Semaglutide Side Effects: What Patients Should Know in 2025

Semaglutide is a type of medication commonly used for the treatment of type 2 diabetes and weight loss. It’s been known to cause potential side effects in some patients, such as nausea and pressure pain in the stomach. Recent FDA warnings in 2025 have highlighted increased concerns about counterfeit versions and compounded formulations of these medications.

Just like any pharmaceutical medication, there are side effects and disclaimers. However, the good news is that semaglutide has been successfully taken by many patients with great results. New research from 2025 continues to demonstrate its effectiveness, particularly when compared to other GLP-1 medications like tirzepatide.

This detailed report shares all the potential side effects of using semaglutide and how to manage them for proper weight loss treatment.

Key Takeaways of Semaglutide Side Effects

• Semaglutide is primarily used for blood sugar control and type 2 diabetes medication, but the FDA recently approved it to help for weight loss.
• Common side effects include nausea, vomiting, diarrhea, stomach pain, sour stomach, fatigue, changes to the face, rebound weight gain and low sugar levels.
• Rebound weight gain may occur after discontinuing semaglutide treatment after prolonged use, increasing the risk for obesity-related diseases like hypertension and diabetes.
• Patients taking semaglutide should watch out for warning signs of low blood sugar, such as blurred vision or dizziness, to avoid life-threatening complications caused by uncontrolled hypoglycemia.
• European regulators in 2025 identified NAION (a rare eye condition) as a very rare side effect of semaglutide medications.
• Cleveland Clinic research from 2025 shows that real-world weight loss results may be smaller than those seen in clinical trials.

Overview of Semaglutide Oral Route

Semaglutide Oral Route is an anti-diabetic medication used to treat type 2 diabetes and comes in the brand names Ozempic, Wegovy and Rybelsus. Another similar medication to semaglutide is Tirzepatide, which is a pharmaceutical drug sold under the brand name Mounjaro. Both are usually taken once a week through injection. Recent studies from 2025 have shown that tirzepatide demonstrates superior weight loss results compared to semaglutide in head-to-head comparisons.

Purpose and Use of Semaglutide for High Blood Sugar

Semaglutide works by controlling blood sugar and insulin levels. Patients treated are those with type 2 diabetes.

Taken orally, this diabetes medication is used in conjunction with diet and exercise programs to help regulate glucose levels in the body. Studies have found it associated with significant weight loss when taken regularly by overweight or obese individuals, who attempted an exercise program to shave excess pounds for over two years. New research from OHSU in 2025 has also shown promising results for adults with type 1 diabetes, with patients losing an average of 18.5 pounds over six months.

While side effects occur from taking such drugs, the potential benefits outweigh any risks if taken as prescribed by a health care professional.

Common Brand Names

Semaglutide belongs to the drug class of incretin mimetics and comes in two forms, subcutaneous injection which is sold as Ozempic, Wegovy and Rybelsus, or an orally taken dissolvable tablet that goes by the brand name of Rybelsus.

Ozempic is produced in multiple doses ranging from 0.25mg to 1mg, whereas Wegovy comes in pre-filled pens containing 1 pen fill of 0.75mg. Injections can be self administered on the upper arm using a ReadyPen device supplied with a needle. However, patients should be aware that the FDA issued warnings in 2025 about counterfeit Ozempic found in the U.S. drug supply chain.

Rybelsus provides one oral dosage per day containing a solution of 3mg semaglutide with various inactive ingredients such as carnauba wax and cornstarch. It’s presented as a tablet and delivers greater convenience compared to injections. Rybelsus tablets offer the same benefits as injections when it comes to controlling high blood sugar levels.

How Semaglutide is Administered on Patients

Semaglutide comes as injectable solutions and oral capsules. The intravenous or IV injection is the only approved route for administration indicated in clinical trials, while oral tablets were just recently approved by the U.S. Food and Drug Administration.

IV injections are typically done weekly in a 1ml to 4 ml volume and bring therapeutic levels within 24 hours. The medication allows once-in-a-week administration of the low dose injection. It results in sustained release through binding to serum albumin.

There is no specific guidance around when this treatment should be applied, whether it should be during waking or sleeping hours owing to its long-duration action. Rebels is a brand name for semaglutide tablets which can be taken with or without food once daily.

Some subcutaneous formulations facilitate common use at home as prescribed by a healthcare provider and require less frequent patient visits than the standard IV injections offered at most clinics across America. However, new FDA policies implemented in 2025 have made all compounded semaglutide and tirzepatide unavailable as of May 22, 2025, requiring patients to transition to FDA-approved branded versions.

