products. Anti-drug antibodies to semaglutide have been reported in up to 1% of patients during clinical trials.

Hepatic

Cholelithiasis has been reported in 1.5% and 0.4% of patients receiving 0.5 mg and 1 mg weekly, respectively.

Other

Fatigue was reported in greater than 0.4% of patients.

Nervous system

Renal

Cardiovascular

A mean increase in heart rate of 2 to 3 beats per minute (bpm) was reported in clinical trials for type 2 diabetes. In weight loss clinical trials, a mean increase in resting heart rate of 1 to 4 bpm was observed. Maximal changes from baseline at any visit of 10 to 19 bpm (41% vs 34% placebo) and 20 bpm (26% vs 16% placebo) were recorded. In weight loss clinical trials, Hypotension and orthostatic hypotension were more frequently seen in patients on concomitant antihypertensive therapy. Some reactions were related to gastrointestinal reactions and associated volume loss.

Dermatologic

See also:

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics."

2. (2022) "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc

3. (2021) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Pharmaceuticals Inc

4. (2021) "Product Information. Wegovy (0.25 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc

Frequently asked questions

Further information

Semaglutide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.