Ozempic Side Effects: what the label lists and when to get help

Key takeaways

• Nausea, vomiting, diarrhea, stomach pain and constipation are the most common Ozempic side effects; nausea affected 20.3% on 1 mg vs 6.1% on placebo in label trials.^[1]
• Most nausea, vomiting and diarrhea happened while the dose was being increased; 3.8% on 1 mg stopped because of digestive side effects.^[1]
• Low blood sugar is uncommon with Ozempic alone but more frequent with insulin or a sulfonylurea.^[1]
• Serious risks include pancreatitis, gallbladder problems, kidney injury from dehydration and diabetic eye complications; Ozempic has a boxed warning about thyroid tumors in rodents.^[1]
• In January 2026 the FDA found no increased risk of suicidal thoughts or behavior with GLP-1 medicines.^[3]

In short: The most common side effects of Ozempic (semaglutide) are nausea, vomiting, diarrhea, stomach pain and constipation. In the label’s placebo-controlled trials in adults with type 2 diabetes, nausea affected 15.8% of people on 0.5 mg and 20.3% on 1 mg, compared with 6.1% on placebo, mostly while the dose was being increased. Serious but less common risks include pancreatitis, gallbladder problems, kidney injury from dehydration and low blood sugar when combined with insulin or sulfonylureas. Ozempic also carries a boxed warning about thyroid C-cell tumors seen in rodents (label checked on 2026-10-06).

This page goes through what the official Ozempic prescribing information and Medication Guide say about side effects: how often each one happened in trials, when they tend to appear, which warning signs need a call to your doctor or emergency care, and who may be at higher risk. It is general information, not medical advice. If something feels wrong, contact the clinician who prescribed it; never stop or change the dose on your own without talking to them.

First, what these numbers come from

Ozempic is FDA approved for adults with type 2 diabetes: to improve blood sugar, to lower the risk of heart attack, stroke and cardiovascular death in those with heart disease, and to slow kidney decline in those with chronic kidney disease. It is not approved for weight management. The side-effect rates on its label come from trials in adults with type 2 diabetes at Ozempic’s doses (0.5 mg and 1 mg weekly in the main pooled table). Wegovy contains the same medicine, semaglutide, at higher doses for weight, and its weight-loss trials reported higher rates of digestive side effects; see Wegovy side effects. If you are using Ozempic for weight, which is off-label, our page on Ozempic for weight loss explains what that means.

Side-effect rates from trials are averages from carefully monitored studies. The label itself notes that rates from different drugs’ trials cannot be directly compared and may not match what happens in everyday practice. Your own experience depends on your dose, how fast it is increased, your other conditions and medicines, and your eating habits.

The most common side effects

The label’s main table pools two placebo-controlled trials (one with Ozempic alone and one added to basal insulin), with an average exposure of about 33 weeks. These are the side effects reported by at least 5% of people on Ozempic and more often than on placebo:

• Ozempic 1 mg
• Ozempic 0.5 mg
• Placebo

Nausea20.3%15.8%6.1%

Vomiting9.2%5%2.3%

Diarrhea8.8%8.5%1.9%

Abdominal pain5.7%7.3%4.6%

Constipation3.1%5%1.5%

Most common Ozempic side effects vs placebo (adults with type 2 diabetes)

Item	Ozempic 1 mg	Ozempic 0.5 mg	Placebo
Nausea	20.3%	15.8%	6.1%
Vomiting	9.2%	5%	2.3%
Diarrhea	8.8%	8.5%	1.9%
Abdominal pain	5.7%	7.3%	4.6%
Constipation	3.1%	5%	1.5%

Pool of 2 placebo-controlled trials: 262 on placebo, 260 on 0.5 mg, 261 on 1 mg. Larger pools and the 2-year heart outcomes trial showed similar types and rates.

Source: Ozempic prescribing information, Table 1 (checked on October 6, 2026)

Less common digestive side effects (under 5%) were also more frequent with Ozempic: indigestion (3.5% on 0.5 mg and 2.7% on 1 mg vs 1.9% on placebo), burping (2.7% and 1.1% vs 0%), acid reflux (1.9% and 1.5% vs 0%), gas (0.4% and 1.5% vs 0.8%) and gastritis. In a separate 40-week trial comparing 1 mg and 2 mg, digestive side effects occurred in 34% on 2 mg vs 30.8% on 1 mg. The label also lists fatigue, a change in taste (dysgeusia) and dizziness as side effects reported in more than 0.4% of people.

