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Wegovy (Semaglutide 2.4 mg) Nausea: When to Call the Doctor At a glance Nausea is the most common Wegovy side effect, reported by 44% of participants in the STEP-1 trial Most episodes are mild to moderate and peak during dose-escalation phases Median time to resolution is 8 to 12 weeks after reaching maintenance dose Severe nausea leading to treatment discontinuation occurred in 2.4% of STEP-1 participants Delayed gastric emptying and direct brainstem GLP-1 receptor activation drive the symptom Red-flag signs include inability to keep liquids down for 24+ hours, hematemesis, or severe epigastric pain Eating smaller meals, staying upright after eating, and avoiding high-fat foods reduce symptom burden Dose escalation follows a 16-week titration schedule designed to minimize GI side effects Ondansetron or other antiemetics may be prescribed for refractory nausea FDA labeling recommends discontinuation if nausea is persistent and clinically significant How Common Is Nausea on Wegovy

Metabolism 65 (5), 699713

Immune modulation: Peptides can reduce pathological inflammation without broadly suppressing immune function

Feng J, Jin T