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The prescribing information tells patients and clinicians to watch for a few serious conditions. Do not manage these at home:
- Severe or persistent stomach pain, sometimes spreading to the back, with or without vomiting — a possible sign of pancreatitis.
- Pain in the upper right belly, fever, or yellowing of the skin or eyes — possible gallbladder disease, which weight loss itself makes more likely.
- Swelling of the face or throat, trouble breathing or swallowing, severe rash — signs of a serious allergic reaction. This one is 911, not a phone call.
- Unable to keep any fluids down — dehydration on these medications has caused acute kidney injury.
- Vision changes, if you have diabetes — report them promptly.
- Planning surgery, a procedure, or sedation? Tell the provider doing it that you take this medication, ahead of time. The label warns that food left in a slow-emptying stomach has been breathed into the lungs (pulmonary aspiration) during anesthesia or deep sedation.
This is education, not medical advice
The incidence numbers here come from the trials of the semaglutide weight-loss injection; tirzepatide and other GLP-1 medications have broadly similar digestive side effects, but your medication's own patient information is the authority for your prescription. Nothing on this page replaces your prescriber — it is meant to make the conversation with them easier.
Sources
4 references
- Wegovy (semaglutide) Prescribing Information: Adverse Reactions and Warnings and Precautions. Novo Nordisk. Current label at DailyMed. Source of every incidence percentage on this page (adult adverse-reactions table) and of the warnings on pancreatitis, gallbladder disease, allergic reactions, dehydration-related kidney injury, diabetic retinopathy, and pulmonary aspiration during anesthesia or deep sedation, and of the dysesthesia rates (2.4 mg, 7.2 mg and the 25 mg tablet).
- Mozaffarian D, et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. The American Journal of Clinical Nutrition. 2025;122:344–367. Full text. Source of the management guidance: small meals every 3–4 hours, limiting fatty and high-fiber foods early on, fluids between meals, prunes and high-water foods for constipation, fiber supplements and stool softeners, anti-diarrheal options, alcohol worsening nausea and reflux, and nutrient adequacy for hair and energy.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine. 2021;384(11):989–1002. doi:10.1056/NEJMoa2032183. The trial program behind the label's adverse-reaction table; gastrointestinal events were mostly mild-to-moderate and clustered around dose escalation.
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). New England Journal of Medicine. 2022;387(3):205–216. doi:10.1056/NEJMoa2206038. Tirzepatide's side-effect profile: the same gastrointestinal events led, also mostly mild-to-moderate and during dose escalation.