When side effects usually show up

According to the label, most reports of nausea, vomiting and diarrhea happened during dose escalation, the weeks when the dose is being stepped up. That is why the label starts everyone on a low dose for 4 weeks, which it describes as a way to reduce digestive reactions, and then raises it in steps at least 4 weeks apart. Your prescriber sets the pace and decides what to do if side effects are bothersome.

The Medication Guide stresses fluids: diarrhea, nausea and vomiting can cause dehydration, which can lead to kidney problems, so it says it is important to drink fluids and to tell your provider right away about nausea, vomiting or diarrhea that does not go away. Practical habits that some people discuss with their care team, such as smaller meals and stopping eating when full, are covered on our GLP-1 diet page.

Low blood sugar (hypoglycemia)

On its own, Ozempic rarely caused low blood sugar in trials: in the 30-week trial of Ozempic alone, documented symptomatic low blood sugar (70 mg/dL or less) occurred in 1.6% on 0.5 mg and 3.8% on 1 mg, and no severe episodes were reported. The risk rises when Ozempic is combined with insulin or a sulfonylurea. With basal insulin, documented symptomatic low blood sugar occurred in 16.7% (0.5 mg) and 29.8% (1 mg) vs 15.2% on placebo, and severe episodes (needing another person’s help) in 1.5% on 1 mg. With a sulfonylurea, severe low blood sugar occurred in 0.8% and 1.2% of people.

• Ozempic 1 mg
• Ozempic 0.5 mg
• Placebo

Documented symptomatic (70 mg/dL or less)29.8%16.7%15.2%

Severe or confirmed 56 mg/dL or less10.7%8.3%5.3%

Severe (needed help from another person)1.5%0%0%

Low blood sugar when Ozempic was added to basal insulin (30 weeks)

Item	Ozempic 1 mg	Ozempic 0.5 mg	Placebo
Documented symptomatic (70 mg/dL or less)	29.8%	16.7%	15.2%
Severe or confirmed 56 mg/dL or less	10.7%	8.3%	5.3%
Severe (needed help from another person)	1.5%	0%	0%

About 130 people per group, with or without metformin. Prescribers often lower insulin or sulfonylurea doses when starting Ozempic.

Source: Ozempic prescribing information, Table 2 (checked on October 6, 2026)

Signs of low blood sugar listed in the Medication Guide include dizziness or light-headedness, blurred vision, anxiety, irritability or mood changes, sweating, slurred speech, hunger, confusion or drowsiness, shakiness, weakness, headache, a fast heartbeat and feeling jittery. The label says the prescriber may consider lowering the dose of insulin or sulfonylureas when Ozempic is started.

Serious side effects and warnings

Boxed warning: thyroid C-cell tumors. In mice and rats, semaglutide caused thyroid C-cell tumors, including cancers, after lifetime exposure. It is unknown whether Ozempic causes these tumors, including medullary thyroid carcinoma (MTC), in people. Ozempic must not be used by anyone with a personal or family history of MTC or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). The label notes that routine blood calcitonin tests or thyroid ultrasounds are of uncertain value for early detection. Tell your provider about a lump or swelling in the neck, hoarseness, trouble swallowing or shortness of breath.

• Pancreatitis. Confirmed in 7 people on Ozempic in diabetes trials (0.3 cases per 100 patient-years) vs 3 on comparators (0.2). Fatal and non-fatal cases have been seen with GLP-1 medicines. Warning sign: severe stomach pain that will not go away, sometimes spreading to the back, with or without vomiting.
• Diabetic eye (retinopathy) complications. In a 2-year heart outcomes trial (SUSTAIN-6), complications occurred in 3.0% on Ozempic vs 1.8% on placebo; the increase was larger in people who already had retinopathy (8.2% vs 5.2%). Rapid improvement in blood sugar can temporarily worsen retinopathy, so people with a history of it are monitored.
• Gallbladder problems. Gallstones were reported in 1.5% (0.5 mg) and 0.4% (1 mg) vs none on placebo; cholecystitis and gallbladder removal have been reported after approval.
• Kidney injury from dehydration. Reported after approval, sometimes needing dialysis, mostly in people with vomiting, diarrhea or nausea.
• Severe digestive reactions. 0.4% (0.5 mg) and 0.8% (1 mg) vs 0%; Ozempic is not recommended for people with severe gastroparesis. Ileus, bowel obstruction and severe constipation with fecal impaction have been reported after approval.
• Serious allergic reactions, including anaphylaxis and angioedema.
• Aspiration during anesthesia or deep sedation. Ozempic slows stomach emptying, and rare reports describe stomach contents entering the lungs during procedures. Tell every surgical and endoscopy team that you take it.
• Never share a pen, even with a new needle, because of the risk of blood-borne infections.

