9 common Wegovy pill side effects and how to manage them

Just like with the injection, Wegovy pill side effects often show up within the first few weeks of starting the weight loss medication and when increasing your dosage. So, knowing what to expect can make treatment feel a lot more manageable.

This guide covers the most common side effects of oral Wegovy, why they happen, and how to manage them. To kick things off, here’s a preview of the Wegovy pill side effects discussed ahead: 

1. Nausea

2. Diarrhea

3. Vomiting

4. Constipation

5. Abdominal pain, upset stomach, and bloating 

6. Headache

7. Fatigue

8. Heartburn

9. Gas

Because the Wegovy injection and pill contain semaglutide, their side effects are similar. 

Gastrointestinal (GI) side effects are the most common adverse effects of glucagon-like peptide-1 (GLP-1) agonists because they slow gastric emptying (i.e. the movement of food through the digestive tract) and reduce appetite. The Wegovy pill is no exception. 

These side effects usually develop when first starting the medication or increasing your dose. In most cases, side effects will improve over time as your body adjusts to the medication. 

Let’s get into the details of some of the Wegovy pill side effects and ways to manage them.

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1. Nausea

Nausea was the most frequently reported side effect of the Wegovy pill in studies of the drug, occurring in 46.6% of people who took it. Research suggests queasiness is most common during the first 4-5 weeks of starting the medication, and it can sometimes linger for months. 

Fortunately, cases of nausea tend to be mild to moderate in severity and improve over time — usually by the time you reach your maintenance dosage of the Wegovy pill (25 mg). There are also strategies you can implement to manage your symptoms. 

How to manage nausea:

• Eat smaller, more frequent meals

• Stay hydrated by drinking plenty of water and clear liquids every day

• Steer clear of greasy, high-fat foods 

• Focus on the food in front of you — i.e. eat more slowly 

2. Vomiting

One of the ways the Wegovy pill works is by keeping food in your gut longer. This helps you feel fuller and lowers your appetite. But it can also lead to vomiting, especially if you’re already nauseated. 

 In fact, vomiting was the second most common side effect reported in clinical trials of the Wegovy pill, happening in 30.9% of people who took it. 

How to manage vomiting: 

• Eat bland, low-fat foods (e.g. rice, toast) and foods that contain lots of water (e.g. soup, gelatin)

• Avoid lying down after eating and instead go for a light outdoor stroll 

• Consume smaller meals more often

3. Diarrhea

In studies, about 1 in 6 people (17.6%) who took Wegovy experienced diarrhea (i.e. loose, watery stools). This may happen because the drug affects the rate at which food moves through your gut. And these changes can end up causing more frequent (or, as we’ll soon discuss, less frequent) trips to the bathroom. 

Research suggests another reason the Wegovy pill may cause diarrhea: Semaglutide (the active ingredient) can change how your intestines absorb certain nutrients, including sugars and fats. When that absorption changes, your body may not digest these nutrients as well, which can lead to diarrhea.

How to manage diarrhea:

• Stay hydrated by drinking clear liquids, such as water, diluted fruit juices, or sports drinks

• Avoid foods that worsen diarrhea, such as dairy and fried or greasy food

• Eat a bland or BRAT diet that consists of rice, toast, bananas, or apple sauce

4. Constipation

Like so many of the Wegovy pill’s side effects, constipation likely comes from how the medication affects digestion and appetite. In clinical trials, 20.1% of people taking the Wegovy pill reported constipation.

The Wegovy pill slows down how quickly food moves through your stomach and intestines, which can make bowel movements less frequent. It can also make you feel fuller sooner, so you may eat and drink less. While this can support weight loss, it can also make stool drier and harder to pass — especially if you’re not staying hydrated. 

And if nausea has you reaching for bland, low-fiber foods, there’s less bulk to keep things moving. 