Common Side Effects of Semaglutide

Patients treated with semaglutide, whether as diabetes medicine or as a weight loss treatment often experience common side effects. Here is a complete list:

Nausea and Vomiting

Nausea and vomiting are some of the most common side effects of semaglutide. It can range from mild to severe and is often accompanied by stomach feeling pressure, cramping or pain.

For women taking semaglutide, nausea may cause prominent common acid if taken on an empty stomach. Though the exact cause of this side effect is unclear, it’s thought that a buildup of acids in the small intestine is to blame for these symptoms.

To minimize nausea, eating something before taking the medication or asking a healthcare provider about compatible medications that help reduce this symptom can help. Dehydration can exacerbate nausea levels, so be sure to keep hydrated, plus avoid large meals right after taking this medication as they can worsen other side effects unnecessarily.

Diarrhea

Studies have shown that 8 to 9 percent of people using Ozempic, one brand of semaglutide, may experience diarrhea. It can usually be managed by adjusting the dosage or timing of the medication, but also requires medical attention and effects continue or become severe.

For some people, surprise diarrhea meaning sudden and unexpected onset of fluid bowel movements may occur, especially after first starting to take semaglutide as the body adjusts to the new medication. If this happens, see a doctor as soon as possible since dehydration and electrolyte imbalance are potential risks associated with this.

Help avoid any gastrointestinal symptoms while taking semaglutide, follow the doctor’s instructions carefully and talk to them about any dietary and lifestyle changes needed to make for managing the loss of fluids during episodes of diarrhea.

Stomach Pain

Both oral and subcutaneous doses of this medication may cause abdominal discomfort, such as bloating, gas, cramping, or sharp pains.

This pain can range from mild to severe and sometimes can lead to pancreatitis. It has been shown that certain people are at a higher risk for developing stomach pain as a side effect of taking semaglutide. Such people are those who are overweight, have pre-existing gastrointestinal disorders, or those who eat a high fat diet while on this drug.

To help reduce the frequency and severity of stomach pain associated with semaglutide use, it would be wise to discuss with a doctor any dietary changes to minimize possible irritation to your digestive system during treatment.

Fatigue

Semaglutide is an oral drug that can treat people with type 2 diabetes and non diabetics for weight loss medications. While the drug has generally been well tolerated by patients, like any other medication with side effects, it can have some side effects that can interfere with productivity on a daily basis.

Fatigue was reported in more than 0.4 percent of people taking semaglutide in clinical trials and also observed in less than 5 percent of individuals using the drug on their own.

If fatigue becomes excessive or does not improve after a few days, contacting a doctor as soon as possible, as it could indicate a potentially serious side effect that requires immediate attention or adjustment to a treatment plan is needed.

Changes to the Body Weight

Semaglutide can cause changes to one’s face due to excessive weight loss. Semaglutide injections used in the anti-diabetic medicine Ozempic have been reported to lead to the loss of facial fat and an aged, gaunt appearance known as the Ozempic face. This occurs due to significant weight loss while taking this drug. Those who experience dramatic decreases in their body mass may be at risk of developing this.

The decrease in fat beneath the facial skin leads to sagging skin, with wrinkles becoming more prominent. Individuals using semaglutide for extended periods may find that these changes become increasingly noticeable over time.

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Rebound Weight Gain

Women may experience rebound weight gain when discontinuing semaglutide or having a missed dose for prolonged time. Studies have shown that after stopping randomized treatments, the average weight gain of trial participants was 11.6 pounds or 1.9 percentage points in the semaglutide and placebo groups, respectively for 52 weeks during an extension phase.

Research also suggests that the effects of cardiometabolic health can be affected following discontinuation of semaglutide use, which can increase risk factors for obesity related diseases such as diabetes and hypertension.

Weight regain is a common issue among women who have taken semaglutide medication to manage their BMI, often making it difficult to maintain long-term weight loss goals due to this phenomenon known as rebound weight gain after stopping its use.

Low Blood Sugar

Semaglutide, when used in combination with other medications, may raise the risk of developing low blood sugar levels or hypoglycemia. Low blood sugar is a serious medical condition that can be life threatening if left untreated.

Symptoms include feeling shaky and dizzy, rapid heart rate, chest trouble, headache, sweating, blurred vision, or hunger indigestion. Monitoring the blood sugar regularly and being aware of these warning signs will help identify if blood sugar levels become too low while taking semaglutide.

