Wegovy side effects, from the pen to the pill

The most common Wegovy side effects

From Wegovy's US prescribing information: three placebo-controlled weight-management trials (STEP 1, 2 and 3) in adults, with 2,116 people on Wegovy 2.4 mg for up to 68 weeks. Every reaction here was reported more often than on placebo.¹

Source: Wegovy prescribing information, Table 3.¹ The full table also lists gastroenteritis, gastritis, low blood sugar in type 2 diabetes and altered skin sensation. Any stomach or bowel side effect: 73% on Wegovy, 47% on placebo.¹ Rates from different trials can't be directly compared.

Wegovy pill side effects

The Wegovy pill is semaglutide taken as a once-daily tablet. In the US it is approved for weight management in adults, and to lower the risk of heart attack, stroke and cardiovascular death in adults with established cardiovascular disease and obesity or overweight.¹ It's taken on an empty stomach in the morning with up to 4 ounces of plain water, waiting at least 30 minutes before eating, drinking or taking other oral medicines.¹

The label doesn't give the pill a side-effect table of its own. It says the types and frequency of common side effects in the pill's 64-week trial, OASIS 4, were similar to the injection's, and adds a few pill-specific figures: severe stomach side effects in 2% on the pill against none on placebo, gallstones in 2.5% against 1%, and altered skin sensation in 5% against none.¹ In the published trial, 74.0% on the pill had a stomach or bowel side effect, against 42.2% on placebo.³

In the UK, the Wegovy tablet was approved in June 2026, and at the time the regulator said it wasn't available on the NHS.⁹ The pill isn't in Handle's medicine list by name yet: add it under "Something else" with its name, amount and daily schedule, and doses, the check-in, weight, food and the report work the same. Compare the two forms in Wegovy pill vs injection.

What people reported in the Wegovy pill trial

OASIS 4 enrolled adults with obesity or overweight and without diabetes. These are the stomach and bowel events, headache and fatigue among the events reported by at least 5% of a group, as posted on ClinicalTrials.gov.²

Source: OASIS 4 results on ClinicalTrials.gov, non-serious adverse events from week 0 to week 71.² These are registry counts, not label figures, so they can't be lined up directly against the injection table. In the label, 6.9% on the pill and 5.9% on placebo stopped because of adverse reactions (section 6.1), most often stomach side effects: 3.4% against 2%.¹

Wegovy HD (7.2 mg): side effects at the higher dose

Wegovy's label now includes a 7.2 mg weekly dose for adults, sold as Wegovy HD. In two 72-week trials, STEP UP and STEP UP T2D, these side effects were reported by at least 2% on 7.2 mg and more often than on both 2.4 mg and placebo.¹

Source: Wegovy prescribing information, Table 4 and section 6.1 (303 people on placebo, 304 on 2.4 mg, 1,311 on 7.2 mg).¹ Dysesthesia means altered skin sensation, such as burning or skin pain; 18% of the people who had it on 7.2 mg did not report recovering during the trial. Hair loss on 7.2 mg was reported by 8.4% of women and 0.2% of men.¹

When Wegovy side effects start and ease

The label describes a pattern rather than a timetable, and your own weeks may differ.

1. Starting out
   The dose starts low

   Wegovy's label starts with a low dose and steps up gradually, a schedule meant to reduce the risk of stomach side effects. Your prescriber sets the steps.¹

2. While the dose is stepped up
   Most reports come now

   Stomach and bowel reactions "were most frequently reported during dosage escalation," the label says.¹

3. The months after
   They usually settle

   In STEP 1, one of the 68-week trials behind Wegovy's approval, nausea and diarrhea were "typically transient and mild-to-moderate in severity and subsided with time."⁴

4. If they don't settle
   Talk to your prescriber

   In the 2.4 mg trials, 6.8% stopped Wegovy because of side effects, against 3.2% on placebo, most often because of nausea (1.8%), vomiting (1.2%) or diarrhea (0.7%).¹ If side effects are hard to live with, tell your prescriber; decisions about your dose are theirs to make with you.

Common side effects, and what can help

General, non-drug measures that apply to the injection and the pill alike. They don't replace your care team's advice, and none of them involves changing your medicine.

