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Ozempic Side Effects (Canada)

semaglutideNovo Nordisk

OZEMPIC® is indicated for the once-weekly treatment of adult patients with type 2 diabetes to improve glycemic control.

About this page. This page summarizes information from Health Canada's product monograph for Ozempic on adverse reactions, warnings, and special populations. It is for informational purposes only and is not a substitute for advice from your prescriber or pharmacist. Always discuss side effects and warnings with your healthcare provider. Read our full medical disclaimer →

Common side effects

Very common (≥10%)

Gastrointestinal disorders

  • Nausea[1]Section 8.2, Table 2, page 14
  • Diarrhea[1]Section 8.2, Table 2, page 14

Common (1–10%)

Nervous system disorders

  • Dizziness[1]Section 8.2, Table 2, page 14

General disorders and administration site conditions

  • Fatigue[1]Section 8.2, Table 2, page 14

Hepatobiliary disorders

  • Cholelithiasis[1]Section 8.2, Table 2, page 14

Investigations

  • Lipase increased[1]Section 8.2, Table 2, page 14
  • Amylase increased[1]Section 8.2, Table 2, page 14

Metabolism and nutrition disorders

  • Decreased appetite[1]Section 8.2, Table 2, page 14

Gastrointestinal disorders

  • Vomiting[1]Section 8.2, Table 2, page 14
  • Abdominal pain[1]Section 8.2, Table 2, page 14
  • Constipation[1]Section 8.2, Table 2, page 14
  • Dyspepsia[1]Section 8.2, Table 2, page 14
  • Abdominal distension[1]Section 8.2, Table 2, page 14
  • Gastro-esophageal reflux disease[1]Section 8.2, Table 2, page 14
  • Eructation[1]Section 8.2, Table 2, page 14
  • Gastritis[1]Section 8.2, Table 2, page 14
  • Flatulence[1]Section 8.2, Table 2, page 14

Uncommon (0.1–1%)

Cardiovascular disorders

  • Increased heart rate (tachycardia, sinus tachycardia)[2]Section 8.3, page 17

Immune system disorders

  • Anaphylactic reaction[2]Section 8.3, page 17

Nervous system disorders

  • Dysgeusia[2]Section 8.3, page 17

General disorders and administration site conditions

  • Injection site reactions[2]Section 8.3, page 17

Special populations

Pregnancy

Studies in animals have shown reproductive toxicity. No clinical trials in pregnant women have been conducted. Therefore, semaglutide should not be used during pregnancy. Women of childbearing potential are recommended to use contraception when treated with semaglutide. If a patient wishes to become pregnant, or pregnancy occurs, semaglutide should be discontinued. Semaglutide should be discontinued at least 2 months before a planned pregnancy due to the long half-life.[8]Section 7.1.1, page 11

Breastfeeding

It is not known whether OZEMPIC® is excreted in human milk. Semaglutide was present in the milk of lactating rats. Because many drugs are excreted in human milk and the effects on the infant are unknown, OZEMPIC® should not be used for the duration of breastfeeding.[9]Section 7.1.2, page 11

Pediatrics

Safety and efficacy of OZEMPIC® have not been studied in pediatric patients. OZEMPIC® is not indicated for patients with Type 2 Diabetes who are under 18 years of age.[10]Section 7.1.3, page 12

Geriatrics

In the pool of glycemic control trials, 1015 (24.7%) OZEMPIC®-treated patients were 65 years of age and above. No overall differences in safety or efficacy were detected between these patients and younger patients, but greater sensitivity of some older individuals cannot be ruled out due to limited data in geriatric patients.[11]Section 7.1.4, page 12

Renal Insufficiency

In the glycemic control trials, 1108 (35.2%) OZEMPIC®-treated patients had mild renal impairment and 83 (2.6%) had moderate renal impairment at baseline. Experience with OZEMPIC® in patients with end stage kidney disease is very limited. The safety profile for patients with chronic kidney disease demonstrated a higher frequency of serious adverse events, fatal adverse events, severe adverse events, and discontinuations due to adverse events for both semaglutide and placebo.[12]Section 7.1.5, page 12

Hepatic Insufficiency

The safety and efficacy of OZEMPIC® in patients with hepatic insufficiency has not been studied. Therefore, OZEMPIC® should be used with caution in this patient population.[13]Section 7.1.6, page 13

Other warnings and precautions

Cardiovascular: Heart Rate Increase and PR Interval Prolongation

OZEMPIC® causes an increase in heart rate. Caution should be observed in patients who have cardiac conditions that might be worsened by an increase in heart rate, such as tachyarrhythmias. OZEMPIC® also causes a prolongation of the PR interval of the electrocardiogram. Caution should be observed in patients with pre-existing conduction system abnormalities (e.g., marked first-degree AV block or second- or third-degree AV block) or a history of rhythm disturbances. There is no therapeutic experience in patients with congestive heart failure NYHA class IV.[4]Section 7, page 9

Hypoglycemia with Concomitant Use of Insulin Secretagogues or Insulin

Patients receiving OZEMPIC® in conjunction with sulfonylurea or basal insulin may have an increased risk of hypoglycemia. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogues) or insulin when initiating treatment with OZEMPIC®.[4]Section 7, page 9

