Starting Treatment
😒 Side Effects
Like all medications, GLP-1 medications can cause side effects in some people. For Ozempic, Zepbound, Wegovy, and Saxenda, the most common side effects are related to how the medication works in your body. For example, the medication slows the speed that food goes through the gastrointestinal tract which can cause nausea in some patients.
Since the compounded GLP-1 offered through Ro contains the same active pharmaceutical ingredient as Ozempic and Wegovy (semaglutide) or Zepbound (tirzepatide), side effects may be very similar to what patients on those drugs experience.
Keep reading to learn about some of the most common side effects, as well as some suggestions on how to manage them.
Side effect | Ways to manage |
|---|---|
Nausea/Vomiting | Switching up diet, mindful eating, ginger based foods (like ginger tea), antacids |
Diarrhea | Diet changes, over the counter remedies (Imodium) |
Constipation | Diet changes, over the counter remedies (Miralax, docusate) |
Abdominal discomfort | Diet changes |
Headache | Tylenol/Advil |
Fatigue | Ensure adequate intake of food/water |
Heartburn | Diet changes, over the counter remedies (TUMS) |
Issues at the injection site | Clean skin well before injection, inject at 90-degree angle; apply cool compress after injection if site is tender |
Find more detailed instructions for how to manage these and other side effects at home by reading this helpful article.
You can also read more about the medications by going to the Important Safety Information pages:
Remember to report any side effects you experience. Even if your side effects improve, it’s important for your Ro-affiliated provider to know this information in order to guide your care.
Common Questions
Are the side effects of Saxenda different from Wegovy and Ozempic?
No, they’re not. Reported side effects across Saxenda, Wegovy, and Ozempic are similar. If you’re experiencing any side effects, please report and discuss them with your provider, who can help you manage them and consider any treatment adjustments if needed.
Are side effects for compounded semaglutide different from Ozempic and Wegovy? Are side effects for compounded tirzepatide different from Zepbound?
Although compounded drugs are permitted to be prescribed under federal law, they are not FDA-approved and do not undergo safety review. Accordingly, the exact side effects are unknown. However, since the compounded GLP-1 offered through Ro contains the same active pharmaceutical ingredient as Ozempic and Wegovy (semaglutide) or Zepbound (tirzepatide), side effects may be very similar to what patients on Ozempic and Wegovy experience. For safety information, see these pages for compounded semaglutide and compounded tirzepatide.
When should I reach out to my Ro-affiliated provider about my side effects?
Your Ro-affiliated provider will be happy to help you manage your side effects. If you experience side effects, you may want to first try some of the suggestions above or in this article. However, if these suggestions don’t seem to help, if your symptoms persist or begin to severely impact your daily life, or if you have additional questions, you can always send a message to your Ro-affiliated provider for more guidance.
If you experience any of the following symptoms, seek treatment immediately at an emergency care facility:
Difficulty breathing or shortness of breath
Lip, tongue, or face swelling
Chest pain
Thoughts of hurting yourself
Blood in vomit
Bloody stools
Black tarry stools
I think I injected too much of my GLP-1. What should I do?
Despite the best intentions, accidents sometimes happen.
If you accidentally take more than the prescribed dose of your GLP-1, you may have a higher chance of experiencing side effects, and those side effects may be more severe than your experience with your regular dose. How severe the side effects may be will depend on the dose you took and how your body responds to it.
Daily medications, such as Saxenda reach their peak level within your body and are cleared from your system within a day. You may find that side effects from taking too much Saxenda will follow a similar pattern.
Weekly medications, such as Wegovy, Zepbound, Ozempic, compounded semaglutide and compounded tirzepatide, can take up to a few days to reach their peak in your body and stay in your system for several days. As a result, it’s possible that side effects from taking too much of a weekly medication may take a few days to develop and may persist for several days.
