The FDA label for semaglutide warns of a small number of rare but potentially serious side effects.
- renal failure Studies have shown that in some cases, semaglutide use can contribute to kidney disease. Side effects of dehydration, especially diarrhea and vomiting, can increase this risk. Nevertheless, for most people, this drug appears to have a positive effect on kidney health.
- gallbladder disease This can cause severe abdominal pain, yellowing of the eyes and skin, fever, and clay-colored stools. Medication or surgery may be required to destroy the gallstones. In extreme cases, cholecystectomy may also be an option.
- Thyroid C cell tumor Semaglutide’s FDA label warns of the risk of developing thyroid cancer, which has been observed in rodent studies. However, European health authorities said they found no link to humans.
- pancreatitis This condition, in which digestive enzymes attack the pancreas, can feel like severe abdominal pain that radiates down your back. However, most experts doubt whether semaglutide really increases the risk.
There have been some reports of allergic reactions to GLP-1 receptor agonists.
Gastroparesis (gastroparesis)
Gastroparesis is a condition in which the stomach emptying is too slow or stops. It causes a variety of gastrointestinal symptoms, including bloating, abdominal pain, nausea, and vomiting. In the worst cases, gastroparesis can make it very difficult to eat or drink anything, which can lead to dehydration and malnutrition.
Delayed gastric emptying, a characteristic of gastroparesis, is a known effect of Ozempic and related drugs. Some of Ozempic’s positive effects of reduced hunger and weight loss are partially explained by this delayed excretion. It can also cause less severe side effects, such as gastrointestinal discomfort.
Fortunately, severe persistent gastroparesis appears to be very rare. This condition was not seen in any of the drug’s Phase 3 trials, which enrolled thousands of participants to assess the safety of semaglutide.
Temporary intestinal paralysis (ileus)
Gastroparesis is not the only severe gastrointestinal side effect reported by users.
In late September 2023, the FDA updated Ozempic’s official label to warn users of the potential risk of ileus, a type of intestinal obstruction. An ileus occurs when the muscles that push food into the intestines become temporarily paralyzed, causing food to become trapped in the intestines. Symptoms can resemble a physical intestinal obstruction, such as bloating and constipation, and can lead to dehydration.
Bowel obstruction is likely a rare side effect and was not seen in previous clinical trials evaluating semaglutide in thousands of participants. “Because these reactions are spontaneously reported in populations of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure,” the FDA noted in the updated guidance.
hypoglycemia
Although Ozempic itself probably does not cause hypoglycemia (hypoglycemia), its hypoglycemic effects can sharply increase the chance that other drugs, primarily insulin or sulfonylureas, will cause hypoglycemia. If Ozempic lowers your baseline blood glucose level, your previous dose of a hypoglycemic drug may be more than needed.
If you have diabetes and start a new dose of GLP-1, you may need to change the dosage of other diabetes medications you are taking. Your doctor may also tell you to be especially careful about testing your blood sugar levels. If you don’t feel comfortable changing your insulin delivery method on your own, you should call your doctor between visits so he or she can provide guidance on adjustments.
