Ozempic and Diarrhea: Why It Happens and How to Manage It
Medically reviewed by Femi Aremu, PharmDMedically reviewed by Femi Aremu, PharmDOzempic (semaglutide) is a prescription medication that is injected once weekly. It is often prescribed for managing blood sugar in people with type 2 diabetes, but it is also used off-label (for non-U.S. Food and Drug Administration [FDA]-approved use) for weight loss.Diarrhea, among other stomach issues, is a common side effect of Ozempic. However, it is usually temporary and tends to ease over time as your body adjusts to the new medication.Your healthcare provider will try to minimize the side effects you experience by starting you on a low dose and gradually increasing it.
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Diarrhea and Other Gut-Related Side EffectsStomach and intestinal side effects are common with Ozempic (as well as other medications that contain semaglutide, such as Wegovy or Rybelsus).The most common side effects of Ozempic include:Diarrhea (this may occur in about 8% to 30% of people who take Ozempic)Nausea (this may occur in 16% to 44% of people who take Ozempic)Vomiting (5% to 36%)Stomach pain (5.7% to 20%)Constipation (3% to 24%)In clinical studies for Ozempic, up to 12% of people taking this medication stopped taking it due to stomach-related side effects.Although gastrointestinal (GI) side effects are common with Ozempic, the exact reasons are not fully understood. Researchers believe these side effects may occur because Ozempic slows down how quickly your stomach empties food, making you feel nauseous, especially after eating.There is also a possibility that the medication affects your brain, causing nausea even when you are not eating. Diarrhea might be due to changes in how your intestines absorb nutrients or the speed at which food moves through your digestive system.Additionally, people who take certain medications, such as metformin or omeprazole, may be more likely to experience diarrhea from Ozempic.
Kidney Problems and OzempicIf you have kidney problems and experience stomach-related side effects from Ozempic, you may be more susceptible to dehydration. Dehydration can worsen kidney issues. It is important to drink enough fluids to avoid dehydration. Consult your healthcare provider for guidance on fluid consumption.
How Long Does It Last?Studies show that most people experience diarrhea from Ozempic within the first week to a month of starting the medication.While some people may experience diarrhea for about three days, it can last longer, especially during the first four to five weeks of treatment. After this initial period, the frequency of diarrhea usually decreases. As your body adjusts to Ozempic, the symptoms generally improve.Healthcare providers often start with a low dose and gradually increase it to help reduce side effects and allow your body to get used to the medication.Can Ozempic Cause Constipation?Yes, Ozempic can cause constipation among its other stomach-related side effects, although constipation is less common than diarrhea, nausea, and vomiting.Constipation generally occurs within the first 16 weeks (four months) of treatment, especially during the first month, and can last longer than other stomach-related side effects.To help manage constipation, you can try the following tips.Eat plenty of fiber and maintain a balanced and healthy diet.Drink plenty of water or other sugar-free liquids.Increase physical activity (consult your healthcare provider before beginning any new exercise program).If constipation persists or worsens, consult your healthcare provider. They may recommend additional measures, like stool softeners or adjusting your medication dose.
What Is a Sulfur Burp?Sulfur burps have a foul, rotten egg smell and can be triggered by eating foods high in sulfur, such as eggs and cheese, or certain medications. While occasional sulfur burps are generally harmless, frequent ones—or those accompanied by symptoms like stomach pain or diarrhea—could be a sign of an underlying condition and should be investigated by a healthcare provider.
How to Reduce the Risk of Side EffectsTo minimize the risk of GI-related side effects from Ozempic, healthcare providers follow specific prescribing guidelines. They start with the lowest possible dose and increase it gradually to help prevent or reduce GI issues.Providers may try one or more of the following if side effects like nausea, diarrhea, or constipation occur:Recommend staying on the lowest dose for an extra two to four weeks before increasing the dose, or delaying a dose increase until the side effects improve.Recommend taking a break from treatment.If side effects happen when increasing the dose, switch back to the previous lower dose for a few days before slowly increasing it again.Consider using a lower maintenance dose if side effects persist.Temporarily stop the treatment until the side effects disappear, then resume as tolerated.Coping With DiarrheaHere are some tips (from a panel of expert healthcare providers) for managing diarrhea due to Ozempic:Eat bland foods like chicken broth, rice, carrots, and very ripe fruit without skin.Stay well-hydrated by drinking plenty of water. You can also add a teaspoon of baking soda to a glass of water. Avoid sports drinks (such as Gatorade).Reduce your intake of high-fiber foods (e.g., grain cereals, nuts), vegetables (e.g., artichokes, asparagus, beans), and skinned fruits (e.g., apples, apricots, blackberries).Avoid dairy products, coffee, alcohol, soft drinks, very cold or hot foods, and products with sweeteners ending in “ol” (such as sorbitol, mannitol, xylitol, and maltitol), including candy and gum.Here are some general tips for minimizing all types of GI side effects:Eat slowly and only when you feel hungry.Eat smaller, more frequent meals and avoid overeating.Avoid lying down or being overly active after meals.Increase fluid intake with clear drinks in small sips and include water-rich foods like soups and yogurt.Choose easy-to-digest, low-fat foods and avoid sweet, spicy, or heavily processed items.Get some fresh air and light exercise.Keep a food diary to identify what might be triggering symptoms.Some people will need other treatments, such as probiotics and/or antidiarrheal medication.SummaryDiarrhea is a common side effect of Ozempic, often starting within the first month of treatment. The exact reason for this is not fully understood, but it is believed to be related to how the medication affects stomach emptying and nutrient absorption.Other GI issues, such as nausea, vomiting, and sometimes constipation, can also occur. To manage diarrhea, eat bland foods, drink plenty of water, and avoid high-fiber or irritating foods.If diarrhea continues or bothers you, consult your healthcare provider for medical advice. Read the original article on Verywell Health.
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