Ozempic side effects: an Australian guide.
Ozempic (semaglutide) is registered in Australia for type 2 diabetes. Its side effects are documented in the TGA-approved Product Information and Consumer Medicine Information. This guide sets them out in plain language: what is common, what is serious, how "Ozempic face" and "Ozempic burp" map onto the official lists, and when to call for help. It is information to take to your doctor or pharmacist, not a substitute for them.
The most common Ozempic side effects are gastrointestinal: nausea, diarrhoea, vomiting, constipation, abdominal pain and bloating. They are usually mild to moderate, cluster in the first months and after dose increases, and ease over time. Serious but less common effects in the Australian Product Information include acute pancreatitis, gallstones, dehydration leading to kidney injury, worsening of existing diabetic eye disease, severe allergic reactions and a rare optic nerve condition. Low blood glucose is mainly a risk alongside insulin or a sulfonylurea. Call 000 for severe symptoms, or healthdirect on 1800 022 222 for advice. Any change to your medicine is your prescriber's decision.
- 28 August 2019 — Ozempic registered by the TGA for type 2 diabetes in adults. TGA ARTG entry with PI and CMI.
- 1 October 2024 — Pharmacy compounding of semaglutide and other GLP-1 medicines becomes unlawful. TGA media release.
- 3 June 2025 — TGA adds class-wide warnings about aspiration during anaesthesia or deep sedation. TGA safety update.
- 18 July 2025 — Ozempic removed from the TGA medicine shortage list. Novo Nordisk Australia product update.
- 23 July 2026 — TGA updates all GLP-1 medicines for the rare optic nerve condition NAION. TGA safety update.
- 1 October 2026 — Ozempic remains PBS-listed for type 2 diabetes only (Authority Required), not for weight management. PBS Schedule item 12075M.
The effects most people ask about.
Semaglutide slows stomach emptying and acts on appetite signals in the brain, so the gut is where most side effects appear. The Australian Product Information (revised 7 May 2024) groups adverse reactions by trial frequency.
| Frequency | Adverse reactions listed in the Australian PI | Trial figures where published |
|---|---|---|
| Very common at least 1 in 10 | Nausea, diarrhoea; hypoglycaemia when used with insulin or a sulfonylurea | Nausea 17.0% (0.5 mg) and 19.9% (1 mg); diarrhoea 12.2% and 13.3% |
| Common 1 in 100 to 1 in 10 | Vomiting, abdominal pain, bloating, constipation, dyspepsia, gastritis, reflux, eructation (burping), flatulence, decreased appetite, dizziness, fatigue, gallstones, diabetic retinopathy complications, raised lipase and amylase | Vomiting 6.4% and 8.4%; gallstones 1.5% and 0.4%; gastrointestinal events led 3.9% and 5.9% to stop |
| Uncommon 1 in 1,000 to 1 in 100 | Acute pancreatitis, delayed gastric emptying, increased heart rate, altered taste, injection-site reactions, hypersensitivity | Pancreatitis 0.3% vs 0.2% comparator; heart rate up 1 to 6 bpm |
| Rare 1 in 10,000 to 1 in 1,000 | Anaphylactic reaction | — |
| Post-marketing frequency not known | Acute kidney injury, angioedema, intestinal obstruction including ileus | Most kidney cases followed vomiting, diarrhoea or dehydration |
Overall, 6.1% of people on 0.5 mg and 8.7% on 1 mg stopped treatment because of an adverse event in trials, against 1.5% on placebo, usually for gastrointestinal effects.
What the Product Information warns about.
Uncommon but potentially severe. Warning signs are severe, persistent abdominal pain that may radiate to the back, often with vomiting. The PI says to stop if pancreatitis is suspected and not restart if confirmed; caution with any past pancreatitis.
None severe with Ozempic alone. With a sulfonylurea, severe hypoglycaemia occurred in 1.2% of people; with insulin, 1.5%. The PI says the risk can be reduced by lowering the dose of those medicines, the prescriber's call.
Gallstones were reported in 1.5% and 0.4% of people on 0.5 mg and 1 mg, none on placebo. Pain under the right ribs with fever or yellow skin needs prompt assessment.
In a two-year trial of 3,297 people with type 2 diabetes at high cardiovascular risk, retinopathy complications occurred in 3.0% on Ozempic vs 1.8% on placebo, mostly in people who already had retinopathy and used insulin. The PI advises monitoring.