To help prevent hypoglycemia its important to check food labels to ensure carbohydrate intake is consistent throughout the day, combined with regular exercise for adequate glucose uptake.

Hair Loss

Hair loss can be an uncomfortable side effect of taking semaglutide or drugs containing the medication. The concern of unanticipated hair loss has been raised in recent years due to reports from patients and research.

Although not listed as a potential side effect in clinical trials or official documentation, 3 percent of the participants reported thinning hair while taking Wegovy during clinical trials compared to 1 percent from the placebo group.

However, this is yet to be confirmed by substantial evidence or primary sources. Patients receiving treatment of semaglutide based medications need to evaluate and contact their doctor if experiencing any symptoms concerning physical changes such as hair loss, so a practical course of action can be given on time.

Serious Side Effects of Semaglutide

As with other medications, semaglutide also compiles a complete list of some of the more serious side effects that should not be ignored when considering taking it as weight loss medication. Some patients reported more serious symptoms and severe issues, such as gallbladder disease, thyroid c cell tumors, and kidney damage.

Gallbladder Disease

Using semaglutide may increase the risk of having gallbladder problems, such as gallstones, and this requires surgical removal. The product label for Ozempic mentions an increased risk of acute gallbladder disease and should not be taken lightly.

Gallstones are hard deposits in the gallbladder that can cause abdominal pain and severe nausea. If untreated, they can lead to infection or inflammation of the bile ducts or blockage.

Kidney Damage

There have been reports of adverse effects on the kidneys with semaglutide use including acute kidney injury and worsening of chronic renal failure which may require hemodialysis. Clinical studies have shown that GLP 1RA medications like semaglutide may affect kidney related adverse effects like kidney stones and severe abdominal pain.

A post hoc analysis suggests that it has protective effects against this type of damage but they need further investigation for confirmation. Doctors should consider special measures in individuals who already suffer from impaired renal function when prescribing semaglutide, and monitor them accordingly for any potential side effects or changes in their condition due to taking the drug over some time.

Thyroid-Related Complications

Thyroid Cancer and Tumors: The FDA has issued a black box warning regarding the potential risk of thyroid tumors and medullary thyroid carcinoma. This serious concern is linked to multiple endocrine neoplasia syndrome type 2. Any patient with a family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome should not use semaglutide.

Allergic Reactions

Semaglutide can cause skin rash, itching, and hives like swelling of the face, lips, tongue, and throat. Signs include difficulty breathing, chest tightness, and dizziness.

If an individual experiences these symptoms while on semaglutide, they must seek medical attention immediately as a severe reaction may occur if left untreated. Anaphylaxis is life threatening and can be observed when there is shortness of breath and rapid swelling inside the mouth.

Other serious allergic reactions such as Stevens Johnson syndrome or SJS have also been linked to using medications containing semaglutide and should be addressed by a healthcare provider immediately.

Other Serious Complications

High Blood Pressure Complications: While semaglutide can help with weight loss, some patients may experience changes in blood pressure that require monitoring. The medication’s effects on the cardiovascular system need regular assessment by healthcare professionals.

Ozempic warns patients about the potential risks and strongly advises stopping its use immediately upon noticing any of the symptoms mentioned above.

When to Contact a Healthcare Provider About Side Effects

Seek medical advice about side effects if symptoms become worse or do not improve over time. If you notice or experience any new side effects showing up as time progresses while using semaglutide, it is vital to call your doctor immediately.

Contact your medical provider services immediately if you experience:

• Any signs of thyroid tumors (neck lumps, persistent hoarseness)
• Severe allergic reactions (trouble breathing, widespread swelling)
• Persistent fever with other concerning symptoms
• Any combination of serious symptoms that feel life-threatening

Remember that while these serious side effects are possible, many patients successfully use semaglutide with only mild, manageable symptoms. However, being informed about potential serious complications ensures you can seek appropriate care when needed.

Having the necessary information about how to manage potential side effects can help ensure the safety and efficacy, resulting in positive health outcomes.

How to Manage and Cope with Semaglutide Side Effects

It is important to speak with an experienced doctor about the best ways to manage the possible semaglutide side effects, since certain management ways may help alleviate any negative symptoms experienced.

