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2019;14(5):e12495

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Very common (10% of patients) Nausea peaks during titration, typically subsides within 48 weeks at a stable dose Vomiting, diarrhoea, constipation Abdominal pain or discomfort Reduced appetite (this is the therapeutic effect, not an adverse effect) Less common but serious stop and see a doctor Severe, persistent abdominal pain radiating to the back possible pancreatitis Right upper abdomen pain, fever, yellowing possible gallstones / gallbladder disease Persistent neck lump, hoarseness, difficulty swallowing evaluate thyroid Rapid heartbeat, severe dehydration from vomiting Hypoglycaemia when semaglutide is combined with insulin or sulfonylureas What the Indian data shows: a 2025 study of Indian patients found GI side effects are the leading cause of discontinuation, peaking during dose escalation

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Regulatory and policy: Regulators face balancing acts

Monomer-dimer equilibrium in glutathione transferases: a critical re-examination