• Ozempic
• Placebo

Retinopathy complications, SUSTAIN-6 (2 years)3%1.8%

Retinopathy complications, people with prior retinopathy8.2%5.2%

Gallstones, 0.5 mg (placebo-controlled pool)1.5%0%

Severe digestive reactions, 1 mg0.8%0%

Selected serious or notable events in Ozempic trials

Item	Ozempic	Placebo
Retinopathy complications, SUSTAIN-6 (2 years)	3%	1.8%
Retinopathy complications, people with prior retinopathy	8.2%	5.2%
Gallstones, 0.5 mg (placebo-controlled pool)	1.5%	0%
Severe digestive reactions, 1 mg	0.8%	0%

Different trials and time frames; shown together for scale only.

Source: Ozempic prescribing information, sections 5.3, 5.7, 5.9 and 6.1 (checked on October 6, 2026)

Other effects people ask about

Heart rate. Ozempic raised average resting heart rate by 2 to 3 beats per minute in placebo-controlled trials. Injection-site reactions such as discomfort or redness were reported by 0.2%. Pancreatic enzymes (amylase and lipase) rose on average by 13% and 22%; the label says the meaning of this is unknown without other signs of pancreatitis. Hair loss (alopecia), headache and dysesthesia (unusual skin sensations) are listed among reports received after approval, where frequency cannot be reliably estimated.

Mood and suicidal thoughts. On January 13, 2026, the FDA said its review of 91 placebo-controlled trials with 107,910 participants found no increased risk of suicidal thoughts or behavior with GLP-1 medicines, and asked for that warning to be removed from the weight-loss labels that carried it. According to the FDA, labels of GLP-1 medicines approved for type 2 diabetes, such as Ozempic, did not include that warning. Anyone with new or worsening depression or thoughts of self-harm should still seek help; call or text 988.

“Ozempic face” and loose skin. “Ozempic face” is a popular, non-medical name for changes in facial fullness some people notice after losing weight; it is not a term from the label. Our Ozempic face guide and the loose skin hub explain what is known. Part of the weight lost on any GLP-1 medicine is lean mass; see muscle loss on GLP-1s.

Who may be at higher risk

• People taking insulin or a sulfonylurea (low blood sugar).
• People with a history of diabetic retinopathy (eye complications).
• People with severe gastroparesis (not recommended) or a history of pancreatitis (tell your provider).
• People who become dehydrated from vomiting or diarrhea, especially with existing kidney problems.
• Anyone with a personal or family history of MTC or MEN 2 (must not use it).
• Anyone scheduled for surgery, endoscopy or deep sedation.

Interactions, pregnancy and breastfeeding

Because Ozempic slows stomach emptying, it may change how other pills are absorbed; the label advises caution with oral medicines, although trials did not show a clinically relevant effect on the ones tested. For pregnancy, the label says Ozempic should be used only if the potential benefit justifies the potential risk to the fetus, and that women should stop it at least 2 months before a planned pregnancy because semaglutide stays in the body a long time. It is not known whether it passes into breast milk. Anyone pregnant, planning a pregnancy or breastfeeding should plan diabetes care with their clinician.

Counterfeit and compounded products

Some side effects reported online come from products that are not real Ozempic. On December 5, 2025, the FDA warned that it had seized counterfeit Ozempic 1 mg pens in the legitimate U.S. supply chain, labeled with lot PAR1229 (an authentic lot number); the counterfeit pens can be recognized by where the EXP/LOT text sits on the label. The FDA advises getting Ozempic only with a prescription from a state-licensed pharmacy. Compounded semaglutide is not FDA approved, and the FDA has received reports of adverse events linked to dosing errors with it. Read more in compounded GLP-1s.

Reporting a side effect

You or your clinician can report suspected side effects to the FDA’s MedWatch program at 1-800-FDA-1088 or online, and to Novo Nordisk at 1-888-693-6742 (numbers from the label). Reports help the FDA spot rare problems that trials can miss.

Cost of staying on treatment

Side effects are one reason people stop a medicine; cost is another. On 2026-10-06, NovoCare Pharmacy listed Ozempic pens at $349 a month for 0.25, 0.5 or 1 mg and $499 for 2 mg, with an introductory $199 a month for the first two fills of the lowest strengths through December 31, 2026. People with commercial coverage may pay as little as $25 a month (maximum savings $100 a month). See our Ozempic overview, the cost hub and the GLP-1 cost comparison tool. For the full picture of the drug class, see our GLP-1 side effects guide.