Tips for Managing Nausea and Vomiting

Managing nausea and vomiting caused by semaglutide can be achieved through proper hydration, diet and exercise program or modifications, and the use of certain over the counter remedies. Stay hydrated when taking this medication as it helps prevent dehydration, which could worsen symptoms such as nausea or vomiting.

One should also eat smaller meals throughout the day rather than three large ones so the stomach does not overload too quickly. Foods high in complex carbohydrates may help maintain energy levels while avoiding acidic ingredients that aggravate nausea and stomach discomfort.

Drinking ginger or peppermint tea can provide relief from gastrointestinal issues. Chamomile has also been known to reduce digestive stress associated with this medication.

Dietary Adjustments

Eating a diet that includes a variety of colorful and nutrient dense foods, including whole grains, legumes, fruits and vegetables, lean proteins, and healthy fats can help support gut health while reducing nausea and other GI issues.

Focusing on small meals, snacks, or dietary supplements throughout the day can also benefit those experiencing stomach pain or diarrhea. Reducing high sodium intake is advised as this may worsen existing symptoms.

Foods that are more easily digested like porridge or oatmeal can also help alleviate stomach discomfort. Those on semaglutide should also try to avoid any triggering foods such as fried or greasy items, sugar sweetened beverages, and processed meats which could aggravate specific side effects like vomiting and stomach pain, respectively.

Managing Low Blood Sugar

Low blood sugar, or hypoglycemia, is a potentially severe side effect of semaglutide. Its important for those taking semaglutide to monitor their blood sugar levels regularly and recognize the signs and symptoms of hypoglycemia.

Symptoms of low blood sugar can include confusion, dizziness, headache, feeling weak or anxious, sweating, and shakiness. To keep blood sugar control and prevent episodes of hypoglycemia, eat regular meals with carbohydrates at least every four hours throughout the day.

Diet advice is crucial to carry a fast acting source of carbs in case an episode occurs. Glucose tablets or candy are convenient options that can help raise blood sugars rapidly if needed, while waiting for more complex foods such as oatmeal porridge to be digested.

Seeking Medical Attention for Serious Side Effects

Patients need to seek medical attention immediately if serious side effects associated with the use of semaglutide occur.

Those who experience chest pain, troubled breathing, difficulty swallowing, increased heart rate, or unusual tiredness should contact their doctor immediately as these are considered to be severe symptoms and life threatening complications.

Any sign of pancreatitis such as abdominal pain that does not improve after rest or treatment should be reported, so the medication can be discontinued and proper treatment be administered.

Important Safety Precautions for Semaglutide Use

Semaglutide should be taken and managed as directed by a healthcare professional.

Storing and Disposing of Medication

Semaglutide should be kept at room temperature away from light and moisture. Keep the medication out of reach of children, pets, and other household members who may not be aware of its use or potential side effects.

Unused, leftover, or expired medications must be disposed of properly so they cannot cause harm to someone else. Depending on the type of medication, there can be different guidelines for proper disposal. Methods such as flushing down the toilet or bringing them back to a pharmacy for safe disposal.

Improper storage or disposal could lead to unwanted consequences such as overdose, abuse, or pollution if these medications reach water sources.

Emergency Procedures for Overdose

An overdose could lead to serious side effects and should not be taken lightly. Potential overdose symptoms can include low blood sugar levels, nausea, vomiting, abdominal pain, sweating, or weakness.

To prevent further complications or injury, contact a healthcare provider immediately for proper diagnosis and treatment. Follow any specific instructions by calling a doctor to manage the situation until emergency medical help arrives if necessary.

Seek a healthcare professional out at the nearest emergency room as soon as possible if you experience an overdose of semaglutide injections.

Frequently Asked Questions About Semaglutide Side Effects: What Patients Should Know in 2025

1. What are the most common side effects of semaglutide?

The most frequently reported side effects include nausea, vomiting, diarrhea, stomach pain, fatigue, and injection site reactions. Studies show that 8-9% of patients experience diarrhea, while nausea remains the most common complaint. These side effects typically occur when starting treatment or increasing doses, often improve as your body adjusts to the medication over time.

2. How can I identify and avoid counterfeit semaglutide products?

Recent FDA warnings have highlighted concerns about counterfeit Ozempic found in the U.S. drug supply chain. These fake products may contain incorrect ingredients, wrong dosages, or harmful substances. Always obtain semaglutide from licensed providers, verify the product’s authenticity, and be suspicious of unusually low prices or online retailers without proper credentials.

