Please refer to a reputable source for drug contraindications and any prescribing updates.
SIDE EFFECTS
By for the most common side effects of semaglutide are GI related. Many people will experience dyspepsia, post-prandial fullness, and ‘burping’. Many people will also experience nausea especially after the initial injection at a new dose.
For most people, the GI side effects are manageable. For people who have more debilitating side effects, there are options to help alleviate symptoms.
- Nausea: Ondansetron (Zofran) frequently alleviates nausea, especially for people who get symptoms for a few days post injection.
- Constipation: Can be managed by increasing fluid intake as well as soluble and insoluble fiber
- Diarrhea: Can be managed with dietary changes or OTC antidiarrheal products.
Other side effects that patients might experience are variable and should be evaluated to insure that symptoms are indeed related to the medication.
A significant benefit of semaglutide is that the side effects, particularly the GI side effects almost invariably resolve over time. Clinicians should work with patients closely, reducing dose when necessary, and reintroducing higher doses very gradually (2-5 units/week) as the vast majority of patients will be able to find a dose that is both effective and with minimal side effects.
However, there are some patients who simply do not tolerate semaglutide. Rarely, patients will have severe side effects, such as intractable vomiting necessitating discontinuation of the medication.
TUNE UPS
Clinicians should counsel patients that it is reasonable and expected that once patients have completed the program and treatment, they may benefit from future short courses of semaglutide treatment. Life’s events can disrupt behaviors and lead to a resumption of old habits. It can take many months or years to develop the consistency and resilience required to maintain healthy behaviors for the long term.
We counsel our patients to reach out if they are struggling with eating or other lifestyle behaviors. It is psychologically damaging to regain lost weight and have metabolic conditions return. A short course of treatment (up to a few weeks to months) can help patients regroup and reset without going through the trauma of regaining their lost weight.
