Wegovy Side Effects Center

Last updated on RxList: 6/10/2021
Wegovy Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

What Is Wegovy?

Wegovy (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia).

What Are Side Effects of Wegovy?

Side effects of Wegovy include:

Dosage for Wegovy

The initial dose of Wegovy is 0.25 mg once weekly for 4 weeks. In 4-week intervals, increase the dose until a dose of 2.4 mg is reached. The maintenance dose of Wegovy is 2.4 mg once weekly, administered on the same day each week, at any time of day, with or without meals.


Wegovy In Children

Safety and efficacy of Wegovy have not been established in pediatric patients.

What Drugs, Substances, or Supplements Interact with Wegovy?
 

Wegovy may interact with other medicines such as:

  • insulin secretagogues (e.g., sulfonylureas) or insulin and
  • other oral medications taken at the same time.

Tell your doctor all medications and supplements you use.


Wegovy During Pregnancy and Breastfeeding

Wegovy is not recommended for use; it may harm a fetus. When pregnancy is recognized, discontinue Wegovy. Discontinue Wegovy at least 2 months before a planned pregnancy because of the long half-life of semaglutide. There will be a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Wegovy during pregnancy. Pregnant women exposed to Wegovy and healthcare providers are encouraged to contact Novo Nordisk at 1-800-727-6500. It is unknown if Wegovy passes into breast milk or ow it could affect a nursing infant. Consult your doctor before breastfeeding.

Additional Information

Our Wegovy (semaglutide) Injection, for Subcutaneous Use Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SLIDESHOW

Surprising Causes of Weight Gain See Slideshow
Wegovy Professional Information

SIDE EFFECTS

The following serious adverse reactions are described below or elsewhere in the prescribing information:

  • Risk of Thyroid C-Cell Tumors [see WARNINGS AND PRECAUTIONS]
  • Acute Pancreatitis [see WARNINGS AND PRECAUTIONS]
  • Acute Gallbladder Disease [see WARNINGS AND PRECAUTIONS]
  • Hypoglycemia [see WARNINGS AND PRECAUTIONS]
  • Acute Kidney Injury [see WARNINGS AND PRECAUTIONS]
  • Hypersensitivity [see WARNINGS AND PRECAUTIONS]
  • Diabetic Retinopathy Complications in Patients with Type 2 Diabetes [see WARNINGS AND PRECAUTIONS]
  • Heart Rate Increase [see WARNINGS AND PRECAUTIONS]
  • Suicidal Behavior and Ideation [see WARNINGS AND PRECAUTIONS]

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.

WEGOVY was evaluated for safety in 3 randomized, double-blind, placebo-controlled trials that included 2116 patients with overweight or obesity treated with WEGOVY for up to 68 weeks and a 7 week off drug follow-up period. Baseline characteristics included a mean age of 48 years, 71% women, 72% White, 42% with hypertension, 19% with type 2 diabetes, 43% with dyslipidemia, 28% with a BMI greater than 40 kg/m2, and 4% with cardiovascular disease.

In clinical trials, 6.8% of patients treated with WEGOVY and 3.2% of patients treated with placebo permanently discontinued treatment as a result of adverse reactions. The most common adverse reactions leading to discontinuation were nausea (1.8% versus 0.2%), vomiting (1.2% versus 0%), and diarrhea (0.7% versus 0.1%) for WEGOVY and placebo, respectively.

Adverse reactions reported in greater than or equal to 2% of WEGOVY-treated patients and more frequently than in placebo-treated patients are shown in Table 3.

Table 3. Adverse Reactions Occurring in ≥ 2% of WEGOVY-treated Patients and More Frequently than with Placebo

