GLP-1 nausea: how common it is, and keeping track of it
Nausea is the most commonly reported side effect of semaglutide and tirzepatide in the weight-loss trials, mostly while the dose was being increased. What the labels report, and how to keep a record of yours.
How common it is
In the trials behind Wegovy, 44% of people on semaglutide 2.4 mg reported nausea, against 16% on placebo. In the trials behind Zepbound, it was 25% to 29% across the tirzepatide doses, against 8% on placebo.
Nausea is the most frequently reported reaction on both labels.
| Placebo | On the drug | |
|---|---|---|
| Wegovy (semaglutide 2.4 mg) | 16% | 44% |
| Zepbound (tirzepatide 5 / 10 / 15 mg) | 8% | 25% / 29% / 28% |
Share of trial participants reporting it, from each label's adverse reactions table.
When it happens
The Wegovy label says gastrointestinal reactions "were most frequently reported during dosage escalation". The Zepbound label says the majority of nausea, vomiting and diarrhea "occurred during dose escalation and decreased over time".
In the trials, 1.8% of people on Wegovy stopped because of nausea (0.2% on placebo).
When the label says to call
Both labels tell people to contact their healthcare provider if stomach problems are severe or won't go away. Wegovy's Medication Guide adds: "It is important for you to drink fluids to help reduce your chance of dehydration. Tell your healthcare provider right away if you have nausea, vomiting, or diarrhea that does not go away." Persistent or severe abdominal pain, sometimes reaching through to the back, is listed as a possible sign of pancreatitis.
Keeping a record
A note on the days around each dose (when it started, how strong, how long) gives you and your prescriber something concrete to look at, especially across a dose change. In PepMe, write it in the Journal note with your sleep, energy, mood and pain ratings; it sits on the same timeline as your logged doses.
Sources
- Wegovy (semaglutide) prescribing information, revised 08/2025 (FDA)
- Zepbound (tirzepatide) prescribing information, revised 08/2026 (Eli Lilly)
Trial figures describe groups of people, not what will happen to you. PepMe keeps a record of what you log; it never suggests what to take. Talk to your prescriber about anything here.