The positive impact Ozempic can have on your blood sugar and weight can help you live an overall healthier life, but for some people the medications also come with pretty uncomfortable side effects. If you’re worried about or currently experiencing Ozempic side effects, here’s what to know — and importantly, what to do about it.
What is Ozempic?
Ozempic (semaglutide) is a weekly injection that’s FDA-approved for blood sugar control in adults with type 2 diabetes. It belongs in a class of medication called GLP-1 agonists, which work by stimulating insulin production and slowing the emptying of food out of the stomach, both of which help lower glucose levels. You’ll need a prescription to take Ozempic, which can come from your provider or an online weight loss clinic.
Common side effects of Ozempic
The following are the most common side effects you may experience when starting on Ozempic, according to the prescribing information:
- Nausea: Occurs in about 16% to 20% of patients, compared to 6% on a placebo.
- Diarrhea: Occurs in about 9% of patients, compared to 2% on a placebo.
- Vomiting: Occurs in about 5% to 9% of patients, compared to 2% on a placebo.
- Stomach pain: Occurs in 6% to 7% of patients, compared to 5% on a placebo.
- Constipation: Occurs in 3% to 5% of patients, compared to 1.5% on a placebo.
Mild side effects of Ozempic
Most of Ozempic’s side effects are considered mild. In addition to the above common ones, you may experience (in alphabetical order):
- Burping
- Dizziness
- Fatigue
- Gas
- Headache
- Indigestion
- Injection site reactions
- Lightheadedness
Serious side effects of Ozempic
While rare, there have been some more serious side effects that have been identified in clinical trials. These are (in alphabetical order):
- Angioedema (an allergy that causes swelling under the surface of the skin)
- Hypoglycemia (too low blood sugar)
- Increased risk of medullary thyroid cancer (not known to cause this issue in humans, only in animal studies)
- Pancreatitis (inflammation of the pancreas)
- Severe allergic reactions
- Stomach paralysis (the medical term is gastroparesis, which is when the muscles of your digestive system struggle to move food through your GI tract)
- Vision changes
Make sure to go over your complete health history with your provider before starting Ozempic to see if you’re at a higher risk for any of these serious side effects. For example, if you have a history of pancreatitis, your provider may decide that it’s too risky to start you on Ozempic, says Dr. Fatima Cody Stanford, M.D., an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School.
Explanation of Ozempic side effects
Aside from "Ozempic face" and "Ozempic butt," several Ozempic side effects are talked about more than others, such as digestive problems, hypoglycemia, allergic reactions, and risk of thyroid cancer. Here’s what you need to know about why those happen.
Stomach problems
“Nausea, nausea, nausea,” is one of the first things Stanford tells patients when talking about Ozempic side effects. “I say it that way because it’s by far the most common side effect,” she says, adding that while nausea typically goes away on its own, it can sometimes be severe enough that it’s tough to get through the day.
Here’s why nausea happens when taking a GLP-1 like Ozempic: “The mechanism by which Ozempic works is that it slows the emptying of the stomach,” says Dr. Samina Afreen, M.D., an endocrinologist who specializes in diabetes and obesity at UVA Health in Charlottesville, Virginia. “Food sits in the stomach longer, and you feel fuller.” But if too much food sits in your stomach, it can make you nauseous. This side effect is most common when you’re first starting Ozempic or increasing your dose because your body is acclimating to the medication.
Then, there are the bathroom problems. That slowdown of food through our GI tract can disrupt your regularity and cause constipation, says Stanford. Diarrhea may also occur because you may be more prone to getting a fecal impaction (dry, hard stool that’s stuck in your rectum). When that happens, she explains, fluid comes in around the stool, which also causes frequent, loose, and watery BMs.
Tips for managing stomach problems
If you notice nausea, stomach pain, diarrhea, or constipation, here are some tweaks you can make:
- Eat smaller portions: Eating past the point of fullness can make side effects worse, and it’s easy to do when you first start taking Ozempic. “I recommend patients start by cutting their portion sizes in half,” says Afreen. Then stop and check in with your hunger. If that half filled you up, don’t finish the whole thing.
- Eat when hungry: You may be used to having three square meals and two snacks a day — don’t feel pressure to keep that same schedule, says Afreen. “Listen to the cues of your body.” If you are still full from breakfast at lunchtime, don’t force yourself to eat.