How to manage constipation:

• Eat fiber-rich foods, such as beans, avocado, and oats

• Drink more water throughout the day

• Increase your physical activity to help move along your bowels

5. Abdominal pain, upset stomach, bloating

Being that the common side effects of the Wegovy pill are gastrointestinal, it’s likely no surprise to learn that the drug can also cause abdominal pain, upset stomach, and bloating. These symptoms were noted in about 18.1% of people taking the Wegovy pill in clinical trials. 

Similar to other GI side effects, these occur most often while your dose is being increased, and they tend to improve over time. 

However, severe abdominal pain that sometimes moves to your back may be a symptom of more serious problems, such as pancreatitis or gallbladder problems. If this occurs, it is a good idea to talk to your healthcare provider. 

How to manage abdominal pain, upset stomach, and bloating:

• Eat smaller, more frequent meals throughout the day instead of large meals

• Practice mindful eating by chewing food thoroughly and slowly 

• Avoid food and drinks that can upset your stomach, such as spicy foods, dairy, or carbonated beverages

6. Headache

Headache is another common side effect of the Wegovy pill, reported by 11.8% of people taking it in clinical trials. It can happen for a few reasons, including changes in eating patterns, hydration, and blood sugar.

Because the Wegovy pill can reduce appetite, some people eat less or skip meals. Irregular meals can cause blood sugar to dip, which may trigger a headache.

The Wegovy pill can also cause vomiting or diarrhea, and both can lead to dehydration. Dehydration is a common cause of headaches in general and may make them feel worse.

In some cases, the Wegovy pill may lower blood sugar levels directly. And if your blood sugar drops too low, that change can also contribute to headaches.

How to manage headaches:

• Stay hydrated by drinking plenty of water throughout the day 

• Consider over-the-counter pain (OTC) relievers, such as Tylenol (acetaminophen) or Advil (ibuprofen)

7. Fatigue

Like headaches, fatigue on the Wegovy pill may be due to the change in your eating and drinking habits during treatment. 

More specifically, decreased caloric intake (thanks to a reduced appetite), dehydration (thanks to fluid loss caused by side effects), and a drop in blood sugar (thanks to the drug’s direct effects) can all be to blame for this side effect. 

How to manage fatigue:

• Stay hydrated by drinking plenty of water throughout the day 

• Prioritize getting at least 7–9 hours of restful sleep each night

• Increase physical activity, which can help boost your energy

8. Heartburn

Another common side effect of the Wegovy pill is heartburn. Heartburn is characterized by a burning feeling in the chest or throat, and it occurs when stomach acid travels upwards toward the mouth. 

It isn’t fully understood why the Wegovy pill can cause heartburn. But it may stem from the medication’s effects on digestion, just like so many of the pill’s side effects.  

Slowed gastric emptying can help you feel fuller for longer, but it can also increase your risk of developing heartburn. Having food sit in your stomach longer means that stomach acid, which helps break down food in your stomach, is also present in your stomach for longer. This can lead to a buildup of gas and acid and, in turn, heartburn. 

How to manage heartburn:

• Limit foods and drinks that can trigger symptoms, such as spicy, fried, and acidic foods or carbonated beverages

• Avoid lying down right after eating

• Consider OTC heartburn medications like Tums or Pepcid (famotidine)

9. Gas

Gas is another possible side effect of the Wegovy pill. For example, in clinical trials, 10.3% of people taking the Wegovy pill experienced belching or burping. 

Because the medication can slow gastric emptying, food may stay in your stomach longer. That extra time can give gut bacteria more time to break down (ferment) food, which can increase gas in the digestive tract.

How to manage gas:

• Eat smaller portions

• Chew food slowly and thoroughly

• Avoid chewing gum and drinking carbonated drinks

It varies from person to person. 

Wegovy pill form side effects typically last a few days to weeks as your body adjusts to the medication. They also tend to occur when you first start treatment and as you increase your dosage. (Remember: Wegovy pill dosing, like that for the Wegovy injection and other GLP-1s, follows a titration schedule.) 

If you’re experiencing side effects that are bothersome or do not go away, talk to your healthcare provider. In rare cases, Wegovy can cause long-term side effects. 

