The side effect profile is the same for Ozempic® and compounded semaglutide injectables — because the active ingredient is the same. The most common side effects are gastrointestinal and typically improve significantly as your body adjusts.
Common side effects:
- Gastrointestinal symptoms: nausea, vomiting, diarrhea, constipation, abdominal discomfort. Most common in the first 2 to 4 weeks of starting and during dose increases. Often resolve as your body adjusts.
- Decreased appetite. A primary effect of the medication, but worth knowing about as you adjust eating patterns.
- Fatigue, particularly in the first few weeks.
- Headaches.
- Injection site reactions mild redness, itching, or swelling at the injection point. Rotating injection sites week to week helps reduce this.
Less common side effects:
- Low blood sugar (hypoglycemia) particularly when GLP-1s are combined with other diabetes medications. Less common in women using semaglutide for weight management alone.
- Gallbladder issues including gallstones or inflammation. The risk is small but worth knowing about. Sudden severe abdominal pain in the upper right of the abdomen warrants immediate clinical attention.
- Dizziness or lightheadedness.
Serious side effects requiring immediate attention:
- Severe abdominal pain that won't resolve particularly with vomiting, which can indicate pancreatitis.
- Signs of an allergic reaction facial swelling, difficulty breathing, severe rash.
- Persistent vomiting that prevents you from keeping fluids down.
- Symptoms that may suggest thyroid changes a lump in the neck, hoarseness, persistent trouble swallowing.
What to do:
- Most common side effects resolve within 2 to 4 weeks. Stay consistent through the adjustment window if you can.
- Eat smaller, more frequent meals during the first weeks. Larger meals are more likely to trigger nausea on GLP-1s.
- Stay hydrated. GI side effects can dehydrate you faster than you'd expect.
Message your clinician if side effects are bothersome, lasting longer than expected, or feel severe.
- Call 911 or go to an emergency room for the serious side effects listed above.
Your clinician will discuss what to expect specifically for your dose and protocol, and can adjust titration if side effects are interfering with daily life.