Ozempic® and kidney stones

The labels: no stones, but a fluid warning

All three official documents were checked on 20 October 2026. None lists kidney stones (nephrolithiasis or urolithiasis). What they do contain is a warning about the kidneys and fluid, and it helps to keep the two topics apart.

What semaglutide trials and studies show

The only trial figure for the same molecule comes from the Wegovy® label. In the SELECT cardiovascular outcomes trial, in people with overweight or obesity and established heart disease, urolithiasis (stones anywhere in the urinary tract) was reported in 1.2% on Wegovy® 2.4 mg and 0.8% on placebo; serious cases were 0.6% against 0.4% ^[4]. Wegovy® uses a higher semaglutide dose than Ozempic®, so this is a pointer rather than an Ozempic® rate.

A 2025 Nature Medicine study of US Department of Veterans Affairs records compared about 216,000 people with diabetes who started a GLP-1 medicine with people continuing usual care across 175 outcomes. GLP-1 use was associated with a higher risk of kidney stones, alongside many other findings in both directions ^[5]. As an observational analysis covering several GLP-1 medicines, it cannot separate the drug from differences between the people who received it.

Pointing the other way, a 2025 study using Medicare claims looked at 24-hour urine collections in people with kidney stone disease. Compared with matched controls, those filling GLP-1 prescriptions showed no significant differences in urine measures that affect stone formation, including in the 154 people who had collections both before and after starting ^[6].

How stones and Ozempic® could connect

What the label documents: Ozempic® causes nausea, vomiting and diarrhoea more often than placebo, and section 5.6 links these to dehydration and acute kidney injury ^[1]. The EU summary asks people to take precautions against fluid depletion ^[2].

What general medicine adds: concentrated urine lets minerals such as calcium and oxalate form crystals, and MedlinePlus names not drinking enough as the single biggest risk factor for stones ^[7]. Whether Ozempic® raises stone risk through this route has not been measured.

A proposed but unstudied link: a smaller appetite can mean drinking less with meals. No Ozempic® study has looked at this.

Other reasons stones form

Cleveland Clinic lists risk factors, several of which are common in people prescribed Ozempic® regardless of the medicine ^[8]:

• Not drinking enough fluids.
• Diabetes, obesity, gout and high blood pressure.
• A family history of kidney stones, or a previous stone.
• Diets high in salt, sugar or meat and other protein-rich foods, and vitamin C supplements.
• Previous stomach or bowel surgery, including gastric bypass.
• Some diuretics, calcium-based antacids and certain other medicines.

Recognising stone pain

Small stones may cause no symptoms. When a stone moves, MedlinePlus describes severe pain that starts and stops suddenly, in the side of the back or belly, sometimes moving towards the groin, possibly with blood in the urine, nausea and vomiting ^[7]. NIDDK adds a constant need to urinate, pain when urinating, passing only small amounts and cloudy or bad-smelling urine, and says to see a health professional right away for any of these ^[9].

Two Ozempic® warnings involve pain in nearby places. The Medication Guide describes pancreatitis as severe stomach pain that does not go away and may reach the back, and gallbladder problems as upper stomach pain with possible fever, yellow skin or eyes, or pale stools ^[1]. Because the causes overlap in location, new severe pain needs a medical assessment rather than a guess.

What general sources suggest

For people who have had stones, MedlinePlus and Cleveland Clinic emphasise drinking plenty of fluids and talking to a clinician or dietitian about diet and, for some stone types, medicines; blood and urine tests can guide prevention ^[7][8]. Cleveland Clinic notes that calcium from food can help prevent stones, unlike calcium supplements and antacids.

For pain during a stone episode, Cleveland Clinic advises asking a provider before taking ibuprofen, because it can raise the risk of kidney failure during an acute attack, particularly with other health conditions ^[8]. That caution is worth noting for anyone on Ozempic®, whose label already flags kidney injury when fluids run low ^[1].

Ozempic® context

Ozempic® is injected weekly and has a separate kidney approval: on the strength of the FLOW trial, it is used to lower the risk of kidney function decline, kidney failure and cardiovascular death when type 2 diabetes and chronic kidney disease occur together ^[1]. That indication concerns chronic kidney disease, not stones. Section 8.6 says no dose adjustment is recommended for kidney impairment ^[1].

Ozempic® and Wegovy® are registered trademarks of Novo Nordisk A/S. PepLabo is not affiliated with or endorsed by Novo Nordisk.

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