Wegovy Side Effects: What Are They?

Should I take this drug called Wegovy? (NICE, 2023) Is Wegovy safe? What will the side effects of Wegovy be? Will Wegovy work? Will Wegovy cause thyroid cancer?
 
All these questions and rightly so. You are considering injecting a drug into your body over a sustained period of time.
 

Medical Mojo will guide you through what to expect when taking Wegovy and the side effects that you may experience (FDA, 2023). To make it easier we have split the side effects into:

Very common side effects(affecting more than 1 in 10 people):

Nausea and Wegovy:

Feeling sick is common, especially at the start of treatment or after dose increases

Vomiting and Wegovy:

Some individuals may experience episodes of vomiting (actually being sick)

Fatigue and Wegovy:

A general feeling of tiredness or weakness may be present and can be a sign of dehydration, or can result from a large reduction in calories

Abdominal pain or discomfort around your abdomen with Wegovy:

Stomach cramping or general discomfort can occur with a feeling of fullness and or bloating

Decreased appetite with Wegovy:

While a reduction in appetite is expected, some people may experience this more than others

Change in bowel habit with Wegovy:

This can be either diarrhoea (loose or frequent stools) or constipation (difficulty in bowel movements)

Headache with Wegovy:

Headaches are frequently noted which can be a sign of dehydration, or can result from a large reduction in calories

Common side effects (affecting 1 to 10 in 100 people):

Indigestion and bloating with Wegovy:

Digestive discomfort and a feeling of fullness are reported

Belching and gas with Wegovy:

Increased burping and flatulence (polite word for farting!) may occur

Dizziness with Wegovy:

Some individuals may experience light-headedness

Hair Loss with Wegovy:

Thinning or loss of hair has been observed. If you are experiencing hair loss have a look at our compounded hair loss treatments.

Injection site reactions with Wegovy:

Redness, swelling, or itching at the injection site can happen

Low blood sugar (hypoglycemia) with Wegovy:

Especially in individuals with type 2 diabetes, low blood sugar levels can occur

Reflux or heartburn with Wegovy:

A burning sensation in the chest is possible. Be careful as symptoms of heart burn and chest pain can feel very similar. Seek medical advice if you are not sure if your symptoms are due to heart burn or chest pain due to your heart

Uncommon side effects(affecting 1 to 10 in 1,000 people):

Increased heart rate with Wegovy:

A faster heartbeat has been noted

Elevated pancreatic enzymes with Wegovy:

Higher levels detected in blood tests

Gastroparesis with Wegovy:

Which simply means a delay in stomach emptying due to stomach paralysis which can lead to nausea and vomiting.

Rare but serious side effects (affecting less than 1 in 1,000 people):

Note: even though these symptoms are rare they require immediate medical attention (BNF, 2023).

Pancreatitis with Wegovy:

Severe and sudden stomach pain, which may radiate to the back, along with nausea and vomiting, could indicate pancreatitis, a serious inflammation of the pancreas which is an organ that sits next to the liver in the upper abdomen. Urgent medical treatment is needed.

Gallbladder problems with Wegovy:

Symptoms like pain in the upper right side of the stomach, fever, a yellow discolouration of the skin and/or eyes (known as jaundice), or clay-coloured stools could indicate gallbladder issues. Gall bladder problems include gallstones. Seek medical attention.

Kidney problems with Wegovy:

If there is excessive nausea, vomiting, or diarrhoea this can lead to dehydration (whereby you lose more water than you are taking into the body) which can then lead to kidney issues, especially in people with pre-existing kidney conditions. Signs of dehydration includes thirst and reduced urine output (you basically pee a lot less). Seek medical attention.

Severe allergic reactions with Wegovy:

Rash, itching, difficulty breathing, or swelling of the face, lips, or tongue could indicate a severe allergic reaction and requires immediate medical attention. Yes-immediate so if you feel your throat tightening or experience difficulty in breathing call 999.

Diabetic eye disease complications with Wegovy:

In people with diabetes, Wegovy may worsen diabetic retinopathy, a condition that affects vision.

Long terms side effects:

Current data on long-term side effects of Wegovy is limited. Clinical trials, such as STEP 5, have not identified any new risks over a two-year period (FDA, 2021).

