Managing Side Effects of Incretin-based Medications (Including Wegovy and Mounjaro)

Incretin-based medicines are prescribed to help people living with obesity lose weight or lower blood glucose levels in type 2 diabetes (T2D). The most recently developed incretin medications include GLP-1 receptor agonists like Wegovy (Semaglutide) and the combination therapy, GIP and GLP-1 receptor-agonist, Mounajro (Tirzepatide). 

All medicines have the potential to cause unwanted side effects. Some side effects are more commonly experienced, whereas others are very rare. If your clinician has prescribed these medications, it’s because they consider the potential health benefits to outweigh potential negative symptoms. They are here to support you, so please let them know if you think you may be experiencing any unwanted effects from your medication. 

The table below contains some of the most common side effects associated with the medications mentioned above. You can find a complete list in the manufacturer's information leaflet (also known as a Patient Information Leaflet or PIL) supplied with your medicine. 

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Very common side effects (affect more than 1 in 10 people)

• Nausea (feeling sick)
• Diarrhoea or constipation
• Headache
• Decreased appetite
• Low blood sugar (hypoglycaemia) can occur in individuals with type 2 diabetes treated with insulin or sulphonylureas: some text
  • Symptoms include feeling shaky or anxious, sweating, looking pale, feeling hungry, a feeling that your heart is pounding (palpitations), and feeling dizzy

Common side effects (affect less than 1 in 10 people)

• Vomiting
• Indigestion, bloating, wind 
• Mild abdominal pain
• Worsening of existing diabetes-related vision problems
• Feeling dizzy or lightheaded

It’s important to note that these symptoms often improve as your body adjusts to the medication. This is one of the reasons that, especially if you have not been treated with an incretin medication before, your doctor will start you on a lower dose and gradually increase it over time. Despite this, sometimes side effects can be troublesome. If side effects persist or impact your daily activities and functioning, make sure to speak with your clinician, who can advise on the best course of action.

Here are some tips to reduce your chances of experiencing or controlling these unwanted symptoms:

• Avoid rich or spicy meals.
• Stick to simple food preparations and avoid big portions.
• Increase your vegetable and fibre intake.
• Drink plenty of water to replace lost fluids and avoid possible dehydration. Aim for at least 2.5 litres of water daily.
• If you are living with T2D, make sure to attend your routine eye examinations and discuss low blood sugar management with your clinician.

How to manage nausea (feeling sick): If you are struggling with severe nausea, then try not to worry too much about following the nutritional guide strictly, until you are feeling better. Bland foods like bananas, rice and toast can be the most easy to tolerate when you’re not feeling well. It is important to try to eat just small amounts, as having an empty stomach can make the nausea worse. For this reason, should you suffer with nausea, avoid time restricted eating until the feeling subsides and you’re able to tolerate a full meal again. 

If you are having heartburn along with nausea, over the counter remedies like gaviscon can be helpful after meals and before bedtime. If you think your symptoms are bad enough to need this, please do make sure you reach out to your clinician so they can assess you fully and advise you on the best course of action.

When to stop the medication and seek urgent medical attention:

• Rash, itching, swelling or a change to your breathingsome text
  • These symptoms may be suggestive of an allergic reaction 
• Severe abdominal pain, persistent sickness or vomitingsome text
  • Which can be suggestive of inflammation of the pancreas (pancreatitis), blockage of your bowels (bowel obstruction) and delayed stomach emptying (gastroparesis).

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