Nausea on a GLP-1: what helps and when to call your doctor

Nausea means an upset stomach, and it is common on GLP-1 medicines, most of all when you start or your dose goes up. It often eases as you stay on the same dose, and smaller meals can help, but some signs mean you should call your provider today or get help now.

Why it happens, and when

Nausea, throwing up, loose stools and constipation can all happen on these medicines. They are most likely while you are starting the medicine or raising the dose. For some medicines, they became less common over time. There is no set week when nausea has to start or stop.

In three studies of the weekly Wegovy shot, 44 in 100 people had nausea, compared with 16 in 100 who got a placebo, which has no medicine in it. These are group numbers, not a prediction for you.

Nausea also has other causes, like a stomach bug, a migraine or pregnancy, so it is not always the medicine.

What can help at home

Eat smaller meals.
Stop eating when you feel comfortably full.
Skip very large or fatty meals for now.
Try not to go a long time without food. Small, regular meals and sips of fluid can work better than one big meal later.
If a meal feels like too much, try soft foods, yogurt, eggs, soup or a nutrition drink.
If drinking is hard, take small sips often. An oral rehydration drink can also help.
Jot down what you ate, how much, your dose and how much you drank. It can show a pattern to talk over with your care team.

Talk with your prescriber before a dose goes up

If your dose is due to go up and the nausea is still bothering you, tell your prescriber first. Your prescriber can decide to wait longer before the next step; the label for the Wegovy shot, for example, lets your prescriber wait four more weeks. Also tell them if the nausea does not go away.

Call your provider today if

You have severe belly pain, or belly pain that will not go away, especially if it spreads to your back. This can be a sign of a problem with your pancreas.
You cannot keep fluids down.
You have very dark urine, a dry mouth, or dizziness when you stand that does not pass. These can be signs that you are losing too much fluid.
You keep throwing up, or the nausea gets worse each day instead of better.
You have a fever with belly pain or throwing up, pain in the upper right side of your belly, or yellow skin or eyes. These can be signs of a gallbladder problem.
You take insulin or a sulfonylurea and feel shaky or sweaty. Low blood sugar is more likely with those medicines.
You could be pregnant. Your prescriber needs to know about your medicine, and pregnancy can also cause nausea.

If you cannot reach your care team today, go to urgent care. If things get worse before you are seen, get emergency care or call your local emergency number.

Get help now if

Call your local emergency number, or get to emergency care now, if:

You throw up blood, or vomit that looks like coffee grounds.
You have trouble breathing, or your face or throat swells.
You faint, you feel confused, or you have peed very little or not at all today.
Your belly is swollen and you cannot pass stool or gas.
Your skin is cold, pale or blotchy, or your heart is racing, along with any of the signs above.

If someone is with you, tell them what is going on so you are not handling it alone.

Your provider knows you best

This page shares general information to talk over with your own provider. It does not diagnose you or change your treatment. If you think you may be having an emergency, call your local emergency number.

Sources

The health facts on this page come from these sources.

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