Post-marketing reports describe acute kidney injury and worsening chronic kidney disease, sometimes needing dialysis, mostly after vomiting, diarrhoea or dehydration. The PI advises monitoring kidney function in anyone with severe gastrointestinal effects.
Rash and urticaria are uncommon; anaphylaxis is rare; angioedema (swelling of the face, lips, tongue or throat) has been reported. Swelling that affects breathing or swallowing is a 000 emergency.
Semaglutide delays stomach emptying. On 3 June 2025 the TGA added warnings about aspiration during anaesthesia or deep sedation. Tell any surgeon, anaesthetist or endoscopy team that you take a GLP-1 medicine.
On 23 July 2026 the TGA updated all GLP-1 medicines for non-arteritic anterior ischaemic optic neuropathy, a rare condition causing sudden, usually painless vision loss that can be permanent. Sudden visual change needs urgent review.
In two-year studies, rats and mice developed thyroid C-cell tumours, a rodent class effect of GLP-1 medicines. The Australian PI states human relevance is unknown and does not list it as a contraindication; a personal or family history of medullary thyroid cancer is worth raising with your prescriber.
Intestinal obstruction, including ileus, has been reported. The PI advises against use in NYHA class IV heart failure, end-stage kidney disease, type 1 diabetes, diabetic ketoacidosis and pregnancy (stop at least two months before a planned pregnancy).
"Ozempic face" and "Ozempic burp".
"Ozempic face" is a social-media term, not a diagnosis or a listed adverse reaction. It describes a hollower, more lined or sagging face after rapid weight loss, because facial fat is lost before skin can retract. A 2025 systematic review of 23 studies in Aesthetic Surgery Journal Open Forum found no evidence that semaglutide preferentially removes facial fat; the change tracks how much and how fast weight is lost, and the authors call the term a passing trend rather than a new side effect. In Australia Ozempic is indicated for type 2 diabetes, and large weight changes are not its intended effect; if you notice facial changes, talk to your prescriber about the pace of weight change.
"Ozempic burp" is burping, sometimes with a sulphur taste. The Product Information lists it as eructation, common, alongside bloating, flatulence, reflux and dyspepsia; it reflects food sitting in the stomach longer. Burping with severe abdominal pain, repeated vomiting or an inability to keep fluids down needs medical advice.
When side effects tend to appear.
The Australian schedule starts at 0.25 mg weekly for four weeks, then 0.5 mg; after at least four weeks the prescriber may increase to 1 mg. The PI says gastrointestinal effects are most frequent in the first months and usually short-lived; many people notice a flare in the days after an injection and the fortnight after each step up. Whether to step up, hold or step back is the prescriber's decision, informed by what you report.
Eating patterns many people find easier.
No food prevents side effects, but eating patterns can make them easier to live with: smaller, slower meals; stopping at comfortable rather than full; keeping very fatty, fried or very sweet meals modest; sipping fluids through the day; protein at each meal when appetite is low; fibre increased gradually. Preptide's guides go deeper: what to eat on Ozempic, foods for GLP-1 nausea, the GLP-1 portion guide and the semaglutide food guide. People with diabetes should check carbohydrate changes with their diabetes team, especially if they use insulin or a sulfonylurea.
When to seek urgent care, and how to report.
Call 000 now
Swelling of the face, lips, tongue or throat, wheeze or difficulty breathing; collapse or severe confusion from low blood glucose that does not respond to sugar; severe chest pain; sudden loss of vision.
Same-day medical review
Severe or persistent abdominal pain; vomiting or diarrhoea that stops you keeping fluids down for more than a day; right-sided rib pain with fever or yellow skin; passing very little urine; sudden vision change; recurring hypoglycaemia.
healthdirect 1800 022 222
Free 24-hour advice from a registered nurse anywhere in Australia if you are unsure how urgent a symptom is.
Report to the TGA
Anyone can report a suspected side effect at tga.gov.au/reporting-problems, or ask your doctor or pharmacist to report for you. Reports feed the Database of Adverse Event Notifications.
Do not stop, skip or change your dose on your own in response to a side effect unless the Consumer Medicine Information or your prescriber says to; call instead. Equally, do not push through red-flag symptoms because nausea is expected.
What are the most common side effects of Ozempic?
Nausea and diarrhoea are listed as very common in the Australian Product Information (at least 1 in 10 people): in trials nausea occurred in 17.0% of people on 0.5 mg and 19.9% on 1 mg, diarrhoea in 12.2% and 13.3%. Vomiting, constipation, abdominal pain, bloating, indigestion, reflux, burping, reduced appetite, fatigue and dizziness are common. Most effects are mild to moderate and ease over time.