Gastrointestinal

Use of GLP-1 receptor agonists may be associated with severe gastrointestinal disease (ileus). Events of delayed gastric emptying, dysgeusia, intestinal obstruction, and ileus have been reported in the post-marketing database with an unknown frequency. Semaglutide-treated patients with gastroparesis may experience more serious or severe gastrointestinal adverse events. Semaglutide should be used with caution in these patients.[5]Section 7, page 10

Hepatic/Biliary/Pancreatic: Pancreatitis and Acute Gall Bladder Disease

Acute pancreatitis has been observed with the use of GLP-1 receptor agonists. In glycemic control trials, acute pancreatitis was confirmed by adjudication in 7 OZEMPIC®-treated patients (0.3 cases per 100 patient years) versus 3 in patients treated with another GLP-1 receptor agonist. Patients should be informed of the characteristic symptoms of acute pancreatitis. If pancreatitis is suspected, OZEMPIC® should be discontinued; if confirmed, OZEMPIC® should not be restarted. Consider anti-diabetic therapies other than OZEMPIC® in patients with a history of pancreatitis. Acute events of gallbladder disease such as cholelithiasis or cholecystitis have been reported in GLP-1 receptor agonist trials and post-market. If cholelithiasis or cholecystitis are suspected, gallbladder studies and appropriate clinical follow-up are indicated.[5]Section 7, page 10

Hypersensitivity

Serious hypersensitivity reactions, including anaphylaxis, may occur with any GLP-1 receptor agonist, including OZEMPIC®. If a hypersensitivity reaction occurs, the patient should discontinue OZEMPIC® and promptly seek medical advice. Do not use in patients with a previous hypersensitivity to OZEMPIC®. Caution should be exercised with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist because it is unknown whether such patients will be predisposed to anaphylaxis with OZEMPIC®.[5]Section 7, page 10

Diabetic Retinopathy Complications and NAION

In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with OZEMPIC® (3.0%) compared to placebo (1.8%). Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with a history of diabetic retinopathy should be monitored for progression. Data from epidemiological studies may indicate an increased risk of non-arteritic anterior ischaemic optic neuropathy (NAION) with a very rare frequency during treatment with semaglutide. Patients reporting a sudden loss of vision should be urgently referred for ophthalmological examination and treatment with semaglutide should be discontinued if NAION is confirmed.[6]Section 7, page 11

Perioperative Considerations: Aspiration Risk

OZEMPIC® delays gastric emptying. Pulmonary aspiration has been reported in patients receiving GLP-1 receptor agonists undergoing general anaesthesia or sedation. This should be considered prior to such procedures.[6]Section 7, page 11

Renal Insufficiency

Use of GLP-1 receptor agonists may be associated with gastrointestinal adverse reactions. This should be considered when treating patients with impaired renal function as nausea, vomiting, and diarrhea may cause dehydration which could cause a deterioration of renal function. In patients treated with GLP-1 receptor agonists, there have been post-marketing reports of acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis. Monitor renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions.[6]Section 7, page 11

Post-market reactions

Gastrointestinal disorders

The following gastrointestinal reactions have been reported during post-approval use of OZEMPIC®: pancreatitis, delayed gastric emptying, intestinal obstruction (grouped term covering intestinal obstruction, ileus, small intestinal obstruction).[3]Section 8.5, page 17

Renal and urinary disorders

The following renal reactions have been reported during post-approval use of OZEMPIC®: acute kidney injury, renal impairment and renal failure.[3]Section 8.5, page 17

Other post-market reactions

The following additional reactions have been reported during post-approval use of OZEMPIC®: cholecystitis (hepatobiliary); dehydration, diabetic ketoacidosis and ketosis (metabolism and nutrition); hypoglycaemic unconsciousness, headache (nervous system); Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) (ocular); angioedema (skin and subcutaneous tissue). Because these events are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure.[3]Section 8.5, page 17

Talk to your pharmacist or prescriber

Side effects and warnings must be assessed in the context of your personal health history. Discuss any concerns about adverse reactions with your prescriber or pharmacist. Use our pharmacy comparison tool to find and connect with a Canadian pharmacy that carries Ozempic.

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Sources

  1. Health Canada Product Monograph — Section 8.2, Table 2, page 14
  2. Health Canada Product Monograph — Section 8.3, page 17
  3. Health Canada Product Monograph — Section 8.5, page 17
  4. Health Canada Product Monograph — Section 7, page 9
  5. Health Canada Product Monograph — Section 7, page 10
  6. Health Canada Product Monograph — Section 7, page 11
  7. Health Canada Product Monograph — Section 3, page 5
  8. Health Canada Product Monograph — Section 7.1.1, page 11
  9. Health Canada Product Monograph — Section 7.1.2, page 11
  10. Health Canada Product Monograph — Section 7.1.3, page 12
  11. Health Canada Product Monograph — Section 7.1.4, page 12
  12. Health Canada Product Monograph — Section 7.1.5, page 12
  13. Health Canada Product Monograph — Section 7.1.6, page 13

Last reviewed May 14, 2026 against the Health Canada Product Monograph dated April 14, 2026. View monograph →

Related information

Ozempic — Dosing Guide

/reference/dosing/ozempic

Ozempic — Injection & Storage

/reference/injection-storage/ozempic

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