The Best Ways to Manage Semaglutide Side Effects

Semaglutide is FDA-approved to treat Type 2 diabetes and metabolic-associated steatohepatitis (MASH). It’s also approved for weight management and to lower the risk of heart attacks, stroke, and worsening kidney disease in people with diabetes. There are three forms of semaglutide: Ozempic, Wegovy, and Rybelsus.

Semaglutide works by copying a gut hormone called glucagon-like peptide-1 (GLP-1). This hormone affects your liver, gut, and brain to help control appetite and improve blood sugar control. 

Like any medication, semaglutide can cause side effects. But these side effects usually go away over time as your body adjusts to the medication. While you wait for your body to adapt, there are steps you can take to stay comfortable. 

Let’s take a look at the best strategies to help you manage semaglutide side effects.

What are the most common side effects of semaglutide?

The most common semaglutide side effects involve your gut and include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Gas and bloating

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Experts think these side effects develop because semaglutide delays the movement of food through your gut.

But semaglutide can cause other symptoms outside your gut, including:

• Headache 

• Fatigue

• Dizziness

• Brain fog

• Mood changes

These side effects are likely related to semaglutide’s impact on blood sugar levels. 

How common are semaglutide side effects?

Real-world studies have shown that some semaglutide side effects are more common than others:

• Nausea affects up to half of people taking semaglutide. 

• Diarrhea occurs in up to 1 in 4 people. 

• Vomiting is also reported in up to 1 in 4 people. 

• Constipation happens in up to 1 in 3 people, though some studies report only 1 in 10.

• Stomach pain affects up to 1 in 5 people. 

• About 1 in 10 people experience gas or bloating.

• Headaches, fatigue, or dizziness occur in roughly 1 in 10 people.

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People taking higher doses of semaglutide are more likely to have side effects than those taking lower doses. 

Luckily, studies also show that most of these side effects go away over time as the body adjusts to the medication. Only about 4% of people stop taking semaglutide because of side effects. This means that for most people, the benefits of semaglutide outweigh the discomfort of side effects. It also suggests that most people find side effects manageable and not too severe.

What are the best ways to manage semaglutide side effects?

There are ways to manage semaglutide side effects so you can stay comfortable and get the full benefits of your medication. The best strategies depend on your symptoms. Let’s look at the best ways to manage semaglutide side effects by symptom.

Nausea and vomiting

Nausea is the most commonly reported side effect. It’s usually mild and goes away on its own. But it can come back anytime you increase your dose. 

You can take the following steps to lessen this nausea from semaglutide:

• Avoid trigger foods, especially highly processed or fatty foods.

• Eat smaller, more frequent meals.

• Try natural nausea remedies like ginger tea or ginger gummies.

• Use the lowest dose of semaglutide that is effective for you.

• Increase your dosage slowly.

• Talk with your healthcare team about prescription nausea medications like Zofran (ondansetron).

Diarrhea

Diarrhea from semaglutide is often mild and goes away on its own. You can use the following strategies to help with diarrhea:

• Drink plenty of water or low-sugar electrolyte drinks to stay hydrated.

• Avoid foods and beverages that may worsen diarrhea, like sugary drinks, caffeinated beverages, and high-fat foods.

• Talk with your healthcare team about over-the-counter (OTC) products like Imodium (loperamide). These medications can slow down your gut and may worsen other semaglutide side effects. So, it’s important to talk with your team before trying them. 

Constipation

Constipation is one of the longer lasting side effects. It can take up to 6 weeks to go away. But you can try several approaches to relieve this symptom:

• Drink plenty of water to keep your stool soft so it’s easier to pass.

• Eat more fiber or try fiber supplements to bulk your stool. This helps make it easier to pass.

• Stay active to help your gut move better.

• Create a regular bowel routine to encourage consistent bowel movements.

• Talk to your healthcare team about laxatives like polyethylene glycol (Miralax) or sennosides (Senna) to treat your symptoms.