Placebo
N = 1261
%
WEGOVY
N = 2116
%
Nausea 16 44
Diarrhea 16 30
Vomiting 6 24
Constipation 11 24
Abdominal Paina 10 20
Headache 10 14
Fatigueb 5 11
Dyspepsia 3 9
Dizziness 4 8
Abdominal Distension 5 7
Eructation <1 7
Hypoglycemia in T2DMc 2 6
Flatulence 4 6
Gastroenteritis 4 6
Gastroesophageal Reflux Disease 3 5
Gastritisd 1 4
Gastroenteritis Viral 3 4
Hair Loss 1 3
a Includes abdominal pain, abdominal pain upper, abdominal pain lower, gastrointestinal pain, abdominal tenderness, abdominal discomfort and epigastric discomfort
b Includes fatigue and asthenia
c Defined as blood glucose <54 mg/dL with or without symptoms of hypoglycemia or severe hypoglycemia (requiring the assistance of another person) in patients with type 2 diabetes not on concomitant insulin (Study 2, WEGOVY N=403, Placebo N=402). See text below for further information regarding hypoglycemia in patients with and without type 2 diabetes. T2DM = type 2 diabetes mellitus
d Includes chronic gastritis, gastritis, gastritis erosive, and reflux gastritis

Acute Pancreatitis

In WEGOVY clinical trials, acute pancreatitis was confirmed by adjudication in 4 WEGOVY-treated patients (0.2 cases per 100 patient years) versus 1 in placebo-treated patients (less than 0.1 cases per 100 patient years). One additional case of acute pancreatitis was confirmed in a patient treated with WEGOVY in another clinical trial.

Acute Gallbladder Disease

In WEGOVY clinical trials, cholelithiasis was reported by 1.6% of WEGOVY-treated patients and 0.7% of placebo-treated patients. Cholecystitis was reported by 0.6% of WEGOVY-treated patients and 0.2% of placebo-treated patients.

Hypoglycemia

Patients with Type 2 Diabetes

In a trial of patients with type 2 diabetes and BMI greater than or equal to 27 kg/m2, clinically significant hypoglycemia (defined as a plasma glucose less than 54 mg/dL) was reported in 6.2% of WEGOVY-treated patients versus 2.5% of placebo-treated patients. A higher rate of clinically significant hypoglycemic episodes was reported with WEGOVY (semaglutide 2.4 mg) versus semaglutide 1 mg (10.7 vs. 7.2 episodes per 100 patient years of exposure, respectively); the rate in the placebo-treated group was 3.2 episodes per 100 patient years of exposure. In addition, one episode of severe hypoglycemia requiring intravenous glucose was reported in a WEGOVY-treated patient versus none in placebo-treated patients. The risk of hypoglycemia was increased when WEGOVY was used with a sulfonylurea.

Patients without Type 2 Diabetes

Episodes of hypoglycemia have been reported with GLP-1 receptor agonists in patients without type 2 diabetes mellitus. In WEGOVY clinical trials in patients without type 2 diabetes mellitus, there was no systematic capturing or reporting of hypoglycemia.

Acute Kidney Injury

Acute kidney injury occurred in clinical trials in 7 patients (0.4 cases per 100 patient years) receiving WEGOVY versus 4 patients (0.2 cases per 100 patient years of exposure) receiving placebo. Some of these adverse reactions occurred in association with gastrointestinal adverse reactions or dehydration. In addition, 2 patients treated with WEGOVY had acute kidney injury with dehydration in other clinical trials. The risk of renal adverse reactions with WEGOVY was increased in patients with a history of renal impairment (trials included 65 patients with a history of moderate or severe renal impairment at baseline), and occurred more frequently during dose titration.

Retinal Disorders In Patients With Type 2 Diabetes

In a trial of patients with type 2 diabetes and BMI greater than or equal to 27 kg/m2, retinal disorders were reported by 6.9% of patients treated with WEGOVY (semaglutide 2.4 mg), 6.2% of patients treated with semaglutide 1 mg, and 4.2% of patients treated with placebo. The majority of events were reported as diabetic retinopathy (4.0%, 2.7%, and 2.7%, respectively) and non-proliferative retinopathy (0.7%, 0%, and 0%, respectively).

Increase In Heart Rate

Mean increases in resting heart rate of 1 to 4 beats per minute (bpm) were observed with routine clinical monitoring in WEGOVY-treated patients compared to placebo in clinical trials. In trials in which patients were randomized prior to dose-escalation, more patients treated with WEGOVY, compared with placebo, had maximum changes from baseline at any visit of 10 to 19 bpm (41% versus 34%, respectively) and 20 bpm or more (26% versus 16%, respectively).

