Hospitalizations For Ozempic Side Effects Are Rare—But When Should You Go to the ER?

Ozempic and Wegovy are hugely popular drugs—and through clinical trial testing, have been dubbed safe and effective. But with reports of extreme nausea, blood clots, and more circulating online, does taking these medications significantly increase your chances of a trip to the emergency room?

A study published earlier this month in Annals of Internal Medicine investigated just how often people taking Ozempic or Wegovy (also known as semaglutide) actually develop severe side effects that send them to the emergency department or hospital.

“We found that it’s very infrequent that semaglutide leads to very serious adverse events that would land a patient in the hospital, but that they do occur,” study author Pieter Cohen, MD, internist at Cambridge Health Alliance and associate professor of medicine at Harvard Medical School, told Health.

As of 2024, about one in eight U.S. adults reported having tried a glucagon-like peptide-1 (GLP-1) receptor agonist drug, such as Ozempic and Wegovy, for diabetes or weight loss.

Here’s what experts had to say about people’s risk of developing severe side effects from semaglutide, how to tell whether a reaction warrants a trip to the emergency room, and ways to stay safe while you’re taking Ozempic or Wegovy.

Cohen and his colleagues used a national surveillance network to track emergency department visits that clinicians attributed to semaglutide. Data was collected across 82 different hospitals between Jan. 1, 2022, and Dec. 31, 2023.

In total, there were 551 people who visited the emergency department for semaglutide side effects. Less than 18% of visits, about 98 cases, resulted in hospitalization. This translates to about four emergency department visits and less than one hospitalization for every 1,000 patients taking the drug.

Nearly 70% of the visits involved gastrointestinal side effects. Nausea and vomiting were by far the most common, followed by abdominal pain and diarrhea, and 15% of these cases required hospitalization.

Another 16.5% of visits were linked to low blood sugar, with nearly 38% requiring hospitalization. Allergic reactions, pancreatitis, and bile duct disease rounded out the list, but were less commonly reported.

The fact that most semaglutide patients went to the emergency department for gastrointestinal symptoms isn’t necessarily surprising.

“The adverse events presented [in this study] are not new,” Mahyar Etminan, PharmD, associate professor of medicine in the department of ophthalmology and visual sciences at the University of British Columbia and CEO of Epilytics, an epidemiology consulting group, told Health.

But researchers didn’t expect to see so many people seek care for low blood sugar, especially when they weren’t taking other blood sugar-lowering medications, Cohen said. There haven’t been many reports of Ozempic and Wegovy leading to hypoglycemia thus far.

Though this study helps quantify these severe reactions to semaglutide, there are some limitations, Peminda Cabandugama, MD, endocrinologist at Cleveland Clinic and spokesperson for The Obesity Society, told Health.

Cabandugama said the findings are “subjective,” since they rely on documentation from emergency room physicians who may “not have had the whole picture” when making their assessments.

Another potential issue is that Cohen and his colleagues didn’t know whether people who visited the hospital were taking Ozempic or Wegovy, or if they were taking compounded semaglutide.

Compounded medications are not FDA-approved and are prepared by pharmacists. They also typically come in vials instead of injection pens, meaning people have to measure out the dose themselves.

Earlier this year, the FDA warned consumers against using compounded GLP-1 drugs, citing reports of counterfeit versions of the drug and higher rates of adverse effects due to dosing errors.

“It’s kind of like the Wild West when it comes to medications [that] are compounded because there is no standardization,” Cabandugama said.

Compounded semaglutide may have inflated the rate of side effects in the study, or could even explain why an unexpected percentage of patients experienced low blood sugar, Cohen explained.

Without knowing whether patients took a compounded version of semaglutide, the study can’t determine if these severe side effects are actually from the drug itself.

In March, the FDA said it may ban compounded semaglutide after determining Ozempic and Wegovy are no longer in shortage.

Before patients start semaglutide or any other GLP-1 drug, doctors should counsel them about the potential side effects of the treatment, experts agreed. The most common side effects include nausea, vomiting, diarrhea, stomach pain, and constipation.

Most of the time, these side effects aren’t life-threatening. People can use over-the-counter medications to manage pain or deal with gastrointestinal symptoms.

However, it’s important to note that over-the-counter pain relievers such as acetaminophen, ibuprofen, or aspirin can be hit or miss, Avlin Imaeda, MD, PhD, a digestive diseases expert and associate professor of medicine at the Yale School of Medicine, told Health.

In general, there’s no hard set rule for when someone should go to the hospital for severe semaglutide symptoms. “Abdominal pain is really challenging both for patients and doctors to assess,” Imaeda said.

However, you may want to seek care if:

• You’re experiencing fever alongside your other gastrointestinal symptoms
• Your vomiting and diarrhea doesn’t subside within a few hours
• You don’t have bowel movements for several days, coupled with vomiting

In rare cases, some people on Ozempic or Wegovy can develop pancreatitis, which may require hospitalization, Imaeda said. Severe pain radiating from the abdomen through to the back could be a sign that you need to seek care.

Gallbladder inflammation, a complication of weight loss, can also be life-threatening. In these cases, pain will originate in the right upper abdomen and radiate around the side and can last several hours, said Imaeda.

If you do end up seeking care at a hospital, make sure to tell emergency room providers that you’re taking a GLP-1 drug, Cohen added.

For some people, a higher risk of semaglutide side effects means they shouldn’t be on the medication at all. Specifically, clinicians should make sure patients do not have a history of pancreatitis before they prescribe Ozempic or Wegovy, said Cabandugama.

“It’s very important to mention that patients go to the right trained providers for weight loss, especially with all the rise of the Instagram clinics and online clinics,” he explained.

Clinicians should also increase semaglutide dosages gradually, as doing it too quickly can sometimes lead to worse side effects, Cabandugama added.

However, avoiding side effects usually comes down to diet, Imaeda said.

“[Patients] really need to alter their diet in order to tolerate the medication,” she explained. “They really have to eat smaller meals and avoid things that are going to make them feel sick, like fatty food, fried food, and fast food.”

Common side effects of semaglutide often flare up after eating.

“This study makes me think maybe I should counsel patients about not being so quick to go to the emergency room,” said Imaeda.