Scientific deep-dive
Wegovy Pill Side Effects: What the Tablet Label Reports
The Wegovy pill's side effects match the shot's: nausea, diarrhea, vomiting, constipation. The label adds one: 5% on the 25 mg tablet reported dysesthesia, an altered skin sensation, against none on placebo.
The Wegovy pill causes the same kinds of side effects as the Wegovy shot: mostly nausea, diarrhea, vomiting, constipation and stomach pain. The FDA label says the tablet's common side effects were “similar” to the injection's.[1] It adds one thing worth knowing before you start: in the tablet trial, 5% of people on the 25 mg pill reported dysesthesia, an altered or burning skin sensation, against none on placebo.[1]
The most common Wegovy pill side effects
The tablet was tested for safety in one 64-week trial of 204 adults taking 25 mg a day. All had obesity, or overweight plus at least one health condition linked to weight, and none had type 2 diabetes.[1] The label does not print a separate symptom-by-symptom table for it. It says the types and frequency of common reactions were similar to the injection's table, which is reproduced below.[1]
| Side effect | Wegovy | Placebo |
|---|---|---|
| Nausea | 44% | 16% |
| Diarrhea | 30% | 16% |
| Vomiting | 24% | 6% |
| Constipation | 24% | 11% |
| Abdominal pain | 20% | 10% |
| Headache | 14% | 10% |
| Fatigue | 11% | 5% |
| Indigestion (dyspepsia) | 9% | 3% |
| Dizziness | 8% | 4% |
| Bloating (abdominal distension) | 7% | 5% |
| Belching (eructation) | 7% | under 1% |
| Flatulence | 6% | 4% |
| Acid reflux (GERD) | 5% | 3% |
| Hair loss | 3% | 1% |
The OASIS 4 trial gives one overall number for the pill: stomach and gut side effects of any kind were reported by 74.0% of people on 25 mg oral semaglutide and 42.2% on placebo.[2] For the injection, the label's equivalent figure is 73% against 47%.[1] For how long each one usually lasts, see the side effect timeline, and for the injection's own page, Wegovy side effects.
Wegovy pill vs. injection: side effects side by side
Where the label does give a tablet-specific figure, it can be set against the matching injection figure from the same document. The two come from different trials with different people, so treat small gaps as noise rather than a verdict on which form is gentler.[1]
| Measure | Pill 25 mg vs placebo | Injection 2.4 mg vs placebo |
|---|---|---|
| Any stomach or gut side effect | 74.0% vs 42.2% | 73% vs 47% |
| Severe stomach or gut side effect | 2% vs 0% | 4.1% vs 0.9% |
| Stopped treatment for any side effect | 6.9% vs 5.9% | 6.8% vs 3.2% |
| Stopped for a stomach or gut side effect | 3.4% vs 2% | 4.3% vs 0.7% |
| Gallstones (cholelithiasis) | 2.5% vs 1% | 1.6% vs 0.7% |
| Dysesthesia (altered skin sensation) | 5% vs 0% | 2% vs 1% |
Two figures stand out. Gallstones were reported a little more often on the tablet than on the injection in their respective trials, and dysesthesia was reported in 5% on the tablet against 2% on the 2.4 mg injection. The label also says heart-rate findings in the tablet trial were similar to the injection's, where resting heart rate rose by 1 to 4 beats per minute on average.[1] Whether the pill works as well as the shot is a separate question, covered in is the pill as good as the shot.
Dysesthesia: the skin side effect on the Wegovy pill
Dysesthesia is an abnormal sensation in the skin. The label groups it with “related events of altered skin sensations including paresthesia, pain of skin, sensitive skin, and burning skin sensation.”[1] In plain terms: tingling, burning, or skin that hurts or feels unusually sensitive to touch.
“The incidence of dysesthesia with WEGOVY increased with increasing dosage and drug levels in the blood.” … “In a clinical trial with WEGOVY 25 mg tablets, 5% of WEGOVY-treated patients and no placebo-treated patients reported dysesthesia adverse reactions.”— Wegovy FDA label, Section 6.1
The label's most detailed data on it come from the higher 7.2 mg injection, where 22% reported it. In that group most people whose dose was paused, lowered or stopped recovered, and events resolved faster when an action was taken than when none was.[1] The label does not report recovery data for the tablet. If you notice new burning or tingling skin on the pill, tell your prescriber rather than waiting it out.