However, potential serious side effects include pancreatitis, severe allergic reactions, and complications with diabetic eye disease in individuals with diabetes as discussed above.

Cancer risk:

Animal studies have shown an increased incidence of certain thyroid tumours with semaglutide, which is the active ingredient in Wegovy. However, this effect has not been observed in humans. Even though this hasn’t been confirmed in humans, just be vigilant. Any signs of thyroid lumps (lumps in the neck), hoarseness, or difficulty in swallowing or breathing you need to see a doctor urgently.

Other potential consequences if using Wegovy long term:

If you’re using Wegovy for a longer time, you should also be aware of the small risk of developing nutrient deficiencies. As you’re consuming less foods and calories than before, this can lead to malnutrition over a longer period. You can also reduce this risk by following a balanced diet, full of fruits and vegetables, some protein, and some healthy fats.

Consulting with a healthcare provider or dietitian about the need for supplements can be beneficial.

Wegovy is a Black Triangle Drug:

Wegovy is a black triangle drug, which means that it is under additional monitoring. You are encouraged to report any side effects to your healthcare provider or directly to the Yellow Card reporting system.

You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

Helpful tips to manage common side effects:

Nausea:

• Eat smaller, more frequent meals, avoid skipping meals.
• Try cool and bland foods like crackers, toast, or pretzels.
• Avoid high-fat, rich meals like fried foods or foods with strong odours.
• Eat more slowly.
• Drink water or ginger herbal tea regularly throughout the day between meals.
• Don’t lie down after a meal.
• Get some fresh air.

Constipation, diarrhoea, or stomach pain:

• Drink plenty of fluids, mostly water.
• Follow a well-balanced meal and eat regular, small meals.
• When adding fibre to your diet, do so gradually over a few weeks.
• Exercise daily. Exercise helps reduce constipation.

Heartburn or gassiness

• Avoid foods and beverages that may worsen reflux, including acidic foods and spicy foods, fried foods, beverages and foods containing caffeine, chocolate, alcohol, peppermint, or spearmint.
• Avoid high-fat meals and foods like fried foods.
• Eat smaller meals.
• Eat more slowly.
• Don’t lie down after a meal.

Headaches or fatigue

• Drink plenty of fluids, mainly water.
• Follow a well-balanced meal plan and eat regular, small meals.
• Exercise daily.
• Get enough sleep each night, generally seven to eight hours.

Contraindications: Who Should Avoid Wegovy?

Do not take Wegovy (BNF, 2023) if:

• You are pregnant or breastfeeding
• Have a known allergy to semaglutide or any other ingredient in Wegovy
• Have a BMI below 30 (or below 27 without other weight-related health issues)
• You have a personal or Family History of Medullary Thyroid Carcinoma (MTC)
• You have Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2)
• You suffer from severe gastrointestinal disease as Wegovy may worsen conditions like gastroparesis (delayed stomach emptying) or inflammatory bowel disease (IBD). People with these conditions should consult a healthcare provider before considering Wegovy.
• You suffer from diabetic retinopathy (for patients with diabetes): Semaglutide (which is in Wegovy) has been associated with an increased risk of diabetic retinopathy complications, so it should be used with caution in people with pre-existing retinopathy.

Onset and duration of side effects with Wegovy:

Side effects may begin after the first dose or upon increasing the dosage Novo Nordisk Limited (2024). They are typically temporary, with nausea lasting an average of 8 days, vomiting 2 days, headache and fatigue generally subsides within the first few days to a couple of weeks, abdominal pian usually resolves after a few days and constipation can last up to 47 days. If side effects persist or are severe, consult your healthcare provider.

Consult with your healthcare provider to determine the most appropriate treatment for your weight loss journey.

So when does a side effect of Wegovy become a side effect that you need to worry about?

Side effects of Wegovey and when to worry?

Severe Nausea, Vomiting, or Diarrhoea

When to Worry: If nausea, vomiting, or diarrhoea is severe, frequent, or doesn’t improve over several days, especially if it leads to dehydration.

