Key takeaways:
Most people with liver conditions, including MASLD and MASH, can safely take Ozempic.
Ozempic isn’t FDA approved to treat any liver conditions. But it may indirectly support liver health by improving blood sugar management in people with Type 2 diabetes.
Ozempic has been linked to rare, but serious side effects. Contact your healthcare team right away if you develop fever, severe abdominal pain, or yellowing of the skin or eyes (jaundice) while taking Ozempic.
Semaglutide is the active ingredient in Ozempic and Wegovy, two popular GLP-1 agonist medications that come as weekly injections or daily oral pills. In just a few years, semaglutide has picked up several FDA approvals: to treat Type 2 diabetes, address chronic weight management, and lower heart-related risks in certain people.
As these uses expand, people living with liver disease may wonder if Ozempic is safe for them?
Research suggests semaglutide may affect liver health in important ways. Here’s what the science says so far, and what you need to know before taking Ozempic (or other forms of semaglutide) if you have liver disease.
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Can you take Ozempic if you have a condition that affects your liver?
Yes, most people with liver conditions can safely take Ozempic (semaglutide). But it depends on your specific situation. Below, we break down what the research says about Ozempic and some common liver conditions.
Metabolic dysfunction-associated steatotic liver disease (MASLD)
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of chronic liver disease. It’s caused by a buildup of fat in the liver.
People with MASLD can safely take Ozempic and other forms of semaglutide, like Wegovy. In fact, some experts recommend semaglutide as a preferred treatment option for people with both Type 2 diabetes and MASLD.
Metabolic-associated steatohepatitis (MASH)
Metabolic-associated steatohepatitis (MASH) is a more advanced form of MASLD. Over time, fat buildup in the liver can cause inflammation. This inflammation can cause liver injury and scarring. So, MASLD becomes MASH when fat buildup in the liver starts to cause ongoing inflammation and liver damage.
People with MASLD can take Ozempic. In fact, Wegovy — another form of semaglutide — is FDA approved to treat MASLD that causes liver scarring. In clinical trials, people taking Wegovy had improvement in either liver inflammation or scarring. Researchers are still looking at how these effects will affect people’s liver health over time.
Cirrhosis
Liver cirrhosis is an advanced form of liver scarring that affects how well your liver can function. Ozempic isn’t safe for everyone with liver cirrhosis.
You may be able to take Ozempic if you have compensated cirrhosis. Compensated cirrhosis means that your liver is still able to complete many of its usual functions.
You may not be able to take Ozempic if you have decompensated cirrhosis. Decompensated cirrhosis means that your liver isn’t working well, and you’re experiencing problems like jaundice, bleeding, or ascites.
Semaglutide can’t slow down cirrhosis or make it more likely for you to move from decompensated to compensated cirrhosis. But there’s some evidence that semaglutide may lower the risk of developing decompensated cirrhosis if you have compensated cirrhosis.
Liver cancer
There’s no evidence that people with liver cancer, including hepatocellular carcinoma, can’t take Ozempic. These conditions aren’t listed as contraindications by semaglutide manufacturers.
But your healthcare team may recommend against taking semaglutide if you’re getting treatment for liver cancer. Semaglutide can cause side effects like nausea and vomiting. Chemotherapy and other treatments for liver cancer can also cause these side effects. Taking semaglutide and chemotherapy together could worsen these side effects, making cancer treatment harder to tolerate.
Viral hepatitis
Viral hepatitis is a liver infection caused by several viruses. Some forms of viral hepatitis, like hepatitis B, can cause liver scarring and cirrhosis. Some forms of viral hepatitis go away on their own. Others, like hepatitis C, can be cured with medication.
Ozempic can’t cure or treat viral hepatitis. But it’s safe for most people with viral hepatitis to take Ozempic.
You can take Ozempic if you have chronic hepatitis B as long as your liver is functioning well. You can take Ozempic if you had hepatitis C in the past or are currently receiving treatment for it. You may not be able to take Ozempic if you have hepatitis A or E until you recover from the infection.
Can Ozempic help treat liver disease?
Ozempic isn’t FDA approved to treat any liver conditions. Wegovy, another form of semaglutide, is FDA approved to treat certain types of metabolic-associated steatohepatitis (MASH).
