Most medications come with potential side effects, and semaglutide is no exception. The good news is that many semaglutide side effects are mild and temporary. But it's still a good idea to educate yourself on what to watch out for. That way, if you do experience any side effects, you'll be prepared to handle them properly.
In this article, we'll explore the common and serious side effects of semaglutide, how it may interact with other medications, and if it's safe to take during pregnancy.
Gastrointestinal Issues
While the weight loss benefits of semaglutide are clear, this medication does come with some temporary side effects. In clinical trials, the most common issues are gastrointestinal in nature, including nausea, diarrhea, and constipation. 1 Let’s take a closer look at the data:
In one major trial, 2,116 overweight or obese adults took semaglutide 2.4 mg for 68 weeks. 1 Throughout the study, the most commonly reported side effects were:
- Nausea (44%)
- Diarrhea (30%)
- Vomiting (24%)
- Constipation (24%) 1
The severity of these side effects varied from person to person. Some were able to tolerate it, while others had to discontinue treatment due to these symptoms. 1
It turns out there's a reason behind the tummy troubles. Semaglutide works by delaying stomach emptying so you feel fuller longer. 1 In fact, studies showed 37% of solid food was still retained after 4 hours. 2 While this mechanism promotes weight loss, it can also wreak some havoc on your digestive system. The good news is that for most people, these issues dissipate over time as your body adjusts.
Managing Nausea
Nearly half of people taking semaglutide 2.4 mg in clinical trials reported experiencing nausea as a side effect. 1 If nausea strikes, there are some tips and tricks to help relieve your discomfort.
- Eat smaller meals more frequently
- Eat foods containing ginger
- Drink ginger or peppermint tea
- Take small sips of a cold drink
- Get fresh air
- Distract yourself by watching TV or listening to music 3
At the same time, there are some things you'll want to avoid:
- Do not wear clothes that are tight around your stomach
- Do not lie down after eating
- Do not have a large drink with meals
- Do not eat too quickly
- Do not cook strong-smelling food
- Do not eat fried or greasy food 3
If your nausea persists or gets worse, it's important to contact your doctor. They may prescribe medications that can help relieve your nausea and make your semaglutide treatment more comfortable.
Managing Diarrhea
Almost a third of people on semaglutide 2.4 mg experienced diarrhea in clinical trials. This unpleasant side effect was reported by 30% of participants on semaglutide compared to only 16% of those on a placebo. 1
If you find yourself suddenly spending more quality time on the porcelain throne after starting semaglutide, try these tips:
- BRAT Diet: Opt for bland and easily digestible foods like bananas, rice, applesauce, and toast. These can help in soothing your stomach and easing digestive issues.
- Stay Hydrated: Keep yourself well-hydrated by drinking plenty of water throughout the day. Including foods with high water content, such as soups and broths, can also aid in replenishing fluids lost due to diarrhea. 4
A day or two of loose stools is unpleasant but usually not dangerous. However, if it goes on much longer than that, call your doctor. Severe, prolonged diarrhea can lead to dehydration and electrolyte imbalances, which require medical attention. 4
Managing Constipation
If semaglutide has you feeling a bit backed up, you're not alone. Clinical trials found 24% of people reported constipation with the 2.4 mg dose, compared to just 11% of folks on placebo. 1
If you're unsure whether you might be dealing with constipation, watch out for these common symptoms:
- Having fewer than three bowel movements per week
- Passing hard, dry stool in small quantities
- Feeling bloated or uncomfortable in the abdominal area
- Experiencing abdominal pain 5
If you find yourself struggling with constipation while taking semaglutide, consider these practical tips to help alleviate the discomfort:
- Up your intake of fiber-rich foods: Aim to consume between 20 to 35 grams of fiber daily to promote the formation of softer, bulkier stool.
- Cut back on low-fiber foods: Reduce your consumption of items like ice cream, cheese, meats, and processed foods.
- If lifestyle changes aren't effective, consider trying out laxatives.
- Stay well-hydrated by increasing your water intake.
- Incorporate regular physical activity into your daily routine to help keep things moving smoothly. 5
Serious Semaglutide Side Effects
While semaglutide is generally safe and effective for most people, there are some rare but serious side effects to be aware of. By having an honest conversation with your doctor about your full medical history, you can reduce the risk of serious side effects. Your doctor needs a full picture of your health to determine if this medication is the right fit.
