What Is Ozempic and Why Side Effects Occur
How Semaglutide Works in the Body
The active ingredient in Ozempic is Semaglutide. It mimics a hormone your body naturally produces called GLP-1 (glucagon-like peptide-1). This hormone tells your brain you’re full, slows down how fast your stomach empties, and triggers your pancreas to release insulin.
Why GLP-1 Receptor Agonists Cause Side Effects
Because GLP-1 receptors are found throughout your digestive system and brain, the drug doesn’t just “target” blood sugar; it affects your whole GI tract. Most side effects happen because your body is adjusting to food staying in your stomach much longer than usual.
Common Ozempic Side Effects
Nausea, Vomiting, and Digestive Discomfort
This is the “big one.” According to clinical data from the FDA, nausea affects a significant portion of users, especially when starting a new dose. It often feels like mild motion sickness.
Diarrhoea, Constipation, and Bloating
Your gut motility changes on Ozempic. Some people find things move too fast, while others find the “slow down” leads to uncomfortable constipation.
Appetite Changes and Early Fullness
While this is technically the goal for weight loss, the sensation of being “stuffed” after just three bites of nasi lemak can be jarring at first.
Fatigue, Dizziness, and Headache
Some Malaysians report feeling “off” or tired. This is often a secondary effect of eating significantly fewer calories or becoming slightly dehydrated.
Less Common but Serious Ozempic Side Effects
Pancreatitis: Warning Signs and Risk Factors
Though rare, inflammation of the pancreas is serious. If you feel severe abdominal pain that radiates to your back, stop the medication and head to a clinic immediately.
Gallbladder Problems and Rapid Weight Loss
Rapid weight loss can trigger gallstones. This isn’t unique to Ozempic but is a known risk of losing weight too quickly.
Kidney Function Changes and Dehydration
If you’re vomiting or have diarrhoea, you risk dehydration, which can strain your kidneys. Always keep a bottle of water handy, especially in our Malaysian heat!
Severe Allergic Reactions
Watch for rashes, swelling, or difficulty breathing. While extremely rare, anaphylaxis requires emergency care.
Ozempic and Thyroid Cancer Risk
Medullary Thyroid Carcinoma (MTC) Warning Explained
You might see a “Boxed Warning” on the packaging. This is because certain thyroid tumors were found in rodents during early testing.
Animal Studies vs Human Evidence
It is important to note that this specific cancer risk has not been proven in humans. However, the European Medicines Agency (EMA) continues to monitor long-term data to ensure patient safety.
Who Should Avoid Ozempic
If you or your family have a history of Medullary Thyroid Carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), Ozempic is generally a “no-go.“
Ozempic Safety for Long-Term Use
Clinical Trial Data and Real-World Evidence
The SUSTAIN trials showed that Semaglutide is generally safe for long-term use in managing diabetes.
Cardiovascular Safety and Benefits
Actually, Ozempic has been shown to reduce the risk of major cardiovascular events like heart attacks and strokes in adults with Type 2 diabetes.
Is Ozempic Safe Beyond One Year?
Current evidence suggests it is safe for multi-year use, provided you are monitored by a qualified doctor in Malaysia.
Ozempic Side Effects Timeline
What to Expect in the First 1–4 Weeks
This is the “adjustment phase.” Most nausea happens here as you start the 0.25mg “loading dose.“
Side Effects During Dose Escalation
Whenever you move up (e.g., from 0.5mg to 1.0mg), side effects might briefly flare up again for a few days.
Long-Term Tolerability Over Months
For most, the “Ozempic ick” fades. By month three, many patients feel completely normal while still enjoying the benefits of the medication.
Who Is at Higher Risk of Ozempic Side Effects
Patients With Gastrointestinal Conditions: If you have Gastroparesis (paralyzed stomach), Ozempic can make it worse.
History of Pancreatitis or Gallstones: These patients need extra caution.
Older Adults: They may be more prone to dehydration and dizzy spells.
Ozempic Safety for Weight Loss vs Diabetes Treatment
Dose Differences and Risk Profiles
While Ozempic is for diabetes, its sister drug Wegovy (also Semaglutide) is approved specifically for weight loss at higher doses. Higher doses generally mean a higher chance of side effects.
Off-Label Use Considerations in Malaysia
In Malaysia, some doctors prescribe Ozempic “off-label” for obesity. This is legal, but it must be done under strict medical supervision.
Medical Supervision Requirements
Never buy Ozempic from unauthorized sellers on Shopee or Telegram. Counterfeit pens have been found globally, and they are incredibly dangerous. Always get your supply from a registered pharmacy or hospital.
Managing and Reducing Ozempic Side Effects
Dose Titration and Injection Schedule
The “slow and steady” approach is best. Don’t rush to increase your dose if you’re still feeling sick.
Dietary Adjustments to Reduce Nausea
Avoid fried, greasy food (goodbye, deep-fried pisang goreng for a while).
Eat smaller, more frequent meals.
Stop eating the moment you feel full.
When to Pause or Stop Treatment
If you cannot keep liquids down or the pain is intense, talk to your doctor about pausing the treatment.
Ozempic Drug Interactions and Precautions
Interactions With Diabetes Medications
If you take Insulin or Sulfonylureas, Ozempic can cause your blood sugar to drop too low (Hypoglycemia).
Alcohol Consumption and Safety
Alcohol can irritate the stomach and increase the risk of low blood sugar. It’s best to limit your intake while on the medication.
Ozempic Use With Other Weight Loss Treatments
Combining Ozempic with other stimulants or weight-loss pills isn’t well-studied and should be avoided unless directed by a specialist.
Ozempic Safety in Special Populations
Pregnancy and Breastfeeding: Ozempic is not recommended. You should stop the medication at least two months before trying to conceive.
Kidney or Liver Disease: Dosage adjustments might be necessary; check with your nephrologist.
Elderly Patients: Monitoring for falls (due to dizziness) and kidney health is vital.
Ozempic Safety Compared to Other GLP-1 Injections
Ozempic vs Wegovy
Both are Semaglutide, but Wegovy goes up to a 2.4mg dose, whereas Ozempic usually caps at 1.0mg or 2.0mg.
Ozempic vs Saxenda
Saxenda (Liraglutide) is a daily injection, while Ozempic is weekly. Many find the weekly Ozempic easier to tolerate.
Safety Profile Comparison
According to the Mayo Clinic, while all GLP-1s share similar GI side effects, the “once-weekly” nature of Ozempic is often preferred for patient compliance.
When to See a Doctor for Ozempic Side Effects
Red Flag Symptoms That Require Immediate Care
Severe persistent abdominal pain.
Persistent vomiting.
Signs of a thyroid lump or swelling in the neck.
When Side Effects Are Not Normal
If your quality of life is plummeting—meaning you can’t work or eat at all—your dose might be too high or the drug may not be right for you.
Frequently Asked Questions
Are Ozempic side effects permanent? No, they typically stop once the medication leaves your system (which can take a few weeks).
Is Ozempic approved and regulated in Malaysia? Yes, it is registered with the National Pharmaceutical Regulatory Agency (NPRA) for the treatment of Type 2 Diabetes.
Is Ozempic safe for non-diabetic weight loss? While widely used for this, you should consult the World Health Organization (WHO) guidelines on obesity management, which emphasize that medication should always be paired with lifestyle changes.