Diabetes Treatment, Diabetic medications and Diabetic drugs, Living with Diabetes

Ozempic Review & Side Effects

Ozempic (semaglutide) Review. What are the Ozempic (semaglutide) side effects? Ozempic Review Pros: Strong A1c reduction Significant weight loss Heart .

Ozempic (semaglutide) Review. What are the Ozempic (semaglutide) side effects?

Ozempic Review

  • Strong A1c reduction
  • Significant weight loss
  • Heart benefits( reduced heart attacks)
  • Convenient: Taken once a week.
  • Gastrointestinal side effects such as nausea and diarrhea
  • Expensive
  • Injectable
  • Potential( not proven) increased risk of rare cancers
  • Potential increased risk of diabetic eye disease


Today we will review Ozempic (semaglutide) from A to Z. We will talk about patient experience and scientific data. It is a great drug for diabetes type 2 to reduce your A1c. Ozempic also has many beneficial side effects such as weight loss and cardiovascular risk reduction. Most of the time patients are either confused or misled about potential Ozempic (semaglutide) side effects (semaglutide). So, today we are going to discuss and do an Ozempic review in addition to how to take Ozempic (semaglutide) and the most common side effects that you need to be aware of.

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Ozempic typically used in addition to metformin or if you cannot tolerate metformin.

You can inject Ozempic (semaglutide) into the abdomen, thigh, or upper arm at any time of day on the same day each week once a week, with or without food.

Ozempic and weight loss

What to do if you forget to take your medication?

Review your Ozempic schedule. If you forget to take your medication you can catch up with that however you will need to take the missed dose within the next 5 days.  That has to be at least 48 hours duration between the 2 doses.  It is not a bad idea to rotate injection sites weekly if injecting in the same area of the body.  This will prevent bruises and reactions to the medication due to repeated exposure.  You should never mix ozempic (semaglutide) with other diabetes products.  That doesn’t mean that you can’t take Ozempic (semaglutide) with other medications however it has to be taken separately.  Pay attention to the solution within the Ozempic (semaglutide) pen. It should be clear. So, do not use if particulate matter and cloudy color are seen.

Does Ozempic need to be refrigerated?

One of the positive reviews aboutOzempic (semaglutide) is  that it can stay in the room temperature up to 56 days.  The pens that you are not currently using should stay in the refrigerator.

Contamination may occur if pens are shared among multiple patients.  Make sure you never use or share your pen with another patient.

Adverse Reactions for Ozempic (semaglutide); Side Effects/Ozempic Review:

Commonly seen Ozempic (semaglutide) side effects are:

Gastrointestinal-Ozempic (semaglutide) side effects: Up to 40% of people can complain about gastrointestinal side effects such as nausea, vomiting, diarrhea or constipation.  Lipase levels can also go up however in the absence of symptoms that are not an indication of pancreatitis. We will talk about how to avoid the side effects block and the following sections of this blog.

Gastroesophageal reflux can occur because Ozempic (semaglutide) slows down the gastrointestinal system.  If you already have gallstones or are high risk for having gallstones your risk of developing more gallstones may increase on Ozempic.

Ozempic can cause an increase in amylase (a pancreatic enzyme).  Most of the time that is a silent side effect.  You would not necessarily feel an increase in amylase.  Do not panic! An increase in amylase does not necessarily mean you have pancreatitis.  Checking amylase is not even recommended after starting Ozempic (semaglutide).

Endocrine side effects of ozempic (semaglutide): Low blood sugars/hypoglycemia can occur especially if you are using Ozempic (semaglutide) with insulin and oral glipizide, glyburide or glimepiride.  Ozempic (semaglutide) by itself is very unlikely to cause very low blood sugars.

Acute pancreatitis is a reported Ozempic (semaglutide) side effect however this is very rare and most clinicians/doctors are not sure if Ozempic (semaglutide) can directly cause pancreatitis.  Studies also do not have clear evidence.  Nevertheless, it is better to be safe than sorry.  If you have pancreatitis, you will have severe abdominal pain radiating to the back associated with nausea and vomiting.

Other minor Ozempic (semaglutide) side effects can be discomfort at the injection sites, injection site reactions such as redness or itching.

Fatigue also has been reported as Ozempic (semaglutide) side effect although most patients in my diabetes practice start feeling more energetic on Ozempic (semaglutide).

Heart and diabetes with Ozempic
Cardiology and diabetes

Cardiovascular Review of Ozempic.. Side effects of Ozempic (semaglutide) include an increased heart rate.  So if you have atrial fibrillation you have to be careful.  On the other hand, Ozempic (semaglutide) has data indicating that it can be beneficial for reducing cardiovascular events such as heart attacks. That is definitely a positive review for Ozempic.  So if you have the underlying cardiovascular disease being on ozempic may be beneficial.

Like any other medication in the world, Ozempic (semaglutide) can also lead to allergy and more serious allergic reactions such as anaphylaxis, angioedema, hypersensitivity reaction.

