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Symptoms, Side Effects, and What to Watch For For people currently taking semaglutide or considering it for an approved indication, the most common side effects reported in clinical trials include: Nausea (most common, particularly when starting or increasing the dose) Vomiting Diarrhea Constipation Abdominal pain Decreased appetite More serious but less common risks include pancreatitis, gallbladder disease, increased heart rate, kidney problems related to dehydration, and in rare cases thyroid tumors (seen in animal studies