Semaglutide (brand names Ozempic, Rybelsus, and Wegovy) is a prescription medication first approved to treat type 2 diabetes but recently, it has gained attention for its potency to induce weight loss in those with obesity or weight-related health problems.
Before starting semaglutide, itโs important to know what the medication can and cannot do, including the risks and side effects. Letโs explore these in more detail after reviewing the basic facts about this medication.
What Is Semaglutide?
Under the brand name Wegovy, semaglutide is approved for both type 2 diabetes and weight loss in people meeting certain criteria. It belongs to a class of GLP-1 receptor agonists and mimics the GLP-1 hormone involved in regulating blood-sugar levels, decreasing appetite, and slowing the speed at which the stomach empties.
Semaglutide is sold under the brand names Ozempic (weekly injection), Rybelsus (daily oral tablet), and Wegovy (weekly injection, daily oral tablet). Only Wegovy is FDA-approved for weight management, while Ozempic and Rybelsus can only be prescribed for it off-label, if deemed appropriate. Each medication is created to address certain treatment objectives, and a healthcare provider can explain which may be the most suitable choice for an individualโs condition.
Before getting a prescription for Wegovy as a part of your weight loss journey, youโll go through a medical evaluation, possibly including lab tests, so your healthcare provider can determine if semaglutide is appropriate for you.
Common Side Effects
Semaglutide can cause side effects, particularly when treatment begins or the dosage changes. Some of the most frequent side effects include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Abdominal pain
- Headache
- Injected site reaction like redness or swelling
- Burping
The general nature of all these side effects is of mild to moderate severity, and they tend to occur less frequently with ongoing treatment as the body becomes accustomed to the medication.
Most of the side effects are related to the way semaglutide slows digestion and impacts the gastrointestinal system. For instance, nausea and bloating are due to food lingering in the stomach longer than normal. However, not everyone will have side effects, and if you do, you can often mitigate them with your providerโs instructionsย
Less Common Side Effects
Although most people do well with semaglutide and may have only mild adverse reactions, some experience less common or rare side effects. One such side effect is facial fat loss, also known as “Ozempic face,” as the facial structure becomes more sunken or aged, which is the result of altered metabolism or sleep patterns.
Some people have reported hair thinning or hairโloss, but it tends to be because they’re losing weight quickly or their diet is deficient, and not because of the medication directly. The metallic or different taste is also noted as a taste alteration due to the medication. Furthermore, once you stop taking semaglutide, rebound weight gain happen, as your appetite and metabolism can revert to the way they were before you started this medicine.
Serious Side Effects and Warnings
Although less common, semaglutide can have serious side effects that need to be treated as soon as possible. Being aware of the warning signs is important to avoid complications or deal with them timely.
- Pancreatitis: The pancreas can become inflamed. Look out for intense pain in your tummy that may spread to your back, along with nausea and vomiting. Consult a doctor if any of these symptoms develop suddenly.
- Gallbladder Issues: Semaglutide may cause gallstones or an inflammation of the gallbladder called cholecystitis. Symptoms include severe pain in the upper right part of the abdomen, fever, and yellowing of the skin or eyes (jaundice).
- Kidney Damage: Prolonged vomiting or diarrhea may cause a severe loss of body fluids, which can result in dehydration and kidney damage. Symptoms may include swelling in the legs, decreased amounts of urine, and fatigue. Itโs important to stay well-hydrated and to let a healthcare provider know if anything unusual is happening with urination.
- Allergic Reaction: Rare, but still a possibility that a person may have a rash, itching, swelling (particularly of the face, tongue, or throat), or feel tightness in the chest; other possible symptoms of allergy include dizziness or trouble breathing. Allergic reactions to semaglutide require emergency care.
- Thyroid Tumors/Cancer Risk: Semaglutide has been associated with thyroid C-cell tumors in animal studies. While the relevance of this finding to humans remains uncertain, semaglutide is contraindicated in people with an individual or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia type 2.
- Stomach Paralysis (Gastroparesis) &โBowel Obstructions: Nausea, bloating, constipation, or vomiting may be typical side effects but itโs crucial to seek medical help if they are long-term and/or severe.
- Low Blood Sugar (Hypoglycemia): This is more common when semaglutide is used in combination with insulin or other diabetes medications. It can cause shakiness, sweating, confusion, dizziness, fast heartbeats, and other symptoms. Keep an eye on blood sugar, too.
- Changes in Vision: Some people may experience blurred vision or changes in vision, especially if the changes in blood sugar levels are extreme. Tell your healthcare provider if this happens.
Who Should Not Use Semaglutide?
Although mostly safe, semaglutide may not be appropriate for everyone. Some medical conditions and life stages can also put people at risk for more severe side effects.
