How to Manage GLP-1 Side Effects on Ozempic, Wegovy, Mounjaro or Zepbound

GLP-1 medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) work partly by slowing how fast your stomach empties. That is a big part of why they reduce appetite, and it is also why stomach side effects are the most common complaint, especially in the first weeks and after each dose increase.

The common side effects

Nausea, fullness, burping, heartburn, constipation and diarrhea are the most common. For most people they are mild to moderate and fade as the body adjusts to each dose.

Managing nausea

• Eat smaller meals, slowly, and stop as soon as you feel full
• Cut back on greasy, fried and very rich foods, which sit longest in a slow stomach
• Avoid lying down right after eating
• Sip fluids through the day rather than large amounts with meals
• Bland foods such as crackers, toast and rice can help on rough days

Managing constipation

Drink more water than you think you need, add fiber gradually from vegetables, fruit, beans and whole grains, and keep moving. If those are not enough, ask about an over-the-counter fiber supplement or stool softener.

Dose increases are where most trouble starts

Side effects often flare for a few days after each step up. If they are hard to tolerate, your prescriber can slow the schedule or stay at a lower dose longer. A slower climb is far better than stopping the medication.

Get same-day or emergency care for

• Severe, constant belly pain that may spread to the back, which can be a sign of pancreatitis
• Pain under the right ribs with fever or yellowing of the skin, which can be a gallbladder problem
• Vomiting that keeps you from holding down fluids, or signs of dehydration such as dizziness and very little urine

Other safety points

• Do not use these medicines if you or a family member has had medullary thyroid cancer or MEN2
• If you also take insulin or a sulfonylurea, your blood sugar can drop too low; ask whether those doses need to change
• Tirzepatide can make birth control pills less effective for four weeks after starting and after each dose increase, so use a backup or non-pill method then
• Tell your surgeon or anesthesiologist you take one before any procedure, because a slow stomach matters for anesthesia
• Stop before trying to become pregnant, with your prescriber's guidance

Get help from Hope Integrative Medicine

If side effects are making your GLP-1 hard to stay on, we can review your dose schedule and your plan. Our primary care team in West Ashley sees patients in person and by telehealth across South Carolina, and new patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.

This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber.