Introduction
If there’s one word that you could use as an instant conversation starter, it would have to be Ozempic. Still, Ozempic is the same as any other drug, and comes with potential side effects. If you’re about to take it, you may wonder, ‘Does semaglutide cause nausea?’
In this article, we dive into semaglutide’s side effects, if nausea is one of them, why it happens, and what you can do to keep it at bay.
Semaglutide: An overview
You may know Ozempic, but did you realize it shares its active ingredient, semaglutide, with Wegovy and Rybelsus? Ozempic and Rybelsus treat type 2 diabetes, while Wegovy targets obesity. Despite their differences, they all share potential side effects like fatigue and nausea.
Because they’re all semaglutide, they all carry the same therapeutic benefits and side effects, which could include fatigue and tiredness. This is also why many healthcare providers choose to prescribe Ozempic and Rybelsus off-label for weight loss.
What is semaglutide?
Knowing what semaglutide is and how it works is essential before diving into its potential side effects. What is semaglutide and how is it able to regulate blood sugar levels and help you lose weight?
It’s in the drug classification semaglutide falls under. Semaglutide is a glucagon-like peptide-1 receptor agonist, or GLP-1 Ra, for short.
When you eat, GLP-1 triggers insulin release to manage blood sugar levels. Semaglutide mimics this process and slows digestion, making you feel full longer and reducing appetite. At the same time, it also signals to your brain that you’re full.
As a result, people on semaglutide have suppressed appetites and don’t eat as much because they have fewer cravings. This is what leads them to lose weight.
Oral and subcutaneous semaglutide
Semaglutide comes in two forms: oral (Rybelsus) and subcutaneous injections (Ozempic and Wegovy). Typically, your healthcare provider will start with a low dose, increasing it gradually to minimize side effects.
- Ozempic/Wegovy: Inject it weekly, either in the upper arm, thigh, or abdomen.
- Rybelsus: Take daily on an empty stomach.
Eligibility
Knowing all of this, are you a candidate for semaglutide? Although it has FDA approval for its safety, not everyone can just take semaglutide. They first need to meet certain diagnostic criteria.
With Ozempic and Rybelsus, you need to have type 2 diabetes. Sometimes, doctors may prescribe these for those with heart disease, as they have the additional approval for lowering the risk of cardiovascular problems. They may also prescribe these for those dealing with insulin resistance.
With Wegovy, on the other hand, you need to have a body mass index (BMI) of 27 or greater and have one weight-related health condition (ex: high blood pressure) or a BMI of 30 or greater.
Dosage and administration
To keep semaglutide working at its optimum, you need to observe its proper dosages, administration, and storage.
Because your body still needs to adjust to semaglutide, your healthcare provider will typically start you off on a low dose, gradually increasing this until you reach a maintenance dose.
Ozempic and Wegovy are injected once weekly with or without meals in either the upper arm, the thigh, or the abdomen. Rybelsus, on the other hand, is taken once daily on an empty stomach.
Safety and efficacy of semaglutide
You’ll be glad to know that Ozempic, Wegovy, and Rybelsus are all FDA-approved, after having gone through extensive clinical studies. The following are highlights from the research that proves semaglutide’s safety, efficacy, and tolerability.
In the STEP 5 trial, researchers looked at the two-year effects of semaglutide in adults who were overweight or with obesity. Participants lost an average of 15 percent of their body weight with semaglutide. Meanwhile, those in the placebo group lost approximately 2.6 percent of their body weight.
Participants who took semaglutide also lost 14.4 centimeters or 5.7 inches off their waistline. In addition, they also saw improvements in their systolic blood pressure by 5.7 mmHg. Participants in the semaglutide group also experienced better diastolic blood pressure, blood sugar levels, total cholesterol, and triglycerides.
A study conducted in December 2022, meanwhile, found that participants on semaglutide lost more body fat than body mass. Additionally, they consumed less food due to a decrease in appetite and had fewer food cravings, especially for greasy foods.
Does semaglutide cause nausea?
The short answer is yes, one of semaglutide’s side effects is nausea.
It’s among the drug’s top three most common side effects: nausea, vomiting, and diarrhea. The good news is that these typically subside after a few weeks of use.
Among the three symptoms, nausea is semaglutide’s most common side effect, with 20% of participants reporting it during clinical trials. With Ozempic, in particular, the onset of nausea generally presents itself on the 8th to 12th week of semaglutide use. Around one in every five people taking Ozempic go through nausea.
Patients are more likely to experience nausea and vomiting as they take higher doses of semaglutide. As mentioned, your doctor will first prescribe you low doses, gradually increasing this as your body gets used to the drug.
Possible reasons for nausea
It’s not clear why semaglutide causes nausea, although it may have something to do with the drug’s effect on the gut.
Semaglutide delays stomach emptying, which can create pressure and discomfort. The drug signals your brain to feel full, potentially causing nausea. However, more research is needed to understand the exact cause.
Duration of nausea
You should expect nausea from semaglutide to last for a few weeks. As mentioned, it usually goes away on its own as the body adjusts to the drug.
However, note that it can resurface every time you increase your dosage of semaglutide.
Dealing with nausea
Fortunately, there are ways to manage your nausea while taking semaglutide. It’s a combination of adjusting your dosage and eating certain foods.
As a general rule, it helps to eat smaller meals and refrain from lying down after eating to help prevent nausea and vomiting. You should also steer clear of oily or sugary foods. The following is detailed guidance on what you can do to manage nausea.
1. Go on the lowest dose first.
Studies show that patients with higher doses of Ozempic tend to experience nausea more. It helps to stay on a low dose first.
Although it’s commonly prescribed to go up to a higher dose, it’s not always the case. If your blood sugar levels are responding well to a low dose, it may be possible to stay on it. Consult your healthcare provider.
2. Slow down as you go up to a higher dose.
Once you increase your dose of semaglutide, do it slowly. This will minimize any unpleasant side effects such as nausea.
3. Limit or eliminate your intake of certain foods.
As mentioned, greasy, deep-fried, oily, or sugary foods are known triggers for upset stomachs and can worsen semaglutide’s side effects. These include:
- High-fat foods (fatty cuts of meat, whole milk, heavy cream, full-fat cheese, butter, and ice cream)
- High-sugar foods (candy, cakes, pastries)
- Sugar-sweetened drinks (juices, soft drinks)
- Highly processed foods (chips, packaged soups, hotdogs, canned foods, etc.)
- Refined carbohydrates (white pasta, white rice, pizza, etc.)
- Salty or spicy foods
- Alcohol
Alternatively, go for more low-fat, bland foods that contain a lot of water such as crackers, toast, and English muffins. Other bland foods are brown rice, soups, baked fish, baked chicken, carrots, popsicles, and gelatin. Ginger, apples, and mint are also known foods that can help relieve nausea.
4. Change the way you eat.
Eat with smaller portions of food, chewing food slowly and savoring each bite. Be mindful of when you feel full and end your meal.
Stay upright and do not lie down right after eating. Try not to eat anything too right before going to bed.
5. Stay hydrated.
Drink a lot of ice-cold, clear drinks such as water and fresh fruit juices, but drink in sips so you don’t tend to feel full. Drink straight from a glass instead of using a straw. It also helps to get some fresh air after eating.
Conclusion
Nausea, along with vomiting and diarrhea are among semaglutide’s most common side effects. However, these are generally mild and manageable and subside after a few weeks of use. It is not clear why nausea is a side effect of semaglutide, although it may be connected to how the drug keeps you feeling fuller for longer.
Factors such as a higher dosage of semaglutide, poor eating habits, and diet play a role in the onset and worsening of nausea.
Go for more low-fat and bland foods such as crackers, toast, baked chicken, and baked fish to prevent nausea.
Should symptoms worsen, consult your healthcare provider.
Glossary of terms:
- GLP-1: Glucagon-like peptide-1 is a gut-based hormone involved in the secretion of insulin to lower blood sugar levels typically elevated after meals.
- GLP-1 Ra: Glucagon-like peptide-1 receptor agonist. It mimics the actions of GLP-1.