Questions to ask your doctor or pharmacist

• Which side effects should I expect at my dose, and which ones mean I should call you?
• Should my insulin or sulfonylurea dose change while I start Ozempic?
• Do I need an eye exam because of my diabetic retinopathy history?
• What should I do before a surgery, colonoscopy or other procedure?
• If side effects continue, can we slow the dose increase or try another option?

Frequently asked questions

What is the most common side effect of Ozempic?

Nausea. In the label's placebo-controlled trials it affected 15.8% of people on 0.5 mg and 20.3% on 1 mg, compared with 6.1% on placebo, mostly during dose increases.

How long do Ozempic side effects last?

The label says most nausea, vomiting and diarrhea happened during dose escalation. The label does not give a typical duration. Tell your prescriber about side effects that persist or get worse so they can review your options.

Does Ozempic cause pancreatitis?

Pancreatitis has been seen with GLP-1 medicines, including Ozempic. In diabetes trials it was confirmed in 0.3 cases per 100 patient-years on Ozempic vs 0.2 on comparators. Severe, persistent stomach pain needs urgent medical attention.

Can Ozempic cause thyroid cancer?

Semaglutide caused thyroid C-cell tumors in rodents, and it is unknown whether it does in people. That is why Ozempic has a boxed warning and must not be used by people with a personal or family history of medullary thyroid carcinoma or MEN 2.

Does Ozempic cause low blood sugar?

Rarely on its own. The risk rises with insulin or sulfonylureas: with basal insulin, documented symptomatic low blood sugar occurred in 29.8% on 1 mg vs 15.2% on placebo. Your prescriber may lower those medicines when starting Ozempic.

Does Ozempic cause hair loss?

Hair loss (alopecia) is listed among reports received after approval, where frequency cannot be reliably estimated. In Wegovy's weight-loss trials, hair loss was linked to weight reduction.

What is "Ozempic face"?

A popular, non-medical name for changes in facial fullness some people notice after losing weight. It is not a side effect listed on the label. See our Ozempic face guide.

Should I stop Ozempic before surgery?

Do not decide alone. The label warns about rare cases of stomach contents entering the lungs during anesthesia or deep sedation and says data are insufficient to recommend stopping. Tell your surgical team you take Ozempic so they can plan.

Are Ozempic side effects the same as Wegovy's?

They are the same type because both contain semaglutide, but Wegovy uses higher doses for weight and its trials reported higher rates, for example nausea in 44% vs 16% on placebo.

Official sources

• Prescribing information (FDA label)
• FDA approval letter or page
• Manufacturer information

References

1. OZEMPIC (semaglutide) injection: prescribing information. Novo Nordisk, via DailyMed, 2026. (accessed October 7, 2026) Drug label
2. Marso SP, Bain SC, Consoli A, et al.. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6). New England Journal of Medicine, 2016. doi:10.1056/NEJMoa1607141 · PMID 27633186 · NCT01720446 (accessed October 7, 2026) Randomized trial
3. FDA requests removal of suicidal behavior and ideation warning from GLP-1 receptor agonist medications. U.S. Food and Drug Administration, 2026. (accessed October 6, 2026) Government page
4. FDA warns consumers not to use counterfeit Ozempic found in U.S. drug supply chain. U.S. Food and Drug Administration, 2025. (accessed October 7, 2026) Government page
5. FDA’s concerns with unapproved GLP-1 drugs used for weight loss. U.S. Food and Drug Administration, 2026. (accessed October 7, 2026) Government page
6. Ozempic online pharmacy: self-pay prices and savings. Novo Nordisk (NovoCare Pharmacy). (accessed October 7, 2026) Other
7. RYBELSUS and OZEMPIC (semaglutide) tablets: prescribing information. Novo Nordisk, via DailyMed. (accessed October 6, 2026) Drug label
8. Drugs@FDA: Ozempic, NDA 209637, approval history. U.S. Food and Drug Administration. (accessed October 6, 2026) Government page
9. Perkovic V, Tuttle KR, Rossing P, et al.. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (FLOW). New England Journal of Medicine, 2024. doi:10.1056/NEJMoa2403347 · PMID 38785209 · NCT03819153 (accessed October 7, 2026) Randomized trial
10. Novo Nordisk announces significant reduction in US list price for Wegovy, Ozempic and Rybelsus. Novo Nordisk (press release), 2026. (accessed October 7, 2026) News (reported facts only)
11. Medicare GLP-1 Bridge: information for providers. Centers for Medicare and Medicaid Services. (accessed October 7, 2026) Government page
12. WEGOVY (semaglutide) injection and tablets: prescribing information. Novo Nordisk, via DailyMed, 2026. (accessed October 7, 2026) Drug label

Facts checked on October 6, 2026

Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.