• Nausea (44% against 16%).¹ Try smaller meals eaten slowly, and go easy on fried or greasy food.¹¹ Our guide to what to eat on Wegovy and Ozempic sets out what Novo Nordisk suggests. Call your care team if it stops you eating or drinking.
• Vomiting (24% against 6%). Take regular sips of fluid.¹¹ The Medication Guide says drinking fluids helps reduce your chance of dehydration, which the label links to kidney injury.¹ Call your care team if you can't keep fluids down.
• Diarrhea (30% against 16%). Keep drinking through the day to replace what you lose, and call your care team if it's severe or doesn't settle.¹
• Constipation (24% against 11%). Fluids and fiber-containing foods such as fruit, vegetables and whole grains can help;¹² ask your care team what suits you. Severe constipation and bowel blockage have been reported since approval, so call them if it's severe or comes with stomach pain.¹
• Bloating, indigestion and burping. Ask your care team whether smaller, plainer meals might help. Stomach pain that is severe or won't go away needs urgent attention; see the warning signs below.

Check with your prescriber or pharmacist before taking any other medicine for side effects.

Less talked-about Wegovy side effects

Figures are for the 2.4 mg injection unless stated, with placebo in brackets.

• Hair loss. 3.3% (1%): 4% of women and 0.9% of men. The label says hair loss was associated with weight reduction, and it was reported more often on 7.2 mg (5.8%).¹ No label describes it as sudden or permanent.
• Tiredness and headache. Fatigue was reported by 11% (5%) and headache by 14% (10%).¹
• Dizziness, low blood pressure and fainting. Dizziness: 8% (4%). Low-blood-pressure events: 1.3% (0.4%), and fainting: 0.8% (0.2%). The label says some were related to stomach side effects and fluid loss.¹
• Burping. Belching (eructation) was reported by 7%, against under 1% on placebo.¹ "Sulfur burps" isn't a label term, and the label says nothing about smell.
• Taste changes. A change in taste (dysgeusia) was reported by 1.7% (0.5%).¹
• Skin sensitivity. Altered skin sensation (dysesthesia), such as burning or skin pain: 2% (1%) on 2.4 mg, 22% on 7.2 mg, and 5% on the pill against none on placebo.¹
• A faster heart rate. Heart rate rose by an average of 1 to 4 beats per minute. At some visit, 26% on Wegovy had a rise of 20 or more, against 16% on placebo.¹
• Injection-site reactions. 1.4% (1%), and the label asks you to rotate injection sites with each dose.¹ See Ozempic and Wegovy injection sites.

Serious Wegovy side effects

Uncommon, but listed as warnings on the label. Figures are from the adult trials: on Wegovy, then on placebo.

• Pancreatitis. Acute pancreatitis, including fatal cases: persistent or severe stomach pain, sometimes spreading to the back, with or without vomiting. Confirmed cases were uncommon: 0.2 per 100 patient-years on Wegovy, against under 0.1 on placebo.¹
• Gallbladder disease. Gallstones in 1.6% (0.7%) on the injection and 2.5% (1%) on the pill, and gallbladder inflammation in 0.6% (0.2%). The label says the difference held even after accounting for how much weight people lost.¹
• Kidney injury from dehydration. 0.4 cases per 100 patient-years on Wegovy, against 0.2 on placebo. Most reported cases followed nausea, vomiting or diarrhea that led to dehydration.¹
• Low blood sugar. In people with type 2 diabetes (STEP 2), 6.2% had a reading below 54 mg/dL, against 2.5% on placebo. The risk is higher with insulin or a sulfonylurea, and your prescriber may adjust those medicines.¹
• Serious allergic reactions. Anaphylaxis and angioedema have been reported. A previous serious reaction to semaglutide or any ingredient means Wegovy isn't for you.¹
• Severe stomach and bowel problems. Reported by 4.1% (0.9%) on the injection and 2% (none) on the pill, and bowel blockage and severe constipation have been reported since approval. Not recommended with severe gastroparesis.¹
• Eye complications in type 2 diabetes. Diabetic retinopathy was reported by 4% on Wegovy against 2.7% on placebo in STEP 2, a trial in adults with type 2 diabetes.¹
• Aspiration during anesthesia. Rare reports of stomach contents entering the lungs during general anesthesia or deep sedation. Tell your healthcare providers you take Wegovy before any planned surgery or procedure.¹ Guidance on what happens next differs between countries; in the UK, the regulator advises patients not to stop treatment without first discussing it with their doctor.⁸
• NAION. EU and UK regulators list this optic nerve condition, which can cause sudden loss of vision, as a very rare side effect of semaglutide, affecting up to 1 in 10,000 people. It isn't in the US label.^6,7
• Thyroid C-cell tumors (boxed warning). Seen in rodents; it's unknown whether semaglutide causes them in humans. Tell your care team about a lump in your neck, trouble swallowing, shortness of breath or hoarseness that won't go away.¹