3. What is NAION and should I be concerned about vision problems?

NAION (Non-Arteritic Anterior Ischemic Optic Neuropathy) is a rare eye condition that European regulators have identified as a very rare side effect of semaglutide medications. This condition can cause sudden vision loss in one or both eyes. Contact your healthcare provider immediately if you experience sudden vision changes, eye pain, or visual disturbances while taking semaglutide.

4. Why are compounded semaglutide formulations no longer available?

FDA policies have made all compounded semaglutide and tirzepatide formulations unavailable, requiring patients to transition to FDA-approved branded versions. This change aims to ensure medication safety and quality control, as compounded versions may have inconsistent dosing and purity standards.

5. Can semaglutide be used for type 1 diabetes medication treatment?

New research shows promising results for adults with type 1 diabetes, with patients losing an average of 18.5 pounds over six months while improving blood sugar control. However, this is still being studied, and patients with type 1 diabetes should only use semaglutide under strict medical supervision. Semaglutide is primarily approved for type 2 diabetes.

6. What is “Ozempic face” and how can it be prevented?

“Ozempic face” refers to facial volume loss, sagging skin, and an aged appearance that can occur with rapid weight loss from semaglutide. This happens when significant weight loss leads to loss of facial fat. To minimize this effect, aim for gradual weight loss, maintain adequate protein intake, and consider facial exercises. Other options could be dermal treatments.

7. How should I manage rebound weight gain after stopping semaglutide?

Studies show patients may regain an average of 11.6 pounds within 52 weeks after discontinuing semaglutide. To minimize rebound weight gain, work with your healthcare provider to develop a comprehensive plan. Include gradual dose reduction, continued dietary modifications, regular exercise, behavioral support, and potentially transitioning to alternative weight management strategies.

8. What are the warning signs of serious allergic reactions?

Serious allergic reactions include skin rash, itching, hives, swelling of face/lips/tongue/throat, difficulty breathing, chest tightness, and dizziness. Anaphylaxis can be life-threatening with symptoms like rapid swelling in the mouth and severe breathing difficulties. Stevens-Johnson syndrome is another serious reaction. Stop the medication immediately and seek emergency medical care if these symptoms occur.

9. How does semaglutide compare to tirzepatide for weight loss?

Recent studies show that tirzepatide demonstrates superior weight loss results compared to semaglutide in head-to-head comparisons. However, both medications have similar side effect profiles, with tirzepatide potentially causing slightly more gastrointestinal symptoms. The choice between them should be based on individual patient factors and healthcare provider recommendations.

10. What precautions should I take regarding kidney function while on semaglutide?

Semaglutide may cause acute kidney injury or worsen chronic kidney disease, potentially requiring dialysis. Maintain adequate hydration, especially during episodes of nausea, vomiting, or diarrhea. Regular kidney function monitoring through blood tests is essential, particularly for patients with pre-existing kidney problems. Report symptoms like decreased urination, swelling, or fatigue to your healthcare provider immediately.

11. How should I properly store and dispose of semaglutide medications?

Store semaglutide at room temperature away from light and moisture, and keep refrigerated versions in the refrigerator (not frozen). Keep medications out of reach of children and pets. For injection pens, use proper needle disposal in sharps containers. Never share injection devices. Dispose of expired medications through pharmacy take-back programs or follow FDA disposal guidelines to prevent accidental ingestion or environmental contamination.

Conclusion and Summary of Semaglutide Side Effects: What Patients Should Know in 2025

Even though semaglutide is commonly used for treating type 2 diabetes, it has gained immense acceptance and popularity as a weight loss treatment for eligible patients. While treatment can effectively achieve desired outcomes, it comes with potential side effects ranging from mild to severe. Dietary and lifestyle changes can help minimize these side effects.

Patients interested in this kind of weight loss treatment should be aware that there are also severe medical issues such as gallbladder issues, heart disease, and kidney damage linked to this drug, making regular monitoring by healthcare providers highly important for anyone taking it long term.

Please note that this article is intended for informational purposes only and should not be construed as medical advice. Before making any changes to your treatments, please consult with your healthcare provider to discuss the appropriateness and safety of such changes.

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About the Author

Dr. Brandon Richland, MD is a respected Board Certified Licensed Newport Beach Plastic Surgeon in Orange County / Southern California specializing in comprehensive weight management, medical weight loss treatments, plastic surgery, reconstructive surgeries, and non-surgical cosmetic procedures for patients at all stages of their weight loss journey.

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