Hypotension And Syncope

Adverse reactions related to hypotension (hypotension, orthostatic hypotension, and decreased blood pressure) were reported in 1.3% of WEGOVY-treated patients versus 0.4% of placebo-treated patients and syncope was reported in 0.8% of WEGOVY-treated patients versus 0.2% of placebo-treated patients. Some reactions were related to gastrointestinal adverse reactions and volume loss associated with WEGOVY. Hypotension and orthostatic hypotension were more frequently seen in patients on concomitant antihypertensive therapy.

Appendicitis

Appendicitis (including perforated appendicitis) occurred in 10 (0.5%) WEGOVY-treated patients and 2 (0.2%) patients receiving placebo.

Gastrointestinal Adverse Reactions

In clinical trials, 73% of WEGOVY-treated patients and 47% of patients receiving placebo reported gastrointestinal disorders. The most frequently reported reactions were nausea (44% vs. 16%), vomiting (25% vs. 6%), and diarrhea (30% vs. 16%). Other common reactions that occurred at a higher incidence among WEGOVY-treated patients included dyspepsia, abdominal pain, abdominal distension, eructation, flatulence, gastroesophageal reflux disease, gastritis, and hemorrhoids. These reactions increased during dose escalation.

Permanent discontinuation of treatment as a result of a gastrointestinal adverse reaction occurred in 4.3% of WEGOVY-treated patients versus 0.7% of placebo-treated patients.

Injection Site Reactions

In clinical trials, 1.4% of WEGOVY-treated patients and 1.0% of patients receiving placebo experienced injection site reactions (including injection site pruritus, erythema, inflammation, induration, and irritation).

Laboratory Abnormalities

Patients treated with WEGOVY had a mean increase from baseline in amylase of 16% and lipase of 39%. These changes were not observed in the placebo group. The clinical significance of elevations in lipase or amylase with WEGOVY is unknown in the absence of other signs and symptoms of pancreatitis.

Immunogenicity

Consistent with the potentially immunogenic properties of protein and peptide pharmaceuticals, patients treated with WEGOVY may develop anti-semaglutide antibodies. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody (including neutralizing antibody) positivity in an assay may be influenced by several factors including assay methodology, sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, the incidence of antibodies to semaglutide in the studies described below cannot be directly compared with the incidence of antibodies in other studies or to other products.

Across the clinical trials with antibody assessments, 50 (2.9%) WEGOVY-treated patients developed anti-drug antibodies (ADAs) to the active ingredient in WEGOVY (i.e., semaglutide). Of the 50 semaglutide-treated patients that developed semaglutide ADAs, 28 patients (1.6% of the total WEGOVY-treated study population) developed antibodies cross-reacting with native GLP-1. The in vitro neutralizing activity of the antibodies is uncertain at this time.

Postmarketing Experience

The following adverse reactions have been reported during post-approval use of semaglutide, the active ingredient of WEGOVY. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Gastrointestinal Disorders: acute pancreatitis and necrotizing pancreatitis, sometimes resulting in death

Hypersensitivity: anaphylaxis, angioedema, rash, urticaria

Renal and Urinary Disorders: acute kidney injury

DRUG INTERACTIONS

Concomitant Use With An Insulin Secretagogue (e.g., Sulfonylurea) Or Insulin

WEGOVY lowers blood glucose and can cause hypoglycemia. The risk of hypoglycemia is increased when WEGOVY is used in combination with insulin secretagogues (e.g., sulfonylureas) or insulin. The addition of WEGOVY in patients treated with insulin has not been evaluated.

When initiating WEGOVY, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia [see WARNINGS AND PRECAUTIONS and ADVERSE REACTIONS].

Oral Medications

WEGOVY causes a delay of gastric emptying and thereby has the potential to impact the absorption of concomitantly administered oral medications. In clinical pharmacology trials with semaglutide 1 mg, semaglutide did not affect the absorption of orally administered medications [see CLINICAL PHARMACOLOGY]. Nonetheless, monitor the effects of oral medications concomitantly administered with WEGOVY.

Read the entire FDA prescribing information for Wegovy (Semaglutide Injection)

© Wegovy Patient Information is supplied by Cerner Multum, Inc. and Wegovy Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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