When Wegovy pill side effects start and ease
The pill starts low and steps up every 30 days. According to the label, that slow climb is there to lower the chance of stomach and gut side effects.[1]
| Days | Daily dose | Stage |
|---|---|---|
| 1 to 30 | 1.5 mg | Starting dose |
| 31 to 60 | 4 mg | Escalation |
| 61 to 90 | 9 mg | Escalation |
| 91 onward | 25 mg | Maintenance |
- Expect the most trouble around each step up. For the injection, the label says stomach side effects were reported most often during dose escalation.[1] The tablet steps up at day 31, day 61 and day 91.
- A step can wait. The label says that if a dose is not tolerated during escalation, the prescriber can consider delaying the next increase.[1]
- If 25 mg is too much, the label suggests considering a switch to the 1.7 mg weekly injection.[1]
- Side effects can outlast the last pill. The label estimates that semaglutide takes 5 to 7 weeks to clear once the final 25 mg tablet is taken.[1]
The full ladder, including what happens after a missed day, is on the Wegovy dose ladder cheat sheet.
How to take the Wegovy pill to avoid avoidable upset
The pill is absorbed mainly in the stomach, and only about 1% to 2% of each dose reaches the blood, so the way you take it matters more than it does for most tablets.[1] The label's rules:
- Each morning, before any food, swallow one tablet with a small amount of plain water, 4 ounces at most. Coffee and juice do not count as water.[1]
- Keep the tablet intact: no splitting, crushing, chewing or dissolving.[1]
- Hold off on breakfast, other drinks and any other pills for 30 minutes or more.[1]
- One tablet a day is the ceiling. Missed a morning? Let it go and resume the next day.[1]
Store the bottle at room temperature, 68°F to 77°F, and keep the tablets in their original bottle to protect them from moisture.[1] The injection's refrigeration rules are different; see Wegovy storage.
Serious Wegovy pill side effects and warnings
The tablet carries the same boxed warning and the same warnings as the injection, because it is the same drug.[1]
- Thyroid C-cell tumors (boxed warning). Semaglutide caused these tumors in rodents; whether it does in people is unknown. It is not for anyone who has had medullary thyroid carcinoma, has a close relative who has, or has MEN 2. Report a neck lump, trouble swallowing, shortness of breath or lasting hoarseness.[1]
- Pancreatitis. Persistent severe stomach pain, sometimes spreading to the back, with or without vomiting. Stop the drug and get checked.[1] More in GLP-1 pancreatitis and gallbladder risk.
- Gallbladder disease. Gallstones were reported in 2.5% on the tablet and 1% on placebo.[1]
- Dehydration and kidney injury. Heavy vomiting or diarrhea can dry you out; the label ties most kidney-injury reports to that.[1]
- Low blood sugar, a risk that rises on top of insulin or a sulfonylurea.[1]
- Faster resting heart rate, and serious allergic reactions.[1]
- Surgery and sedation. Tell whoever is sedating you that you take it, because it slows stomach emptying.[1]
Compounded 'oral semaglutide' is not the Wegovy pill
Many telehealth sellers offer compounded semaglutide as tablets, dissolving tablets or drops. These are not Wegovy. They are made by compounding pharmacies, and the FDA says compounded drugs lack FDA approval: the agency does not check them for safety, effectiveness or quality before sale.[3] The Wegovy tablet is made with a specific absorption enhancer (SNAC), and the label's side-effect figures describe that product, not a compounded one.[1] For the differences in full, see compounded vs. brand semaglutide. To compare sellers who prescribe the branded drug, see brand semaglutide providers, and for the pill's price at each dose, what the Wegovy pill costs.
Frequently Asked Questions
References
- 1.Novo Nordisk Inc. WEGOVY (semaglutide) injection and WEGOVY (semaglutide) tablets: US Prescribing Information (revised June 2026), Sections 2, 5, 6.1, 7.2, 8.2, 12.3 and 16 DailyMed (FDA-approved labeling). 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
- 2.Wharton S, Lingvay I, Bogdanski P, et al.; OASIS 4 Study Group Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity N Engl J Med. 2025. PMID: 40934115.
- 3.US Food and Drug Administration. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss FDA. 2026. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss
- 4.Novo Nordisk. FDA approves Novo Nordisk's Wegovy pill, the first and only oral GLP-1 for weight loss in adults PR Newswire. 2025. https://www.prnewswire.com/news-releases/fda-approves-novo-nordisks-wegovy-pill-the-first-and-only-oral-glp-1-for-weight-loss-in-adults-302648344.html
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Where to get semaglutide (Ozempic / Wegovy) online, safely: sellers our editors have checked
These are telehealth sellers our editors have checked. For each one we hold a price, the form the drug comes in, and the states it reaches.
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Bodybuilding Health+
Seeing what it charges before you answer any medical questions
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Starting below a standard dose, with microdose tiers
From $149/mo
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Compounded semaglutide at $249/month
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