Wegovy side effects: injection and pill

Wegovy’s most common side effects are stomach and bowel problems, led by nausea: 44% of adults on the 2.4 mg injection vs 16% on placebo. The higher 7.2 mg dose adds a skin-sensitivity effect in 22% of people, and the daily Wegovy pill showed a similar pattern to the shot. One label covers all three: the Wegovy prescribing information (rev. 06/2026), which every number below comes from. For comparisons with other GLP-1s and general tips that help, see our GLP-1 side effects guide.

The boxed warning comes first

Wegovy is semaglutide, sold as a weekly injection and as a daily pill. Both carry the same boxed warning, the FDA’s strongest:

• In mice and rats, semaglutide caused thyroid C-cell tumors, with more tumors at higher doses and longer use. Whether it does the same in people is unknown.
• Wegovy is not for anyone with a personal or family history of medullary thyroid carcinoma (MTC) or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Tell your clinician about a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.

Wegovy injection 2.4 mg: the label table

The main table pools 3 placebo-controlled trials with 2,116 adults on Wegovy 2.4 mg for up to 68 weeks. It lists effects reported by at least 2% of people on Wegovy and more often than on placebo.

Source: Wegovy label, Table 3 (placebo n=1,261; Wegovy n=2,116). The low blood sugar row comes from the trial in people with type 2 diabetes.

The useful number is the gap with placebo. Nausea at 44% vs 16% means about 28 extra people in every 100. Side effects led 6.8% of people on Wegovy to stop for good, vs 3.2% on placebo, most often because of nausea (1.8%), vomiting (1.2%) or diarrhea (0.7%).

Wegovy 7.2 mg (Wegovy HD)

Adults who have tolerated 2.4 mg for at least 4 weeks and need more weight reduction may go up to 7.2 mg, sold as Wegovy HD. Two 72-week trials compared 7.2 mg, 2.4 mg and placebo. This table lists effects that were at least 2% at 7.2 mg and more common than on both 2.4 mg and placebo.

Scroll sideways to see the full table

Source: Wegovy label, Table 4 (placebo n=303; 2.4 mg n=304; 7.2 mg n=1,311).

Dysesthesia is the effect to ask about. The label describes it as altered skin sensation: tingling, burning, pain of the skin or sensitive skin. It rose with dose and blood levels of the drug. Among the 288 people who had it at 7.2 mg, 2% stopped Wegovy, 8% paused and 23% lowered their dose; most of those recovered. Overall, 18% did not report recovering during the trial, and most of them had kept the same dose. Of 38 people who went back up to 7.2 mg after recovering, 17 had it again.

Despite the higher rates, 5% stopped because of side effects on 7.2 mg, the same as on 2.4 mg, vs 2% on placebo.

Wegovy pill (25 mg tablets)

The pill was tested in one 64-week trial with 204 adults on 25 mg (people with type 2 diabetes were excluded). The label says the types and rates of common side effects were similar to the injection’s table above. The differences it does report:

• Side effects led 6.9% to stop vs 5.9% on placebo, most often stomach effects (3.4% vs 2%).
• Severe stomach problems affected 2% vs 0% on placebo.
• Gallstones were reported by 2.5% vs 1%.
• Skin sensitivity affected 5% vs 0%.

The pill has rules of its own. Take one tablet each morning on an empty stomach with up to 4 ounces of water, swallow it whole, and wait at least 30 minutes before eating, drinking or taking other pills. Breastfeeding is not recommended while taking the tablets. Our Foundayo vs Wegovy pill guide compares the two daily pills.

How the dose ladder affects stomach side effects

Both forms start low, and the label says to follow the steps “to reduce the risk of gastrointestinal adverse reactions”.

Scroll sideways to see the full table

On the injection, 73% of adults had a stomach or bowel side effect vs 47% on placebo, and these were most often reported during dose escalation. Stomach side effects made 4.3% stop vs 0.7% on placebo, and severe ones affected 4.1% vs 0.9%.

The label builds in slack. If a step is too hard to tolerate, your clinician can delay the next increase (by 4 weeks on the injection). The injection has two maintenance options, 1.7 mg and 2.4 mg. If the 25 mg pill is not tolerated, the label suggests switching to the 1.7 mg weekly injection. Do not change your dose yourself.

