Semaglutide is a prescription medication that is sold under the brand names Ozempic (for type 2 diabetes) and Wegovy (for weight loss). While highly effective, it can cause common gastrointestinal side effects, including constipation. This article will explore why it causes digestive symptoms and what you can do to prevent and treat constipation.

Does Ozempic Cause Constipation?

How Semaglutide Slows Digestion

Yes, Ozempic can cause constipation in some people. The active ingredient in Ozempic, semaglutide, mimics a natural hormone in the body called GLP-1. It causes reduced gut motility, delayed gastric emptying, and slowed digestion.

This means Ozempic and other similar drugs affect the stomach’s ability to push food out to the intestines and the rate of digesting food. As a result, food stays in the digestive tract longer, leading to fewer bowel movements (constipation) as a side effect.

How Common Is Constipation on Ozempic?

While constipation is one of the common side effects of Ozempic, not everyone taking the medicine develops this symptom. During clinical trials, only 3 to 5% of patients taking Ozempic reported constipation.

Rates of constipation are higher with Wegovy (up to 24%) and Rybelsus (5–6%), since they use different doses or forms of semaglutide. The maintenance dose of Wegovy is 1.7 mg or 2.4 mg per week, compared to Ozempic, which has a maintenance dose of 1 mg or 2 mg per week.

Who Is At Higher Risk of Ozempic Constipation?

People who are at a higher risk of constipation on Ozempic include:

Older adults
Those with a history of chronic constipation
People taking higher doses of Ozempic
Those who have inadequate fiber intake or are dehydrated

Common Symptoms of Ozempic Constipation

1. Fewer Bowel Movements

Constipation typically means fewer than three bowel movements a week. Infrequent bowel movements (less than three a week) are therefore the main symptom of Ozempic constipation.

2. Hard, Dry Stools

People with constipation due to any cause often have dry, hard stools that are difficult or painful to pass.

3. Bloating or Discomfort

Backed-up food and waste in the gastrointestinal tract can lead to bloating, abdominal distension, and discomfort in people experiencing constipation during Ozempic therapy.

Note: There’s no official normal frequency for bowel movements. Experts say a healthy frequency can range anywhere from three times a day to three times a week. If there’s a change in your bowel movement frequency while on this medication, this points to Ozempic diarrhea or Ozempic constipation.

How Long Does Ozempic Constipation Last?

Semaglutide constipation usually lasts for a few weeks. Healthcare providers start patients on a low dose of semaglutide and gradually increase the dose, which gives the body time to adjust to the medicine.

Most patients report gastrointestinal symptoms, including constipation, when taking semaglutide during the first 8 to 12 weeks of treatment, particularly during dose escalation.

When To Call A Doctor

Contact your healthcare provider in the following instances:

If you have severe or persistent constipation on Ozempic.
If you are unable to pass gas or have bowel movements. This can be a sign of serious side effects, including a condition called gastroparesis (stomach paralysis) or bowel obstruction.
If constipation is accompanied by severe abdominal pain, nausea, vomiting, bloating, feeling full after eating small amounts of food, and acid reflux.
If constipation is accompanied by rectal bleeding.

Similarly, if you have severe or persistent diarrhea on Ozempic, tell your doctor immediately, as this can put you at risk of dehydration. Signs of dehydration may include excessive thirst, dry mouth, decreased urination, and dark yellow urine.

Managing Constipation On Ozempic

Lifestyle Tips

Most people can get constipation relief on Ozempic with lifestyle changes, including:

A high-fiber diet adds bulk to stool and makes it easier to pass.
Increased hydration softens stool, making it easier to pass through the gastrointestinal tract and preventing dehydration.
Regular exercise helps stimulate the muscles in the intestines, facilitating the movement of food and waste through the digestive system.

Over-The-Counter Treatments

If you’re experiencing occasional or mild constipation while taking Ozempic, over-the-counter remedies like stool softeners and laxatives may help. They work by drawing more water into the stool and/or increasing contractions of intestinal muscles. Examples of OTC stool softeners and laxatives include:

Osmotic laxatives like magnesium hydroxide, polyethylene glycol, Milk of Magnesia, and MiraLAX.
Bulk-forming laxatives such as Citrucel, FiberCon, Benefiber, and Metamucil.
Stool softeners include docusate sodium, docusate calcium, and Colace, as well as Surfak.
Stimulant laxatives, such as Dulcolax, senna/sennosides, and Senokot (Bisacodyl).
Rectal suppositories like Bisacodyl and Dulcolax.

Dietary Adjustments

You may get relief from constipation on Ozempic by making changes to your dietary habits:

Eat smaller, more frequent meals.
Eat slowly and chew food thoroughly.
Continue eating if you’re constipated, but avoid foods that can worsen constipation (for example, processed foods, low-fiber foods).
Avoid foods that can cause discomfort due to excess gas and bloating, for example, cruciferous vegetables and fermented foods.

Medication Changes

If the above-listed lifestyle changes and OTC medicines do not relieve constipation caused by Ozempic, your doctor may lower the dose of Ozempic or switch you to alternative treatments.

Safety Considerations

Ozempic and other semaglutide products (Wegovy, Rybelsus) may not be safe for everyone. Tell your healthcare provider if you have a medical history of the following conditions:

Thyroid cancer (personal or family history).
Gastroparesis (stomach paralysis) or other stomach problems.
Bowel obstruction (intestinal blockage).
Chronic kidney disease or kidney failure.
Diabetic retinopathy (eye problems).
Gallbladder problems.
Pancreatitis.
Hypoglycemia (low blood sugar) - this is more likely in people taking other medications for diabetes management.
Allergic reactions to semaglutide or other similar drugs (GLP-1s).
Mental health problems, including suicidal behavior or ideation.
Pregnancy or breastfeeding