Contraindications
People with a personal or family history of a type of thyroid cancer called Medullary Thyroid Carcinoma (MTC) and people with Multiple Endocrine Neoplasia syndrome type 2 (a rare, inherited cancer syndrome that involves at least one of several endocrine glands) are not supposed to take semaglutide because these diseases are linked to an increased risk of developing tumors in the thyroid gland. People who have a history of allergic reactions to semaglutide should also not use it.
Special Populations
- Pregnant Patients: Semaglutide is not recommended for use during pregnancy as it may harm an unborn baby. Itโs important to stop the medication at least two months before planning to get pregnant.
- Breastfeeding Patients: It is not known if semaglutide passes into breast milk. However, itโs almost universally recommended that individuals who are breastfeeding not use medication, unless specifically instructed by a health professional.
- Children and Teenagers: There have been no studies conducted to prove whether semaglutide is safe and works for weight loss in people under 18, so it’s generally not recommended for use in childrenโor teenagers.
- Older Adults: Older adults may be more sensitive to the side effects of semaglutide, such as gastrointestinal issues or kidney problems. Close surveillance is advisable, particularly at the onset of therapy.
Drug Interactions and Precautions
Before starting semaglutide, it is important to consider potential interactions with other medications, foods, or substances that may impact its safety and effectiveness.
- Other Diabetes Medications: You might develop hypoglycemia (low blood sugar) if you use semaglutide with insulin or other medications that lower blood sugar (such as sulfonylureas). Changing the dose may be necessary to avoid sideโeffects.
- Gastrointestinal Medications: Medications affecting the speed at which the stomach becomes empty, as well as medications for gastrointestinal problems, might disrupt how semaglutide works or is tolerated, particularly early in treatment.
- Oral Medications: Because semaglutide can slow gastric emptying, it may interfere with the absorption of certain oral medications. This might diminish their effectiveness or change how theyโre metabolized.
- Alcohol: Consuming alcohol while taking semaglutide can increase the risk of gastrointestinal side effects and impact blood sugar. Restrict or abstain from alcohol, particularly early in treatment.
- Over-the-Counter (OTC) Medications and Herbal Supplements: Semaglutide may interact with some herbal products and over-the-counter supplements. For instance, St. Johnโs Wort has been shown to alter a medicationโs metabolism.
Tell your healthcare provider about all the medications you use, including prescription and over-the-counter medicines, vitamins, and herbal products. This allows them to screen for drug interactions and adjust dosages if necessary.
Managing and Preventing Side Effects
Although semaglutide can be effective in helping to control blood sugar and facilitate weight loss, it takes some time to adapt to the medication in the first few weeks of treatment. Below are some ways to manage the side effects.
- Adjust Your Diet: The most common side effects include nausea, vomiting, and upset stomach. Eating smaller meals more often and choosing low-fat or low-greasy foods may help alleviate GI disturbances. Plain foods such as toast, rice, or crackers are frequently easier on the stomach.
- Stay Well-Hydrated: Semaglutide could cause dehydration, especially if you have vomiting or diarrhea. Try to stay well hydrated all day. Electrolyte-filled beverages also can help maintain balance, especially during bouts of digestive distress.
- Gradual Dose Increases: The lowest effective dose, increased upward as directed by your healthcare provider, will help your body adapt to the medication and limit the side effects. Avoid changing the dose yourself.
- Lifestyle Changes: Regular exercise, adequate sleep, and stress management can help maintain general health and possibly minimize the severity of side effects. Do not drink alcohol, as it can make nausea or dizziness worse.
Though many side effects are typically mild and temporary, be sure to get in touch with your healthcare provider if you experience any of the following:
- Intractable nausea, vomiting, or diarrhea
- Signs of dehydration (dry mouth, dizziness, reduced urination)
- Abdominal pain, intense vomiting
- Changes in your ability to see, or signs of low blood sugar, such as shakiness, confusion, or sweating
- Any pain that affects your daily activities or doesn’t get better as time goes on
The Takeaway
Semaglutide may cause side effects, especially during the first few weeks of treatment. Knowledge of potential side effects and interactions enables you to make informed decisions about your health. You should always communicate openly with your healthcare provider about any concerns or side effects and inform them of any medications or supplements you may be taking. Continued guidance from a medical professional you trust will help your treatment meet your individual needs and lead to a proper outcome.
ย [1]โMany patients experience mild gastrointestinal symptoms when starting semaglutide, but these effects are often manageable with gradual dose escalation, hydration, smaller meals, and close communication with a healthcare provider. Education and realistic expectations are key to long-term success.โ
ย [2]โSemaglutide should never be viewed as a stand-alone solution. The patients who tend to do best long term are those who combine medication therapy with sustainable nutrition habits, physical activity, sleep optimization, and ongoing medical follow-up.โ
The owners and authors of Cinnamon Hollow are not doctors and this is in no way intended to be used as medical advice. We cannot be held responsible for your results. As with any product, service or supplement, use at your own risk. Always do your own research and consult with your personal physician before using.
Meg is an author at Cinnamon Hollow. She writes on a variety of topics sharing tips and ideas for daily life.