Rare but potentially serious side effects can occur in people taking the Wegovy pill. These may include: 

• Thyroid cancer. The Wegovy pill has a boxed warning about the increased risk of thyroid cancer because of animal studies of a drug similar to Wegovy. It isn’t known if Wegovy can cause this side effect in humans. If you have a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), you should avoid taking Wegovy.

• Pancreatitis (inflammation of the pancreas). Symptoms include persistent or severe abdominal pain that sometimes moves to your back, which can also occur with nausea and vomiting. 

• Gallbladder problems. In rare cases, taking the Wegovy pill can lead to gallbladder problems, like gallstones. Symptoms include fever, nausea, vomiting, abdominal pain, jaundice (yellowing of your skin or eyes), and clay-colored stool. 

• Hypoglycemia (low blood sugar). Taking Wegovy can cause hypoglycemia, and the risk is higher if you take diabetes medications like insulin. Symptoms include dizziness, lightheadedness, shaking, sweating, confusion, weakness, and a fast heart rate.  

• Serious allergic reactions. Like other medications, Wegovy pill form side effects include severe allergic reactions. Symptoms include difficulty breathing, rash, swelling in your face, lips, or throat, and a fast heart rate. 

• Kidney problems. Taking the Wegovy pill can result in kidney problems, especially if you are dehydrated, and worsen existing kidney problems (if any). 

• Fast heart rate. Taking the Wegovy pill can sometimes increase your resting heart rate. Due to this risk, your healthcare provider may have you monitor your heart rate at home. Tell your provider if you have palpitations (feelings of a pounding heart) or feel like your heart is racing. 

If you develop any signs or symptoms of these side effects, contact your healthcare provider right away. 

Because the Wegovy pill and injection contain the same active ingredient, their side effects are similar. 

The main difference between the two medications is that the Wegovy injection can cause injection-site reactions, such as redness, itchiness, and irritation where the medication is injected. The Wegovy pill (as an oral treatment) does not cause this side effect. 

Although the Wegovy pill is generally considered a safe and effective medication, it isn’t right for everyone. You should not take the drug if you:

• Are allergic to any of the ingredients in Wegovy

• Have a personal or family history of certain thyroid cancers, such as medullary thyroid carcinoma and MEN 2

• Are pregnant, planning to get pregnant, or breastfeeding

• Have certain stomach conditions, such as severe gastroparesis

Mild to moderate side effects can occur while taking the Wegovy pill. However, bothersome, persistent, worsening, and severe side effects warrant a call to your healthcare provider. They can help determine the cause and evaluate whether it is safe for you to continue taking the Wegovy pill. 

Fortunately, you’ll likely be in constant communication with your healthcare provider while taking the Wegovy pill. (At least this is the case when you receive treatment on Ro!) 

This allows you to report or ask questions about any side effects — even mild ones. Your healthcare provider can recommend ways to manage your symptoms or even adjust your Wegovy dosage until your body adjusts. 

If you experience any of the following while taking the Wegovy pill, contact a healthcare provider: 

• Develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath

• Have trouble passing gas or ongoing constipation

• Experience severe or persistent abdominal pain that sometimes radiates to your back

• Have signs or symptoms of an allergic reaction, such as trouble breathing, swelling of your face, lips, throat, or tongue, or hives

• Become pregnant

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The FDA approved Wegovy in pill form in December 2025. While it is an effective and safe option for weight loss, it can cause side effects. Here are a few key points to keep in mind about Wegovy pill form side effects:

• The most common side effects of the Wegovy pill are digestive in nature, including nausea, diarrhea, vomiting, constipation, and abdominal pain. These side effects are typically mild to moderate in severity and improve over time. 

• Rare but serious side effects can occur while taking the Wegovy pill. These may include pancreatitis, gallbladder problems, hypoglycemia, and kidney problems, among others.

• The main difference between the side effects of the Wegovy pill and injection is that the injection can cause reactions at the injection site. 

• If you develop side effects that are bothersome, persistent, worsening, or severe, contact your healthcare provider. Examples include intense abdominal pain, trouble breathing, hives, or a lump in your neck.