Can Ozempic Give You Diarrhea? Understanding This Common Side Effect

October 13, 2025 •

4 min read

In clinical trials, diarrhea was reported by approximately 8% to 9% of people taking Ozempic [1.3.1, 1.3.4]. So, can Ozempic give you diarrhea? Yes, it is one of the most common gastrointestinal side effects of this medication, often occurring when starting treatment or increasing the dose [1.2.2].

Quick Summary

Diarrhea is a frequent and well-documented side effect of Ozempic (semaglutide). It typically occurs as the body adjusts to the medication, especially during initial use or after dose increases. Management involves diet, hydration, and medical consultation.

Key Points

Diarrhea is Common: Yes, Ozempic can give you diarrhea; it is one of the most frequently reported gastrointestinal side effects, affecting about 8-9% of users in clinical trials [1.3.1, 1.3.4].
Mechanism: Diarrhea is primarily caused by Ozempic slowing down digestion and altering how the intestines absorb nutrients and water [1.2.5, 1.2.6].
Timing: The side effect is most common when starting the medication or after a dose increase and typically resolves within a few weeks as the body adapts [1.2.2, 1.2.7].
Management: Managing symptoms involves staying hydrated, eating bland, low-fat foods, and avoiding triggers like spicy food, caffeine, and alcohol [1.4.3, 1.4.6].
Medical Consultation: If diarrhea is severe, persistent, or accompanied by signs of dehydration, it is crucial to consult a healthcare provider [1.2.1].
OTC Options: Over-the-counter medications like loperamide (Imodium) may help, but should only be used after consulting with a doctor [1.4.3].
Serious Risks: Severe, unmanaged diarrhea can lead to dehydration, which in turn can cause acute kidney injury, a serious but rare side effect of Ozempic [1.2.7, 1.7.3].

What is Ozempic and How Does It Work?

Ozempic, with the active ingredient semaglutide, is an injectable prescription medication approved by the FDA to improve blood sugar levels in adults with type 2 diabetes [1.2.3, 1.2.6]. It is also prescribed to reduce the risk of major cardiovascular events like heart attacks and strokes in adults with both type 2 diabetes and heart disease [1.2.3]. Ozempic belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists [1.5.7]. It works by mimicking the GLP-1 hormone, which stimulates insulin secretion, suppresses glucagon production, and significantly slows down gastric emptying—the rate at which food leaves the stomach [1.5.4, 1.5.6]. This delayed digestion helps regulate blood sugar and promotes a feeling of fullness, which is why weight loss is a common effect [1.5.6].

Why Does Ozempic Cause Diarrhea?

The precise mechanisms by which Ozempic causes diarrhea are not fully understood, but it's believed to be linked to its effects on the digestive system [1.2.1, 1.2.5]. Several factors may contribute:

Slowed Digestion: By delaying gastric emptying, food remains in the digestive system for longer. This can alter gut motility and how the intestines absorb nutrients and water, potentially leading to diarrhea [1.2.5, 1.2.6].
Gastrocolic Reflex: The prolonged stretching of the stomach can activate the gastrocolic reflex, which stimulates muscle movement in the colon. An overactive reflex can increase bowel activity and cause diarrhea [1.3.5, 1.2.7].
Changes in Gut Microbiota: The medication may alter the balance of bacteria in the gut, which can affect fluid absorption in the intestines [1.2.1].
Bile Acid Processing: Some research suggests Ozempic may alter bile acid processing, which can lead to gut irritation and diarrhea [1.3.7].

Diarrhea is most common when first starting Ozempic or after a dose increase, as the body needs time to adjust [1.2.2]. While many cases are mild, severe or persistent diarrhea can lead to dehydration and may require medical attention [1.2.1, 1.2.7].

Managing Diarrhea While on Ozempic

If you experience diarrhea while taking Ozempic, several strategies can help manage the symptoms. It's crucial to consult your healthcare provider before making significant changes or starting over-the-counter medications [1.2.1].

Dietary Adjustments

Eat Bland Foods: The BRAT diet (bananas, rice, applesauce, toast) is often recommended because these foods are easy to digest and can help firm up stool [1.4.1]. Other gentle options include soups, boiled vegetables, lean proteins, and crackers [1.2.1, 1.2.2].
Eat Smaller, More Frequent Meals: Large meals can overload the digestive system. Eating smaller portions throughout the day can reduce this pressure [1.4.1].
Avoid Trigger Foods: Certain foods can aggravate diarrhea. It's often helpful to avoid high-fat, greasy, or fried foods, spicy foods, sugary drinks, alcohol, caffeine, and high-fiber foods like raw vegetables and nuts [1.2.2, 1.4.3].