Gas and Bloating

Gas and bloating will go away on their own as your body gets used to semaglutide. You can reduce gas and bloating with these tips:

• Chew food completely before swallowing to swallow less air.

• Avoid carbonated beverages, which can introduce more air into your stomach.

• Eat fewer gas-producing foods, such as beans and lentils. 

• Talk with your healthcare team about OTC products like simethicone (Gas-X).

Headache

People taking semaglutide usually develop headaches because of dehydration or lower blood sugar levels. You can use the following management strategies to combat this effect.

• Drink plenty of fluids to keep you hydrated.

• Check your blood sugar regularly if you have diabetes.

• Eat a snack if your blood sugar is lower than usual. 

• Try an OTC pain reliever like acetaminophen (Tylenol) or ibuprofen (Motrin) to relieve an occasional headache. Talk with your healthcare team about other options if you need to take these regularly for headaches. There are other options that work better to relieve chronic headaches. 

Dizziness

Like headaches, dizziness can be from dehydration or low blood sugar. To help manage and reduce dizziness you can:

• Drink plenty of fluids to keep you hydrated.

• Check your blood sugar regularly if you have diabetes.

• Eat a snack if your blood sugar is lower than usual. 

• Change positions slowly to help your body adjust. Sit briefly before standing, and stand up slowly before walking.

Fatigue

You might feel tired at first after starting semaglutide. This can be from lower blood sugar levels or from your body adjusting to eating fewer calories. Some tips to help fight semaglutide fatigue include the following:

• Eat smaller, more frequent meals to keep blood sugar levels steady.

• Choose nutrient-dense foods so smaller meals are still packed with calories, vitamins, and minerals.

• Include complex carbohydrates like vegetables and legumes that maintain a steady blood sugar.

How long do semaglutide side effects usually last?

Many semaglutide side effects improve over time as your body adjusts to the medication. Typically, they last for a few days or weeks. But they can come back if you need to increase your semaglutide dose. 

In clinical trials, some side effects lasted longer than others. Here’s a closer look:

• Nausea: Usually got better within a few days to a week

• Diarrhea: Also improved in less than a week

• Vomiting: Typically only lasted a few days

• Constipation: Could last weeks to months, but it usually improved over time

When should you seek care for semaglutide side effects?

Contact your healthcare team if semaglutide side effects:

• Don’t go away within a week

• Don’t get better with the home management strategies discussed above

• Aren’t relieved with OTC medications

Your team may offer prescription options to relieve symptoms. They may also suggest adjusting your semaglutide dose. 

It’s rare, but some semaglutide side effects can be an emergency. Semaglutide has been linked to serious medical conditions including:

• Hypoglycemia in people with Type 2 diabetes

• Worsening diabetic retinopathy

• Pancreatitis

• Gastroparesis and intestinal blockages

• Non-arteritic anterior ischemic optic neuropathy (NAION)

• Gallstones and gallbladder inflammation (cholecystitis)

Seek medical care right away if you experience: 

• Vomiting or diarrhea that stops you from eating or drinking

• Less urine output than normal

• Low blood sugar that doesn’t get better after eating15 g of carbohydrates

• Blood sugar lower than 55 mg/dL

• Chest pain

• Changes in heart rate or palpitations

• Fainting

• Severe stomach pain that doesn’t go away or gets worse

• Stomach pain that gets worse when you eat

• Yellowing of your eyes or skin

• Vision changes or loss of vision

Allergic reactions to semaglutide are possible. Call 911 if you or a loved one develops signs of anaphylaxis (a serious allergic reaction) after taking semaglutide. Signs include:

• Hives

• Trouble breathing 

• Wheezing

• Chest tightness

• Trouble swallowing

• Throat tightness or swelling

• Swelling of the eyelids, lips, or tongue

• Vomiting, diarrhea, or abdominal pain

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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