If you have a baseline kidney disease or you are at high risk for dehydration you need to watch for acute renal failure, chronic renal failure. Ozempic (semaglutide) does not have direct kidney toxicity however, some people will be more prone to dehydration due to reduced appetite with Ozempic (semaglutide).  Stay hydrated.  Your doctor also will continue to monitor your kidney function when you are on Ozempic (semaglutide).

Are there contraindications to Ozempic (semaglutide)/Ozempic Review?

If you had an allergic reaction to semaglutide such as in the rybelsus Ozempic (semaglutide); if you have a personal or family history of medullary thyroid carcinoma (MTC); and patients with multiple endocrine neoplasia syndrome type 2 (MEN2) must not use Ozempic (semaglutide).  There is no data indicating that Ozempic (semaglutide) would cause medullary thyroid carcinoma or pancreatic carcinoma in humans.  On the other hand, due to some cases of these cancers are noted when Ozempic (semaglutide) was studied on rats. Taking caution and avoiding Ozempic (semaglutide) if you have a family history of these conditions would be a wise choice.  Nevertheless, if you have any neck mass or thyroid nodules please report to your diabetes specialist or endocrinologist for further evaluation if necessary.

Concerns related to adverse effects:

Special populations on Ozempic (semaglutide) Review:

  • Bariatric surgery:

If you have had bariatric surgery recently you may be at risk for dehydration.  Your doctor will evaluate and monitor you for the signs of dehydration if you have to take Ozempic (semaglutide) after bariatric surgery.  Most of the time patients after bariatric surgery do not need a lot of diabetic medications.  If you are on Ozempic (semaglutide) prior to bariatric surgery it may not be a bad idea to stop ozempic (semaglutide).  After bariatric surgery, exposure to gastrointestinal hormones such as the ones like Ozempic (semaglutide) increases.  As we discussed when dehydration happens, acute and chronic kidney failure exacerbation may occur.  If you develop nausea, vomiting or diarrhea when you are on Ozempic (semaglutide) after bypass surgery stop Ozempic (semaglutide).

  • Diabetic retinopathy:

Negative review: If you already have diabetic retinopathy, Ozempic (semaglutide) may worsen your underlying diabetic nephropathy.  So if you are going to be on Ozempic (semaglutide) you will need to make sure that you stay in close contact with your ophthalmologist and report any worsening in eye symptoms to your endocrinologist or to your ophthalmologist.  Although we are not sure about the possibility of Ozempic (semaglutide) directly causing retinopathy, most patients in this study who had worsening of their retinopathy were the ones with a history of retinopathy at the baseline.

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Can Ozempic (semaglutide) affect the other medications you are on and are there any interactions?

Since Ozempic (semaglutide) slows down the absorption of anything and everything, some medications such as birth control pills and antibiotics that are very time-sensitive can be affected by Ozempic (semaglutide).  You are to discuss this with your doctor if this could be a problem for you.  There may be interactions with other agents although that is not common.  Your diabetes specialist or endocrinologist will discuss that with you in detail.

Other important warnings: Ozempic (semaglutide) is not a replacement for insulin.  You will need to discuss with your diabetes specialist or endocrinologist regarding what to do with your insulin when you start Ozempic (semaglutide).  Dose adjustments may be necessary for your long-acting and short-acting insulins.

What are the good Ozempic side effects?

Now we have reviewed the Ozempic let’s talk about good side effects> Not every side effect means an adverse effect.  Some of the side effects can be beneficial.

Ozempic can help reduce weight but how?

Ozempic can reduce blood sugars in a very unique way.  One of them is cutting the appetite which will allow you to reduce the portion size.  Some patients can lose up to 30 or 40 pounds on Ozempic although that is not necessarily true for every patient.  Secondly, some patients on Ozempic can reduce the amount of insulin they take and occasionally totally stop the mealtime insulin with Ozempic.  Thirdly, fluctuations in blood sugars get much better with Ozempic compared to insulin injections which will help you feel better overall.  Lastly, if he can control diabetes with a once a week injection you will enjoy the convenience of once a week injection compared to multiple injections of insulin a day.  Not every patient is a candidate for Ozempic.  If your endocrinologist/diabetes specialist thinks that you are a good candidate you may be looking for long-term diabetes control with Ozempic.

As we discussed, Ozempic can reduce the risk of cardiovascular events such as heart attacks by 26%!

To get the best results out of Ozempic, you need to stay in close contact with your endocrinologist and diabetes coach in order to get the most out of Ozempic (semaglutide) and use it correctly.  If you have any issues they will need to address that immediately.  For that, 24/7 diabetes care would be very useful.

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I hope after this article you feel much more informed and educated about Ozempic.  If you still have any questions about Ozempic or any other agent in this class you can definitely consult with your diabetes specialist/endocrinologist for further information.  Remember, you are a unique patient.  Your needs and wants may be totally different than someone who is sitting next to you.

Ahmet Ergin, MD, CDE, ECNU
Endocrinologist and Founder of SugarMDs


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