Missed doses matter too. If you miss 2 or more injections in a row, the label restarts the ladder at a lower dose to lower the risk of stomach side effects, so call your clinician.

Serious risks on the label

These are less common. Rates are from the adult weight trials unless noted.

• Pancreatitis. Confirmed in 4 people on Wegovy (0.2 cases per 100 patient-years) vs 1 on placebo. Fatal cases have been seen with drugs in this class.
• Gallbladder disease. Gallstones in 1.6% on the injection vs 0.7% on placebo; gallbladder inflammation in 0.6% vs 0.2%.
• Kidney injury from dehydration. 0.4 cases per 100 patient-years vs 0.2, some alongside stomach side effects or dehydration.
• Low blood sugar. In people with type 2 diabetes, 6.2% vs 2.5% on placebo. The risk rises with insulin or a sulfonylurea.
• Severe stomach problems. Not recommended in severe gastroparesis.
• Serious allergic reactions, including anaphylaxis and swelling of the face and throat.
• Eye changes in type 2 diabetes. Diabetic retinopathy was reported by 4% vs 2.7% on placebo.
• Faster heart rate. Resting heart rate rose by 1 to 4 beats per minute on average; 26% had a rise of 20 or more at some visit vs 16% on placebo.
• Breathing in stomach contents under anesthesia. Rare cases have been reported with drugs in this class.

Other effects on the label: low blood pressure in 1.3% vs 0.4%, fainting in 0.8% vs 0.2%, and appendicitis in 0.5% vs 0.2%. In the heart outcomes trial, hip and pelvis fractures were more common in women (1% vs 0.2%) and in people 75 and older (2.4% vs 0.6%).

Never share a Wegovy FlexTouch pen, even with a new needle. The June 2026 label lists its former section on suicidal behavior and ideation as removed in January 2026. Tell your clinician about any change in mood all the same.

Pregnancy and other medicines

• Pregnancy. Wegovy may harm an unborn baby. For weight loss or heart risk, stop it when a pregnancy is recognized, and at least 2 months before a planned pregnancy because semaglutide stays in the body a long time.
• Other pills. Wegovy slows stomach emptying, which can change how oral medicines are absorbed. Drugs that need close monitoring may need extra checks.
• Diabetes medicines. Your clinician may lower your insulin or sulfonylurea dose when you start.

When to call a doctor

The Medication Guide that comes with Wegovy sets out these signs.

Stop Wegovy and call your clinician right away for severe stomach pain that will not go away, with or without vomiting. It may spread to your back.

Stop Wegovy and get medical help right away for signs of a serious allergic reaction: swelling of the face, lips, tongue or throat, trouble breathing or swallowing, severe rash or itching, fainting or dizziness, or a very fast heartbeat.

Tell your clinician right away about nausea, vomiting or diarrhea that does not go away.

Also call your clinician about:

• Upper stomach pain, fever, yellow skin or eyes, or clay-colored stools (gallbladder).
• Stomach problems that are severe or do not go away.
• A racing or pounding heart at rest that lasts several minutes.
• Vision changes, if you have type 2 diabetes.
• Signs of low blood sugar if you have type 2 diabetes, such as shakiness, sweating, confusion or blurred vision.

Taking too much can cause severe nausea, severe vomiting and severe low blood sugar. Call your clinician or Poison Help at 1-800-222-1222, or go to an emergency room. You can report side effects to the FDA at 1-800-FDA-1088 or through MedWatch.

A note on compounded semaglutide

These rates come from trials of Wegovy. Compounded semaglutide is not Wegovy and not a generic of it. A compounding pharmacy prepares it, it isn’t FDA-approved, and the FDA does not review compounded drugs for safety, effectiveness or quality before they are sold. As of May 31, 2026, the FDA had received 990 adverse event reports linked to compounded semaglutide, and it has had reports that may be related to dosing errors (FDA). See our guide to compounded semaglutide’s legal status and safety.

The bottom line

On Wegovy, expect the stomach first: nausea hit 44% of adults on 2.4 mg vs 16% on placebo, mostly while the dose was rising. The 7.2 mg dose adds more vomiting and a skin-sensitivity effect in 22% of people, and the pill tracks the injection. Read the boxed warning, know the signs that need a call, and let your clinician set the pace. To compare costs, see our Wegovy cost guide, and to compare prescribers, the brand-name GLP-1 rankings.