Why: Severe gastrointestinal symptoms can lead to dehydration, electrolyte imbalances, and kidney issues, particularly if they persist. Staying hydrated is essential, and you may need medical help to manage these symptoms.

Severe or Persistent Abdominal Pain

When to Worry: If you experience severe, sharp, or long-lasting pain in the upper abdomen, especially if it radiates to the back.

Why: This could be a sign of pancreatitis (inflammation of the pancreas), a rare but serious side effect. Pancreatitis can worsen quickly and requires prompt medical attention.

Severe Allergic Reaction

When to Worry: If you experience symptoms like swelling of the face, lips, tongue, or throat, difficulty breathing, rash, or itching.

Why: These are signs of a severe allergic reaction (anaphylaxis), which is a medical emergency. Immediate treatment is needed to prevent potentially life-threatening complications.

Vision Changes

When to Worry: If you notice sudden changes in vision, blurred vision, or floaters, especially if you have diabetes.

Why: Wegovy can increase the risk of diabetic retinopathy complications in patients with type 2 diabetes. Vision changes should be evaluated to prevent further eye damage.

Rapid Heart Rate

When to Worry: If you notice a consistently fast or irregular heartbeat.

Why: While an increased heart rate can be a side effect, persistent or rapid heartbeats may need further evaluation, especially if you feel dizzy, lightheaded, or have chest discomfort.

Severe Constipation

When to Worry: If constipation is severe, lasts longer than a few weeks, or is accompanied by pain, bloating, or nausea.

Why: Severe constipation could lead to bowel obstruction or other complications. Your doctor may adjust your dose or suggest treatments to relieve it.

Signs of Gallstones

When to Worry: If you experience intense pain in the upper right abdomen, fever, yellowing of the skin or eyes (jaundice), or clay-coloured stools.

Why: These symptoms may indicate gallstones or other gallbladder issues, which can be a side effect of rapid weight loss or semaglutide. Gallbladder problems may require further evaluation or treatment.

General rule about Wegovy side effects

If any side effect feels severe, doesn’t improve, or interferes significantly with daily life, seek medical advice. Your healthcare provider can assess whether an adjustment in your dose or additional treatment is needed.

Alternative Weight Loss Medications:

MedicalMojo offers a range of other prescription weight loss treatments if Wegovy is not tolerated:

• Mounjaro: A once-weekly injectable, similar to Wegovy, working on two gut hormones.
• Saxenda: A daily injectable (containing liraglutide, a GLP-1 agonist).
• Orlistat: A capsule that prevents fat absorption (branded as Xenical or Alli).
• Mysimba: An oral tablet that curbs appetite and cravings.

With Medical Mojo, patients can easily complete a secure online questionnaire. Our providers will review each case to ensure safety and suitability before issuing a prescription, available by delivery or for pick-up at selected pharmacies.

Note: This information is for educational purposes only and should not substitute for professional medical advice.

References:

BNF National Institute for Health and Care Excellence (NICE) (2023) ‘Semaglutide: Contra-indications’, British National Formulary. Available at: https://bnf.nice.org.uk/drugs/semaglutide/#contra-indications (Accessed: 3 November 2024).

FDA Wegovy Prescribing Information: U.S. Food and Drug Administration (FDA) (2023) ‘Wegovy (semaglutide) injection, for subcutaneous use: Prescribing Information’, FDA. Available at: https://www.fda.gov/drugs/drug-approvals-and-databases/wegovy (Accessed: 3 November 2024).

National Institute for Health and Care Excellence (NICE) (2023) ‘Semaglutide for managing overweight and obesity’. Available at: https://www.nice.org.uk/guidance/ta875 (Accessed: 3 November 2024).

Novo Nordisk Limited (2024) ‘Wegovy 1 mg, FlexTouch solution for injection in pre-filled pen: Summary of Product Characteristics’. Available at: https://www.medicines.org.uk/emc/product/13801/smpc (Accessed: 3 November 2024).

Pharmacy Times (2021) ‘FDA approves prescription weight loss therapy for adults with obesity’. Available at: https://www.pharmacytimes.com/view/fda-approves-prescription-weight-loss-therapy-for-adults-with-obesity (Accessed: 3 November 2024).