Hydration is Key

Diarrhea leads to fluid loss, making dehydration a significant risk. Severe dehydration can even contribute to kidney injury [1.2.7].

Drink Plenty of Fluids: Sip water throughout the day. Clear broths and electrolyte-rich drinks can also help replenish lost fluids and minerals [1.4.3, 1.4.6].
Monitor Hydration: A good indicator of hydration is urine color; it should be pale yellow or clear [1.4.5].

Other Management Strategies

Talk to Your Doctor: If diarrhea is severe or doesn't improve, contact your healthcare provider. They may adjust your dosage, slow down the rate of dose increases, or recommend a temporary break from the medication [1.2.7, 1.4.4].
Over-the-Counter (OTC) Medications: Medications like loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol) can provide relief by slowing down the intestines or coating the stomach lining [1.4.3]. Always consult your doctor before using OTC remedies, as they can sometimes interact with Ozempic's effects [1.4.3].
Probiotics: While not definitively proven to help with Ozempic-induced diarrhea, some sources suggest probiotics may help restore a healthy gut bacterial balance [1.4.1, 1.4.3]. Strains like Saccharomyces boulardii have been noted for effectiveness against general diarrhea [1.4.5].

Comparison with Other GLP-1 Medications

Diarrhea and other gastrointestinal issues are common across most GLP-1 receptor agonists, including Wegovy (a higher-dose semaglutide) and Mounjaro (tirzepatide) [1.6.6].


Medication	Active Ingredient	Common GI Side Effects	Note
Ozempic	Semaglutide	Nausea, vomiting, diarrhea, constipation, abdominal pain [1.2.3]	Side effects may be more frequent when starting or increasing the dose [1.6.7].
Wegovy	Semaglutide	Nausea, diarrhea, vomiting, constipation, abdominal pain [1.7.4]	Prescribed at a higher dose than Ozempic, potentially leading to a higher incidence of side effects [1.6.7, 1.7.4].
Mounjaro	Tirzepatide	Nausea, diarrhea, decreased appetite, vomiting, constipation [1.6.3]	Acts on both GLP-1 and GIP receptors. Some studies suggest a potentially milder side effect profile compared to semaglutide [1.6.1, 1.6.4].

Conclusion

Diarrhea is a known and common side effect of Ozempic, directly related to how the medication affects the digestive system. For most users, this side effect is mild and temporary, typically improving within a few weeks as the body adjusts [1.2.7]. However, it can be bothersome and, in rare cases, severe. Management strategies focusing on diet, hydration, and careful dose titration under a doctor's supervision are effective in mitigating symptoms. Open communication with a healthcare provider is essential to ensure the benefits of Ozempic outweigh any discomfort from side effects. Find out if you're eligible for a weight care program that can help manage side effects.

Frequently Asked Questions

For most people, diarrhea from Ozempic is temporary. It often occurs when starting the medication or increasing the dose and usually resolves within a few days to a few weeks as your body gets used to the drug [1.2.2, 1.2.7].

Stick to bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet). Also beneficial are lean proteins, soups, and boiled vegetables. Avoid greasy, spicy, high-fiber, and sugary foods [1.2.2, 1.4.1].

Yes, increasing your dose of Ozempic can trigger a new or worsening episode of diarrhea. This is a common occurrence as your body adjusts to the higher dosage, and it typically resolves within a few days [1.4.3].

While usually a mild and temporary side effect, severe or persistent diarrhea can lead to dehydration and, in rare cases, kidney problems [1.2.7, 1.7.3]. If you have severe abdominal pain, blood in your stool, or signs of dehydration, contact your doctor immediately [1.2.1].

Over-the-counter anti-diarrheal medications like loperamide (Imodium) may help manage symptoms. However, it is essential to consult your healthcare provider before taking any new medication to ensure it is safe and appropriate for you [1.4.2, 1.4.3].

No, not everyone experiences this side effect. Clinical studies show that diarrhea affects roughly 8% to 9% of patients, though some reports indicate it could be higher. Nausea is the most common side effect [1.3.1, 1.7.4].

Other common gastrointestinal side effects of Ozempic include nausea, vomiting, abdominal pain, and constipation. Nausea is the most frequently reported side effect [1.2.3, 1.7.6].