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Very common (10% of patients) Nausea peaks during titration, typically subsides within 48 weeks at a stable dose Vomiting, diarrhoea, constipation Abdominal pain or discomfort Reduced appetite (this is the therapeutic effect, not an adverse effect) Less common but serious stop and see a doctor Severe, persistent abdominal pain radiating to the back possible pancreatitis Right upper abdomen pain, fever, yellowing possible gallstones / gallbladder disease Persistent neck lump, hoarseness, difficulty swallowing evaluate thyroid Rapid heartbeat, severe dehydration from vomiting Hypoglycaemia when semaglutide is combined with insulin or sulfonylureas What the Indian data shows: a 2025 study of Indian patients found GI side effects are the leading cause of discontinuation, peaking during dose escalation

These results, using either pharmacology or mouse genetics, show that reduction in CNS GIPR signalling can positively impact peripheral tissue metabolism

Methods We administered glucose, mixed meal or water orally to 256 mice, and took blood samples before and 2, 6, 10, 20, 30, 60 or 90 min after stimulation

However, these drugs can also slow down stomach emptying and alter gut motility

(2018) 20(Suppl 1):521