Kidney Failure
Semaglutide has been linked to acute kidney injury and worsening of chronic renal failure in some patients. Surprisingly, this has happened both in people with and without a prior history of kidney issues. 1
Researchers have found that most of these kidney problems have occurred when people using semaglutide have become dehydrated from side effects like nausea, vomiting, and diarrhea. When you're dehydrated, your kidneys can struggle to function properly. 1
Here are some tips to help you stay hydrated and protect your kidneys:
- Start your day with a glass of water, and drink water before each meal.
- Monitor the color of your urine - it should be clear or light in color, indicating adequate hydration.
- Set reminders on your phone to drink water throughout the day.
- Add water-rich foods to your diet, such as soups and broths.
It's also essential to inform your doctor if you have a history of kidney issues. This way, your doctor can monitor your kidney function when starting semaglutide or increasing your dose and keep an eye out for any side effects that can lead to volume depletion. 1
Diabetic Retinopathy
In a two-year clinical study involving individuals with type 2 diabetes who were prescribed semaglutide, researchers observed that 3% of the participants experienced diabetic retinopathy. Diabetic retinopathy is a condition caused by damage to the blood vessels in the retina, leading to potential vision complications. 1
Importantly, the risk was higher for those who already had a history of diabetic retinopathy at the start of the trial. 1 So, what's the link between semaglutide and this eye condition?
Researchers believe it's due to the drug's rapid blood sugar-lowering effects. When blood sugar drops quickly, it can temporarily worsen diabetic retinopathy before the condition stabilizes again. For individuals with a prior history of diabetic retinopathy, it is crucial to inform your healthcare provider before initiating semaglutide therapy. 1
Thyroid C-Cell Tumors
Research in rodents has raised some eyebrows about the potential thyroid effects of semaglutide. Studies have shown that semaglutide may cause thyroid tumors in rats and mice. 1 But what does this mean for humans?
The verdict is still out if semaglutide increases thyroid cancer risk in people. However, as a safety precaution, the FDA has placed a black box warning on semaglutide, warning patients about the risk of thyroid tumors. 1 Because of this, your doctor will avoid prescribing semaglutide if you have a personal or family history of:
- Medullary thyroid carcinoma (MTC)
- Multiple endocrine neoplasia syndrome type 2 (MEN 2) 1
While taking semaglutide, it’s wise to keep an eye out for potential thyroid cancer symptoms. Contact your healthcare provider right away if you experience:
- Trouble catching your breath
- A hoarse or strained voice
- A lump or swelling in your neck 6
Semaglutide Drug Interactions
When starting semaglutide, it's crucial to provide your doctor with a full list of all medications you're taking. This helps prevent unwanted drug interactions and side effects.
In the case of semaglutide, it’s important to be mindful of a few key drug interactions:
- Oral Medications: Semaglutide has the potential to impact the absorption of oral medications by slowing down the process of stomach emptying. To address this, your healthcare provider may recommend regular monitoring of the blood levels of these medications and make necessary adjustments to your dosage.
- Insulin: Given that both semaglutide and insulin work to lower blood sugar levels, combining them can result in dangerously low blood sugar levels. If you are prescribed both insulin and semaglutide, your healthcare provider may opt to reduce your insulin dosage. 1
Semaglutide and Pregnancy
The safety of semaglutide during pregnancy is still unclear at this time. There just isn't enough data available yet on taking this medication while pregnant or trying to conceive. 1 So, if a baby is part of your future plans, it's crucial to talk with your healthcare provider about the risks versus benefits of staying on semaglutide.
If you and your doctor decide to come off semaglutide before pregnancy, your doctor will likely recommend stopping semaglutide at least two months before you start trying to get pregnant. This gives the medication enough time to fully clear from your system prior to conception. 1
Conclusion
Semaglutide can be a game-changer for controlling blood sugar levels and promoting weight loss. However, to get the most benefit from this medication while minimizing side effects, proper administration, careful management, and open communication with your doctor are key.
The good news is that most side effects of semaglutide are temporary. Nausea, vomiting, diarrhea - these should improve over the first few weeks. If you do experience side effects, remember that being proactive is key. Stay hydrated, take anti-nausea medication if needed, and stick closely to your doctor's recommendations for managing symptoms.
The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical conditions, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.