- Drink more water: Because you’ll be eating less, there’s also a tendency to drink less water, says Afreen. “That can put you at risk for dehydration.” And dehydration is a common cause of constipation. Keep a water bottle by your side and sip throughout the day to stay well-watered.
- Ramp up doses slowly: The recommendations for taking Ozempic are to start with a lower dose and gradually increase every four weeks, as tolerated. That means if you’re having nausea and other stomach issues, talk to your doctor before increasing your dose so side effects don’t get worse.
- Consider anti-nausea medication: If you typically feel nauseated for the first couple days after your weekly injection (and cutting portion sizes doesn’t help), your doctor may recommend taking an anti-nausea medication like Zofran (ondansetron). Medication can also help with regularity and diarrhea, so bring those up to your doctor as well.
Hypoglycemia
If you’re taking Ozempic along with another medication to manage your blood sugar, such as sulfonylurea or insulin, it’s rare — but possible — to have hypoglycemia, which is when your blood sugar falls too low (below 70 mg/dL). In clinical trials, 1.5% or fewer people on Ozempic experienced severe hypoglycemia, according to the manufacturer.
Tips for managing low blood sugar
Make sure that you’re working with your provider to monitor and, if needed, adjust the dose of any current medication you’re taking to manage your blood sugar. If you experience signs of hypoglycemia — shakiness, sweating, chills, confusion, dizziness, lightheadedness — take action to bring your blood sugar back up. The American Diabetes Association recommends eating 15 grams of carbohydrates (such as glucose tablets or gel, 4 ounces of juice or soda, or candy) and checking your glucose levels after 15 minutes until you reach that 70 mg/dL blood sugar threshold.
Allergic reactions
It’s possible that the place where you give yourself the injection can hurt or look red, but that happened in just 0.2% of people in trials. There is also a risk — low but there — for anaphylaxis, a life-threatening allergic reaction that can occur when taking any medication or supplement.
Tips for managing allergic reactions
“You can’t predict which patient would have an allergic reaction,” says Afreen. What is useful is knowing the symptoms — swelling of your face, lips, tongue, or throat, trouble breathing, rapid heart rate, feeling faint — and calling 911 if they occur.
Thyroid cancer risk
Early animal studies on rodents found that Ozempic could cause medullary thyroid cancer, though this has not been shown in people. However, this warning specifically applies to a type of thyroid cancer called medullary thyroid cancer. Afreen screens her patients by asking if they have a personal or family history of medullary thyroid cancer. If so, Ozempic is not recommended.
Tips for managing or identifying thyroid cancer
In addition to knowing your family medical history, being able to spot the signs of a thyroid problem is always a good thing. These include a lump in your throat, trouble swallowing, or hoarseness. Ozempic’s manufacturer recommends promptly telling your provider if you develop any of those symptoms.
The bottom line
Ozempic results in food staying in your stomach longer, which can cause side effects like nausea, vomiting, stomach pain, constipation, and diarrhea. There are some other mild side effects, like redness around the injection site, that are less common. In some cases, Ozempic can cause severe side effects, like pancreatitis, but they are very rare. For a full list of side effects, visit the Ozempic site. If you are taking Ozempic and are experiencing side effects that won’t go away or that are severe, talk with your provider about your options. You may slow down how quickly you go up in doses or even try an Ozempic alternative. “Sometimes patients feel disappointed that the thing that works for friends and family didn’t work for them, but it’s not possible to predict who can tolerate it,” says Afreen. “We do have other options.”
FAQs
Do not use Ozempic if you are pregnant or plan to become pregnant in two months, are breastfeeding, have a family history of medullary thyroid cancer, have been diagnosed with multiple endocrine neoplasia syndrome type 2, or have had a serious allergic reaction to semaglutide or an ingredient in Ozempic.
No. A high-risk medication is one that has a high chance of causing harm. The most common side effects of Ozempic are typically mild, such as nausea and constipation. These can typically be managed with proper dosing and tweaks to your eating habits.
Ozempic butt is a term to describe changes to one’s butt, such as sagging or lax skin, that can occur as a result of rapid weight loss from taking a GLP-1 medication like semaglutide.