That said, Ozempic may still support liver health in people with Type 2 diabetes. Semaglutide improves blood sugar management and insulin sensitivity. Metabolic-associated steatotic liver disease (MASLD) is closely linked to Type 2 diabetes and insulin resistance. So, better management of blood sugar levels may lower the risk of developing MASLD — or its progression into MASH.
Semaglutide can also promote weight loss and improve cholesterol levels. These are important for lowering liver inflammation and long-term liver damage. For people taking Ozempic for diabetes treatment, these benefits can help keep the liver healthy — even though the medication isn’t a direct treatment for liver disease itself.
What are the risks of taking Ozempic if you have a liver condition?
Like all medications, Ozempic can cause side effects. The most common side effects of Ozempic include:
Vomiting
Stomach upset
Some people have developed more serious complications while taking Ozempic, including:
It’s not clear if people with liver conditions are at higher risk of developing Ozempic-related side effects or complications. Contact your healthcare team right away if you develop any concerning symptoms while taking Ozempic, such as:
Intense stomach pain
Yellowing of the eyes or skin (jaundice)
Inability to eat or drink from nausea or vomiting
Stomach distension
Bleeding
Fever
Vision changes
Frequently asked questions
Certain people shouldn’t take Ozempic or other forms of semaglutide. You shouldn’t take Ozempic if:
You have an allergy to semaglutide or other ingredients in Ozempic.
You have a history of medullary thyroid cancer, gastroparesis pancreatitis, or multiple endocrine neoplasms (MEN-2) syndrome.
Your family members have either MEN-2 syndrome or medullary thyroid carcinoma.
It’s not clear if Ozempic is safe during pregnancy. Talk with your healthcare team about whether you should stop taking Ozempic if you are pregnant or nursing.
No, generally Ozempic isn’t harmful to the liver. There have been rare reports of people developing liver injury while taking Ozempic. But it’s not clear if Ozempic directly caused the injuries.
Insurance plans and Medicare will generally not cover Ozempic to treat liver disease. Currently, only Wegovy is FDA approved to treat certain liver conditions.
Certain people shouldn’t take Ozempic or other forms of semaglutide. You shouldn’t take Ozempic if:
You have an allergy to semaglutide or other ingredients in Ozempic.
You have a history of medullary thyroid cancer, gastroparesis pancreatitis, or multiple endocrine neoplasms (MEN-2) syndrome.
Your family members have either MEN-2 syndrome or medullary thyroid carcinoma.
It’s not clear if Ozempic is safe during pregnancy. Talk with your healthcare team about whether you should stop taking Ozempic if you are pregnant or nursing.
No, generally Ozempic isn’t harmful to the liver. There have been rare reports of people developing liver injury while taking Ozempic. But it’s not clear if Ozempic directly caused the injuries.
Insurance plans and Medicare will generally not cover Ozempic to treat liver disease. Currently, only Wegovy is FDA approved to treat certain liver conditions.
The bottom line
Ozempic is generally safe for most people with liver conditions. It’s not FDA approved to treat any liver conditions, but it may support your liver health by improving blood-sugar levels. Talk with your healthcare team if you have Type 2 diabetes and metabolic-associated steatotic liver disease (MASLD). They may recommend Ozempic as part of your treatment plan.
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References
Cusi, K., et al. (2025). Metabolic dysfunction-associated steatotic liver disease (MASLD) in people with diabetes: The need for screening and early intervention. A consensus report of the American Diabetes Association. Diabetes Care.
Huang, D. Q., et al. (2025). Metabolic dysfunction-associated steatotic liver disease in adults. Nature Reviews Disease Primers.
Kalsi, H., et al. (2025). Semaglutide-induced liver injury. ACG Case Reports Journal.
Kanwal, F., et al. (2024). GLP-1 receptor agonists and risk for cirrhosis and related complications in patients with metabolic dysfunction-associated steatotic liver disease. JAMA Internal Medicine.
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. (2025). Semaglutide. National Institute of Diabetes and Digestive and Kidney Diseases.
Novo Nordisk. (2025). Ozempic (semaglutide) injection, for subcutaneous use [package insert].
Sanyal, A. J., et al. (2025). Phase 3 trial of semaglutide in metabolic dysfunction–Associated steatohepatitis. The New England Journal of Medicine.
Targher, G., et al. (2025). Metabolic dysfunction-associated steatotic liver disease. The New England Journal of Medicine.
U.S. Food and Drug Administration. (2025). FDA approves treatment for serious liver disease known as ‘MASH’.