Follow the steps below if you believe you have taken more than your prescribed GLP-1 dose:
If you have no symptoms:
First, call Poison Control at 1-800-222-1222
Next, notify your Ro-affiliated provider
Monitor for any side effects that may develop over the next several days
If you develop mild symptoms:
First, call Poison Control at 1-800-222-1222 if you haven’t already
Next, notify your Ro-affiliated provider
Use the tips in our article on managing side effects
If your side effects aren’t manageable with the help of those tips, or if your side effects become more severe, seek treatment at an emergency care facility
If you develop severe symptoms:
If you experience any of the following symptoms, seek treatment immediately at an emergency care facility:
Severe nausea and vomiting or inability to keep fluids down
Severe abdominal pain that won’t go away or keeps coming back
Severe headache
Lightheadedness or passing out
Seizure
Difficulty breathing or shortness of breath
Lip, tongue, or face swelling
Chest pain
Blood in vomit
Bloody stools
Black tarry stools
Thoughts of hurting yourself
After you’ve received medical care for your symptoms, please contact your Ro-affililated provider to let them know what happened.
I’ve heard that you can lose muscle while taking a GLP-1. Is that true?
Losing weight, no matter what approach is used, can result in losing some muscle mass. Weight loss with GLP-1 medication is no different. You can preserve muscle in a couple of different ways.
First, ensuring that you have adequate protein in your diet can ensure your body has the building blocks needed to repair and build muscle.
Second, adding resistance or weight lifting exercises to your physical activity regimen can help you preserve and even build new muscle mass. Tips for both of these approaches will be included in the educational curriculum you’ll receive as part of the Body Program in the months ahead.
What about long-term side effects? If GLP-1s are meant to be taken long-term, is it safe to do so?
We can never rule out long-term side effects of any drug until we see the data. For example, we can never say with absolute certainty that some particular side effect will or won’t happen in 50 years with continued use of medication until we study the drug over 50 years. We can make educated estimates but we cannot know with absolute certainty.
Fortunately, with GLP-1s, we do have safety data stretching back 18 years. Even though these medications have only recently been used widely for weight management, this class of medications has been studied for treating diabetes for nearly two decades. While GLP-1s do have potential risks and side effects, currently available data does not show harm from long-term use of these drugs. However, more analyses across the GLP-1 drug class need to be conducted in order to make conclusive statements on long-term safety. Alternatively, we do have strong evidence of harm by not treating obesity. For every individual, starting medication should be based on your personal medical history, and risks and benefits should be discussed with your healthcare provider.
With respect to compounded drugs, they are not FDA-approved and the exact side effects are unknown. However, since the compounded GLP-1 offered through Ro contains the same active pharmaceutical ingredient as Ozempic and Wegovy (semaglutide) or Zepbound (tirzepatide), the side effects may be very similar to what patients on those medications experience.
I’ve heard that these medications could be linked to suicidal thoughts or thoughts of self-harm. Is that true?
In the U.S., FDA-approved prescribing information for Saxenda and Wegovy includes a warning to monitor for depression and suicidal thoughts and to discontinue treatment if symptoms develop.
In the case of Saxenda (liraglutide), this is because there were reports of suicidal ideation in clinical trials. In the case of Wegovy, there were also several cases of suicidal ideation in the clinical trials. Ozempic, which is also semaglutide but is not approved for weight management, does not carry this warning.
Although compounded drugs are permitted to be prescribed under federal law, they do not undergo safety review. Accordingly, the exact side effects are unknown. However, since the compounded GLP-1 offered through Ro contains the same active pharmaceutical ingredient as Ozempic and Wegovy (semaglutide) or Zepbound (tirzepatide), the side effects may be very similar to what patients on those medications experience.
You can read more important safety information for Saxenda here, Wegovy here, Ozempic here, compounded semaglutide here and compounded tirzepatide here.
While severe side effects are rare, they may occur, and the clinical protocols for Ro's affiliated practice include monitoring signs of depression or suicidal thoughts across all patients prescribed any GLP-1 medication through our platform.
For those starting a GLP-1 medication, it's important to share your entire medical history with your provider, including if you have a history of depression or suicidal thoughts or behavior.
For those on treatment with a GLP-1 medication, you should pay attention to any mental health changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Contact your provider right away if you have any mental changes that are new, worse, or worry you.
If you're experiencing a medical emergency, please contact 911 immediately or go to your nearest emergency room. If you are experiencing a mental health crisis or have thoughts of not wanting to live, please call or text the Suicide and Crisis Lifeline at 988. You can also use the 24/7 Crisis Text Line by texting "HOME" to 741-741.
Ro's team is aware of and following the European Medicines Agency's review of GLP-1 medications for similar risks. Currently, neither Wegovy nor Ozempic carry a warning for suicidal ideation in the EU or UK.