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Semaglutide side effects

Semaglutide is the active ingredient in Ozempic®, Wegovy® (injection and tablets) and Rybelsus®. Each product has its own label, trials and doses; this page shows what they share.

Published · Updated · Side effects · Written by the PepLabo editorial team

Products that contain semaglutide

  • Ozempic®: a weekly injection for adults who have type 2 diabetes.
  • Wegovy®: a once-weekly 2.4 mg injection and a daily 25 mg tablet for weight management; the label also has cardiovascular risk-reduction and MASH indications.
  • Rybelsus® (also named Ozempic® tablets in the current FDA label): a daily tablet for type 2 diabetes.

Nausea and diarrhea in the label tables

Nausea and diarrhea are among the most common side effects in every one of these labels. The table below copies those two rows from each label’s main placebo-controlled table, using the highest dose column in that table.

Label (population)Placebo nausea %Nausea, highest dose in table %Placebo diarrhea %Diarrhea, highest dose in table %
Ozempic® 1 mg (type 2 diabetes)6.120.31.98.8
Rybelsus® 14 mg (type 2 diabetes)620410
Wegovy® 2.4 mg injection (weight management)16441630

Each row comes from a different trial programme with different people, durations and doses. The labels themselves say rates from one medicine’s trials cannot be compared directly with another’s, so this table is not a ranking. [1][3][2] The European Union product information (SmPC and package leaflet) is published by EMA [4][5]; local leaflets can differ in detail.

Shared serious warnings

All three labels carry the boxed warning: in rodent studies semaglutide led to thyroid C-cell tumors, and whether it does in humans is unknown. Serious adverse reactions the labels share [1][2][3]:

  • Risk of thyroid C-cell tumors (the boxed warning)
  • Acute pancreatitis
  • Acute gallbladder disease
  • Low blood sugar (hypoglycemia), with a higher risk alongside insulin or sulfonylurea-type medicines
  • Acute kidney injury due to fluid loss (volume depletion)
  • Severe gastrointestinal adverse reactions
  • Hypersensitivity (allergic) reactions
  • Diabetic retinopathy complications (eye problems related to diabetes)
  • Food or liquid entering the lungs (pulmonary aspiration) under general anesthesia or deep sedation

The Wegovy® label also lists heart rate increase.

What happens if I stop semaglutide?

The labels do not describe how side effects change after stopping; they note that semaglutide leaves the body slowly [1][2].

In weight-management research, after 68 weeks on semaglutide 2.4 mg, people who then stopped had put back roughly two-thirds of their lost weight a year later (STEP 1 extension) [11].

Stopping, pausing or restarting is a decision to make with your prescriber.

Semaglutide, pregnancy and birth control

All three labels ask for a gap of at least 2 months ahead of a planned pregnancy; for weight management, the Wegovy® label says to stop when a pregnancy is recognized, and breastfeeding is not recommended with the tablets (Rybelsus® and Wegovy® tablets) [1][2][3]. None of them gives an instruction to change or add a birth-control method.

Should I mention semaglutide before surgery or sedation?

Yes, according to the labels. They describe rare postmarketing reports of food or liquid getting into the lungs (pulmonary aspiration) under general anesthesia or deep sedation in people taking GLP-1 receptor agonists, even when they had followed fasting instructions. They say the data are not enough to recommend whether to change fasting or pause the medicine, and asks patients to tell their healthcare providers before any planned surgery or procedure [1][2][3].

Can I drink alcohol while taking semaglutide?

None of these labels mentions drinking alcohol [1][2][3]. Two related facts come from general medical sources: heavy alcohol use is one of the most common causes of pancreatitis [6], which the labels list as a serious risk [1][2][3]; and drinking too much alcohol without enough food can cause low blood sugar in people with diabetes [7]. How alcohol fits with your treatment is a question for your prescriber.

Is hair loss listed for semaglutide?

The Wegovy® label lists hair loss in 3.3% on 2.4 mg vs 1% on placebo (more often in women) and links it to weight reduction [2].

In Ozempic®, Rybelsus®, hair loss is not in the clinical-trial tables; “alopecia” appears only in the postmarketing section, where neither frequency nor cause can be reliably established [1][3].

MedlinePlus describes a usually temporary kind of shedding (telogen effluvium) that can follow major physical stress, illness, surgery or crash diets [10].

Ozempic®, Wegovy® and Rybelsus® are trademarks of Novo Nordisk. PepLabo is not affiliated with this company. This page is not medical advice; percentages come from clinical-trial tables in the label and do not predict what you will experience.

When to get help

SignWho to contactHow fastSource
Swelling of the lips, tongue, face or throat, struggling to breathe or swallow, fainting or a racing pulseEmergency services. According to the guide, semaglutide should be stopped and urgent medical help sought.EmergencyOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]; MedlinePlus [9]
Belly pain that is severe and does not ease, whether or not you vomit; it can reach through to the backYour healthcare provider right away; the guide says to stop using semaglutide. If you cannot reach them, urgent care.EmergencyOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]; NIDDK [6]
Ongoing nausea, vomiting or diarrhea, or dehydration signs such as feeling very thirsty, a dry mouth, urinating less than usual, dark urine or dizzinessYour healthcare provider, right away: fluid loss can lead to kidney problems.TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]; MedlinePlus [8]
Pain in the upper stomach, fever, yellowing of the skin or eyes, or clay-colored stoolsYour healthcare provider (gallbladder problems).TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]
Shakiness, sweating, confusion, blurred vision or a fast heartbeat; the risk is higher alongside insulin or a sulfonylureaFollow the low-blood-sugar plan from your healthcare provider; the guide asks you to discuss it before starting.TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]; MedlinePlus [7]
A new neck lump or swelling, a hoarse voice, difficulty swallowing or breathlessnessYour healthcare provider (thyroid section of the guide).TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]
A racing or pounding heart at rest that lasts several minutesYour healthcare provider.TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]
Changes in vision during treatmentYour healthcare provider.TodayOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]
A planned surgery or a procedure with anesthesia or deep sedationTell every healthcare provider involved that you use this medicine, before the procedure.At your next appointmentOzempic®, Wegovy® and Rybelsus® Medication Guides [1][2][3]
Mild nausea, constipation, heartburn or other common side effects that you can manageMention them at your next appointment; a dated log helps.At your next appointmentCommon reactions: label section 6 [1][2][3]

Questions

Are semaglutide side effects the same in every product?

The type of side effects is similar across the labels, mostly digestive, but the reported rates differ because each label is based on different trials, populations and doses.

Does oral semaglutide have different side effects from the injection?

The Wegovy® label says the 25 mg tablet trial showed common side effects similar in type and frequency to the injection. Rybelsus® has its own table, also led by nausea.

Where can I read the full label?

The sources below link to each FDA label on DailyMed and to the EU product information on the EMA site. Your pharmacist can give you the local leaflet.

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