What is "Ozempic face"?
"Ozempic face" is a lay term, not a diagnosis or a listed side effect. It describes the hollower, more lined face that can follow rapid weight loss of any cause, because facial fat is lost faster than skin can adapt. A 2025 systematic review of 23 studies found no evidence that semaglutide specifically targets facial fat. In Australia Ozempic is registered for type 2 diabetes, so large weight changes are not its intended effect.
How long do Ozempic side effects last?
The Product Information says gastrointestinal effects are most often reported in the first months of treatment and are usually short-lived. They commonly flare for a few days after each dose increase, then settle. Effects that persist, worsen or stop you eating and drinking should be reported to your doctor.
Can Ozempic cause pancreatitis?
Acute pancreatitis is an uncommon listed reaction: 0.3% of people on semaglutide versus 0.2% on comparator in phase 3 trials, and 0.5% versus 0.6% in the two-year cardiovascular trial. The PI advises stopping if pancreatitis is suspected and not restarting if confirmed. Severe, persistent abdominal pain, sometimes spreading to the back, needs urgent assessment.
Does Ozempic cause low blood sugar?
On its own, no severe hypoglycaemia was seen in trials. The risk rises when Ozempic is combined with a sulfonylurea (severe hypoglycaemia in 1.2% of people) or insulin (1.5%). The PI notes the risk can be lowered by adjusting the dose of those medicines when Ozempic is started; that adjustment is the prescriber's decision.
Does Ozempic affect your eyes?
Two separate issues. In people with type 2 diabetes who already have retinopathy and use insulin, rapid glucose improvement was linked to more retinopathy complications in a two-year trial (3.0% vs 1.8%); the PI advises monitoring. Separately, in July 2026 the TGA updated all GLP-1 medicines for NAION, a rare optic nerve condition causing sudden painless vision loss. Any sudden vision change needs urgent attention.
Is Ozempic linked to thyroid cancer?
In two-year studies, rats and mice given semaglutide developed thyroid C-cell tumours, a known rodent class effect of GLP-1 medicines. The Australian PI states that relevance to humans is unknown and does not list thyroid cancer as a contraindication. A personal or family history of medullary thyroid cancer is worth raising with your prescriber.
How do I report an Ozempic side effect in Australia?
Tell your doctor or pharmacist, who can report for you, or report directly to the TGA at tga.gov.au/reporting-problems. Consumers and health professionals can both report; reports feed the Database of Adverse Event Notifications and help identify new safety signals.
Primary sources checked for this page.
- TGA ARTG 315107: Ozempic Product Information and Consumer Medicine Information (PI revised 7 May 2024; sections 4.2, 4.3, 4.4, 4.6, 4.8 and 5.3).
- TGA Australian Public Assessment Report: Ozempic (semaglutide).
- healthdirect: Ozempic medicine information, additional monitoring and reporting.
- TGA safety update, 3 June 2025: new warnings on anaesthesia and deep sedation.
- TGA safety update, 23 July 2026: GLP-1 RAs and NAION.
- TGA: report an adverse event or safety problem.
- TGA media release: GLP-1 RA compounding changes from 1 October 2024.
- Daneshgaran, Shauly and Gould, "Ozempic Face" in Plastic Surgery: a systematic review, Aesthetic Surgery Journal Open Forum 2025.
- Novo Nordisk Australia: Ozempic removed from TGA shortage list, 18 July 2025.
- PBS Schedule item 12075M: semaglutide (Ozempic), type 2 diabetes.
Editorial method: the TGA-approved Australian Product Information and TGA safety updates were the primary sources and are quoted or closely paraphrased; peer-reviewed literature was used only for the "Ozempic face" section; healthdirect for helpline and reporting pathways. Percentages are those published in the PI, not independent estimates. Named clinical review is pending; this page has not yet been reviewed by an independent clinician. See the Preptide editorial policy for corrections and review standards.
Important: General information only, not medical advice. Wegovy and Ozempic are registered trademarks of Novo Nordisk; Mounjaro is a registered trademark of Eli Lilly. Preptide is independent and is not affiliated with, endorsed by or sponsored by either company. Preptide is food, not medication, and does not prescribe, sell, recommend or promote prescription medicines. Talk to your doctor or pharmacist about any medicine. In an emergency call 000. Read our editorial policy and Health Acknowledgement.