Ozempic® Digestive Issues

Ozempic is a weekly injectable semaglutide medication approved by the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes. Ozempic is a glucagon-like peptide receptor agonist (GLP-1 RA), a class of drugs that mimic a hormone the body produces naturally. Semaglutide is the active ingredient in Ozempic.

Per the Ozempic prescribing information, patients typically take 0.25 mg (milligrams) once weekly for four weeks. After four weeks, the dose increases to 0.5 mg. After another four weeks, the dose can be increased to 1 mg if needed.

Ozempic increases insulin production, slows the speed of stomach emptying and causes a feeling of fullness. These effects are important for treating type 2 diabetes because Ozempic can help manage blood sugar levels.

For non-diabetic patients, the appetite-suppressing effects of Ozempic can lead to weight loss. Because of this, Ozempic is commonly used off-label as a weight loss drug. Ozempic doesn’t have FDA approval to treat obesity.

People taking the drug for type 2 diabetes or weight loss may experience Ozempic side effects. Some common digestive issues, like nausea, vomiting, diarrhea and constipation, appear on Ozempic’s warning label. Potential Ozempic side effects like gastroparesis and intestinal blockages, which can both be severe, don’t appear on the label. Some patients are filing lawsuits against Ozempic because of this alleged oversight.

Ozempic may cause digestive issues such as nausea, vomiting, diarrhea, abdominal pain and constipation. Ozempic treats type 2 diabetes, a disorder of the pancreas — which is part of the digestive system. As a result, anything affecting the digestive system can affect the pancreas, and vice versa.

Some but not all of these adverse reactions are listed on Ozempic’s labeling and package inserts. Ozempic’s manufacturer is Novo Nordisk, which allegedly didn’t warn customers about the risks of gastroparesis and intestinal obstructions, among other risks.

Digestive issues listed on the Ozempic label

The Ozempic label lists the five most commonly reported adverse reactions. More than 5% of users had these reactions during clinical trials. They occurred more often in patients using Ozempic than in patients using placebos.

This list shows the percentage of patients who reported one of these adverse reactions during clinical trials.

• Abdominal pain: 7.3% with 0.5 mg dose and 5.7% with 1 mg
• Constipation: 5% with 0.5 mg dose and 3.1% with 1 mg
• Diarrhea: 8.5% with 0.5 mg dose and 8.8% with 1 mg
• Nausea: 15.8% with 0.5 mg dose and 20.3% with 1 mg
• Vomiting: 5% with 0.5 mg dose and 9.2% with 1 mg

Patients reported some side effects less often. Those side effects included belching and burping, gastric reflux, heartburn and flatulence.

The commonly listed gastrointestinal symptoms may subside over time. But they may signal the onset of more serious conditions. For some people, the effects are so serious they must stop using the medication. Contact a healthcare professional if you experience any stomach problems while taking Ozempic.

Ozempic’s label lists common digestive issues like nausea and vomiting. It also lists severe conditions that affect the stomach and digestive organs. Next, we’ll look at some of the issues mentioned on the label.

Pancreatitis/Necrotizing pancreatitis

Pancreatitis is a potentially life-threatening inflammation of the pancreas. The pancreas is an organ lying above and behind the stomach and liver. It secretes enzymes into the stomach to aid digestion. It also makes the hormones insulin and glucagon. Pancreatitis can be caused by:

• A blocked pancreatic duct that can’t deliver enzymes into the stomach
• High levels of triglycerides (fat particles) in the blood
• Stomach surgery or injury

Pancreatitis is potentially life-threatening because it may cause long-term damage to the pancreas. Pancreatitis is listed as a warning on the Ozempic label. It’s there because some patients reported the condition during clinical trials. Ozempic’s manufacturer hasn’t researched the drug’s impacts on patients who’ve had pancreatitis. Symptoms of pancreatitis include:

• Fever
• Nausea and vomiting (or inability to vomit)
• Rapid heart rate
• Severe stomach and upper abdominal pain radiating to the back, especially after eating
• Swelling or fluid buildup in the upper abdomen

Pancreatitis can feel like a heart attack. If this medical emergency happens, patients should tell their doctor about any medications they’re taking, including diabetes or weight loss drugs. They should also tell their doctor about any heart medications they’ve taken.

According to the FDA Adverse Events Reporting System (FAERS) Public Dashboard, there were 731 reports of pancreatitis and 39 reports of necrotizing pancreatitis from 2018 through 2024. Twenty-one deaths occurred among these cases.

*FAERS is intended to help identify safety concerns related to marketed products, but it does not prove any product or drug is linked or caused a particular side effect or injury. Reports by themselves are not an indicator of a medical product’s safety profile. In addition, FAERS may include duplicate reports or may significantly undercount injuries.

Hypoglycemia

Hypoglycemia comes about when a person’s blood glucose level falls below a specific level. Blood glucose level is the amount of sugar in the bloodstream. Individuals with diabetes often experience mild hypoglycemia. It can be caused by taking too much medication or not eating enough food. Early symptoms of hypoglycemia include sweating, headache, anxiety and hunger pains. Later symptoms include dizziness, lightheadedness, confusion and unconsciousness.

Untreated hypoglycemia can cause heart arrhythmia, which can lead to seizures and death. Symptomatic hypoglycemia happened to 17.3% of patients who were taking a 0.5 mg dose. That percentage of patients went up to 24.4% when the dose increased to 1 mg.

