Strong human trialsFDA approved as Ozempic +2

Semaglutide side effects

Also known as: Ozempic · Wegovy · Wegovy HD · Rybelsus · Ozempic tablets · Compounded semaglutide

Updated Oct 23, 202632 sources

16 side effects reported for Semaglutide: 9 from studies and labels, 7 from users and guides. 8 come with the ways people manage them.

Semaglutide overview

Side effects reported in studies and labels

Rates as each trial or label states them. A rate from one trial does not carry over to research-grade vials or other doses.

From trials and regulators9

Clinical studies and regulatory documents.

Abdominal pain
20% on Wegovy 2.4 mg vs 10% on placebo (Wegovy label)
Headache
14% on Wegovy 2.4 mg vs 10% on placebo (Wegovy label)
Fatigue
11% on Wegovy 2.4 mg vs 5% on placebo (Wegovy label)
Dizziness
8% on Wegovy 2.4 mg vs 4% on placebo (Wegovy label)
Hair loss
3.3% on Wegovy 2.4 mg (4% of women, 0.9% of men) vs 1% on placebo; 5.8% on 7.2 mg (Wegovy label)
Dysesthesia (odd skin sensations)
22% on Wegovy 7.2 mg vs 6% on 2.4 mg (Wegovy label)
Stopping treatment because of side effects
6.8% on Wegovy 2.4 mg vs 3.2% on placebo stopped for adverse reactions (Wegovy label)
Thyroid C-cell tumors (boxed warning)
Seen in rodent studies. The label carries a boxed warning and rules out people with a personal or family history of MTC or MEN 2.
How people manage it
- Tell your prescriber about any family history of medullary thyroid cancer or MEN 2 before starting.
Overdose from unit mix-ups
FDA reports describe people drawing 5 to 20 times the intended dose from compounded vials, including a prescription written as 25 units when 5 units was meant
How people manage it
- Confirm your vial's concentration in mg per mL before you convert any dose to syringe units.
- Use a calculator set to your exact vial and water volume instead of a chart made for a different vial.

Side effects users and guides report

What people post and what dosing guides list. These are reports, not measured rates.

From users and guides7

Community reports, competitor and vendor guides, media.

Nausea
44% on Wegovy 2.4 mg vs 16% on placebo (Wegovy label); 20.3% on Ozempic 1 mg (Ozempic label). Most common during dose increases.
How people manage it
- Eat smaller meals and cut back on greasy food.
- Step up more slowly, or stay on the current dose another 4 weeks before moving up.
- Ginger and a bedtime injection are common community tricks.
Nausea on step-ups (community)
Commonly reported in community posts, mostly in the days after a dose increase
How people manage it
- Slower steps of 6 to 8 weeks are the usual fix.
- Smaller, less greasy meals and more fluids.
Diarrhea
30% on Wegovy 2.4 mg vs 16% on placebo (Wegovy label); 8.8% on Ozempic 1 mg (Ozempic label)
How people manage it
- Drink more fluids.
- Cut back on greasy food.
Vomiting
24% on Wegovy 2.4 mg vs 6% on placebo (Wegovy label); 9.2% on Ozempic 1 mg (Ozempic label)
How people manage it
- Stay on the current dose longer before stepping up.
- Smaller meals and steady fluids.
Constipation
24% on Wegovy 2.4 mg vs 11% on placebo (Wegovy label); 3.1% on Ozempic 1 mg (Ozempic label). Also commonly reported in community posts.
How people manage it
- Drink more water and add soluble fiber slowly.
- A daily walk helps keep things moving.
- Ask a provider about a laxative if it persists.
- Days without a bowel movement plus a swollen, painful belly and vomiting needs a clinician the same day.
Strong appetite loss
Commonly reported in community posts
Sulfur burps
Commonly reported in community posts
How people manage it
- Simethicone can help, per clinic guides.
- Skip carbonated drinks and straws, which add swallowed air.
- Smaller, less greasy meals.

How much is known

Strong human trials

STEP 1 (1,961 adults, 68 weeks): 14.9% average weight loss vs 2.4% on placebo. SELECT (17,604 adults): 20% fewer major heart events, 6.5% vs 8.0% (HR 0.80). STEP UP and OASIS 4 back the 7.2 mg and oral doses. All of this is branded product. Compounded and research vials have no trial data or verified identity.