Mood: a warning removed in 2026

Until February 2026, Wegovy's label included a warning about suicidal thoughts and behavior.¹ The FDA asked for it to be removed after an analysis of 91 placebo-controlled trials with 107,910 patients found no increased risk of suicidal thoughts or behavior, or of related problems such as anxiety or depression.¹⁰

The FDA still asks people to tell their health care professional about new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior.¹⁰

Long-term Wegovy side effects, and stopping

The longest data in the label come from SELECT, which followed adults with cardiovascular disease, on Wegovy or placebo, for a median of 41.8 months: 16% stopped the study medicine because of an adverse event, against 8% on placebo.¹ In that trial, more hip and pelvis fractures were reported on Wegovy in women (1% against 0.2%) and in people aged 75 and over (2.4% against 0.6%), and kidney stones in 1.2% against 0.8%.¹

After stopping, weight tended to come back. In STEP 4, people switched from Wegovy to placebo after 20 weeks regained 6.9% of their body weight over the next 48 weeks, while those who continued lost another 7.9%.¹ In the STEP 1 extension, people regained about two-thirds of the weight they had lost within a year of stopping; the trial's lifestyle program ended at the same time.⁵

Regain after stopping was the average experience in these trials, so it isn't a personal failure. It's a signal worth discussing with your prescriber, who can help you plan any change.

Who should not take Wegovy

• Anyone with a personal or family history of medullary thyroid carcinoma (MTC), or with multiple endocrine neoplasia syndrome type 2 (MEN 2). This is the boxed warning.¹
• Anyone who has had a serious allergic reaction to semaglutide or any ingredient in the injection or tablet.¹
• People already taking another semaglutide medicine or any other GLP-1 medicine: the label says combining them isn't recommended.¹
• People with severe gastroparesis, for whom it isn't recommended.¹
• Children and teenagers: the injection is approved for weight management from age 12, but not at the 7.2 mg dose, and the pill isn't approved for anyone under 18.¹
• If you're planning a pregnancy, talk to your prescriber early: the label advises stopping Wegovy at least 2 months beforehand. Breastfeeding isn't recommended while taking the pill.¹ Our Wegovy half-life guide explains how long semaglutide stays in the body.
• Never share a Wegovy FlexTouch pen with anyone else.¹

Tracking Wegovy side effects for your prescriber

Side effects are easiest to talk about when you can show them. A short daily record makes the pattern visible: which weeks, how often, how bad, and what else was going on.

Handle keeps your Wegovy doses (with injection sites, if you use the pen), your daily check-in, weight and food on one timeline. It shows them side by side and doesn't claim that one explains another. See our GLP-1 side effect tracker guide, set up your plan with the Wegovy tracker, or read about GLP-1 side effects across the class.

Questions to ask your prescriber about Wegovy

Useful at the start and after any change. If you're weighing options together, Zepbound vs Wegovy, Mounjaro vs Wegovy, Ozempic vs Wegovy and Foundayo vs Wegovy set out the facts side by side.

1. Which side effects should I call you about, and which can I manage at home?
2. What should I do if I can't keep fluids down?
3. Would the injection or the pill fit better with my routine and my other medicines?
4. Do any of my other medicines, such as insulin or a sulfonylurea, need a closer look?
5. I have a procedure coming up. Who should I tell, and what applies to me?