There were 181 FAERS reports of Ozempic-related hypoglycemia from 2018 through 2024. These reports included three deaths.

Acute kidney injuries

Ozempic users have reported acute kidney injuries. As of December 31, 2024, there were 253 FAERS reports of acute kidney injuries related to using Ozempic. These reports included 11 deaths.

Novo Nordisk suggests these injuries are most common in people who already have kidney disease. Most reports of acute kidney injury were from people who had other side effects — like nausea, vomiting or dehydration. The most common kidney injury associated with Ozempic is renal failure with a need for dialysis.

Patients with diabetes often also have kidney disease. They should speak with their doctor about known renal issues before using Ozempic.

Some Ozempic risks aren’t listed on the warning label. Two of these involve the digestive system. They’re potentially life-threatening if not recognized and treated immediately.

Gastroparesis

Gastroparesis is the medical term for “paralysis of the stomach.” In layperson’s terms, the stomach stops moving, and everything in the stomach and small intestine stays there. With time, the food has the potential to form a hardened mass called a bezoar. A bezoar can eventually block the stomach completely.

Gastroparesis can cause several unpleasant symptoms, including:

• Abdominal pain
• Belching
• Heartburn
• Lack of appetite
• Nausea
• Vomiting

Ozempic acts by delaying “gastric emptying,” which slows the exit of digested food from the stomach and small intestine. The package insert mentions a “delay of gastric emptying” in relation to oral medications. But it doesn’t mention the potential for preventing gastric emptying.

Ozempic patients experiencing this severe digestive issue are filing gastroparesis lawsuits.

Bowel obstruction

Bowel obstructions or intestinal blockages can occur in the large or small intestine. When this injury occurs, food and liquid can’t pass through the intestines. Bowel obstructions cause constipation and abdominal pain. If the obstruction doesn’t pass by itself, it must be removed surgically. These obstructions can lead to a higher risk of infection. The obstruction irritates and eventually inflames the bowel wall. There were 344 reports, including three deaths, related to intestinal obstructions and Ozempic use as of December 31, 2024.

Ileus

Some Ozempic patients claim the drug causes ileus through stomach paralysis. Ileus is a condition where the muscles in the intestine don’t move food through the digestive tract. This condition doesn’t involve a physical blockage. “Gastrointestinal: ileus” was added to the Postmarketing Experience section of Ozempic’s label in September 2023. But ileus is still not listed as a warning.

As of December 31, 2024, there were 205 FAERS reports of Ozempic users contracting ileus. One death was reported.

Pulmonary aspiration

The American Society of Anesthesiologists (ASA) issued a press release about concerns over Ozempic and other GLP-1 RAs in June 2023. The press release warns about reports of intraoperative pulmonary aspirations that may be linked to the use of Ozempic and similar drugs. As of December 31, 2024, there were 21 reports of Ozempic-related aspiration, including three deaths.

Intraoperative pulmonary aspiration occurs when content of the stomach may enter the lungs and airways while a patient is under anesthesia. It’s a serious and potentially dangerous condition. The ASA’s release details concerns that “delayed gastric emptying from GLP-1 receptor agonists can increase the risk of regurgitation and pulmonary aspiration of gastric contents during general anesthesia and deep sedation.”

While the ASA recommends ceasing GLP-1 RAs ahead of elective surgeries, no medication should be stopped without consulting your physician. Discuss whether this is necessary with your doctor before taking action.

Ozempic has been on the market since 2017. Questions about digestive issues with Ozempic have been frequent ever since. Some of the most frequently asked questions about Ozempic digestive problems are answered below.

Does Ozempic cause stomach problems?

Stomach problems are common among Ozempic users. The most frequent are nausea, vomiting, diarrhea and constipation. Less common are severe issues like pancreatitis, gastroparesis and gallbladder disease.

What does Ozempic do to your gut?

Ozempic affects the gut (stomach) by delaying gastric emptying. This keeps food in your stomach longer, slows down digestion and can make you feel bloated. Such delayed gastric emptying may also cause nausea, vomiting and gastric reflux.

Does Ozempic cause permanent gastroparesis?

Research shows that Ozempic may cause gastroparesis and lead to other chronic health issues. Gastroparesis can be a permanent condition for some. Lawsuits have been filed by Ozempic users who have suffered both short- and long-term gastroparesis.

Motley Rice attorneys Jonathan Orent and Sara Couch are court-appointed leads in the multidistrict litigation (MDL). The MDL is captioned In re: Glucagon-like Peptide-1 Receptor Agonist (GLP-1 RAS) Products Liability Litigation. This MDL includes lawsuits against Ozempic, Wegovy®, Rybelsus®, Mounjaro® and Trulicity®, among other drugs.

Our team also has extensive experience litigating prescription and over-the-counter drug cases. We know the legal and scientific aspects of medical litigation, and we have experience in cases that claim aggressive marketing practices were involved in bringing drugs to market.

If you think Ozempic or another medication has hurt you, we have the resources to investigate your claim.

Read more on our medical drug litigation experience.

Don’t stop taking prescribed medication without first consulting your doctor. Discontinuing a prescribed medication without your doctor’s advice can result in injury or death. Ozempic, Wegovy, Rybelsus, Mounjaro and Trulicity are still approved by the U.S. Food and Drug Administration.