GLP-1 Medications Compared: Side Effects of Every FDA-Approved Option
GLP-1 medications compared: side effects of every FDA-approved option
Wegovy, the Wegovy pill, Zepbound, Foundayo, Saxenda, Ozempic and Mounjaro, side by side. How each is taken, and how often the common side effects show up, straight from the labels.
Are the side effects the same for every GLP-1? Mostly, yes. They all list the same main side effects (nausea, vomiting, diarrhea, constipation) and the same safety warnings. What differs is how often they happen: it depends on the drug, the dose, and how quickly the dose goes up.
Weight-loss GLP-1 medications
Percent of people in the main trials who reported each side effect at the doses studied. Placebo rates are shown so you can see how much is the medication.
| Medication | How it’s taken | Nausea | Vomiting | Diarrhea | Constipation | Placebo (N / V / D / C) | Notes |
|---|---|---|---|---|---|---|---|
| Wegovysemaglutide · Novo Nordisk | Injection, once weekly | 44% | 24% | 30% | 24% | 16 / 6 / 16 / 11% | 2.4 mg dose. A higher 7.2 mg dose was approved in March 2026. |
| Wegovy pilloral semaglutide 25 mg · Novo Nordisk | Pill, once daily, on an empty stomach | See note | See note | See note | See note | n/a | Approved December 2025. In the OASIS 4 trial, 74% had a GI side effect vs 42% on placebo; nausea, vomiting and constipation were most common. |
| Zepboundtirzepatide (GIP + GLP-1) · Eli Lilly | Injection, once weekly | 25–33% | 8–12% | 19–23% | 12–17% | 10 / 2 / 7 / 6% | Range covers the 5, 10 and 15 mg doses (SURMOUNT-1). |
| Foundayoorforglipron · Eli Lilly | Pill, once daily, with or without food | 26–35% | 13–24% | 21–25% | 20–27% | 10 / 4 / 11 / 9% | Approved April 2026. First non-peptide GLP-1 pill. Range covers 5.5 to 17.2 mg. |
| Saxenda (and generic liraglutide)liraglutide 3 mg · Novo Nordisk; generic since 2025 | Injection, once daily | 39% | 16% | 21% | 19% | 14 / 4 / 10 / 9% | Older daily option. Injection-site reactions in 14%. |
These numbers come from separate trials, not head-to-head comparisons, so they can’t rank one drug over another.
Diabetes GLP-1 medications
Same medicine class, often at lower doses. Some are prescribed off-label for weight.
| Medication | How it’s taken | Common side effects in the label |
|---|---|---|
| Ozempicsemaglutide | Injection, once weekly | Nausea 16–20%, diarrhea about 9% (0.5 to 1 mg). |
| Mounjarotirzepatide | Injection, once weekly | Nausea 12–18%, diarrhea 12–17%, vomiting 5–9%, constipation 6–7%. |
| Rybelsusoral semaglutide | Pill, once daily, on an empty stomach | Same class pattern: GI effects most common. See the label. |
| Trulicitydulaglutide | Injection, once weekly | Same class pattern: GI effects most common. See the label. |
| Victoza (and generic liraglutide)liraglutide | Injection, once daily | Same class pattern: GI effects most common. See the label. |
What actually changes from one GLP-1 to another
Dose and pace
Higher doses and faster dose increases bring more stomach side effects. Most labels raise the dose every 4 weeks for that reason.
Pill vs. injection
Injections can cause injection-site reactions. The Wegovy pill must be taken on an empty stomach; Foundayo can be taken with or without food.
Daily vs. weekly
Daily options (Saxenda, Foundayo, Wegovy pill) and weekly shots (Wegovy, Zepbound) differ in schedule, not in the type of side effects.
What about compounded semaglutide or tirzepatide?
Compounded versions are not FDA-approved, so the FDA has not reviewed them for safety, quality or effectiveness, and doses may not match the branded products. Ask your prescriber where your medication comes from.
Call your prescriber right away if
- You can’t keep fluids down, or vomiting won’t stop
- Severe stomach pain, which may spread to your back
- Signs of dehydration: dizziness, very dark urine, very little urine
- Yellowing skin or eyes, or pain in the upper right belly
Common questions
Do all GLP-1 medications have the same side effects?
Mostly the same kind, at different rates. Every GLP-1 medication lists stomach and gut effects as the most common side effects, and they share the same safety warnings. What changes is how often they show up, which depends on the drug, the dose and how fast the dose is raised.
Which GLP-1 has the fewest side effects?
There is no fair ranking from these numbers. Each rate comes from a different trial with different people and doses. Lower doses usually cause fewer side effects, and most stomach side effects happen while the dose is being raised. Your prescriber can help match a medication and pace to you.
Are GLP-1 pills easier on the stomach than injections?
Not necessarily. Pills avoid injection-site reactions, but the stomach side effects are similar. The Wegovy pill and Foundayo both list nausea, vomiting, diarrhea and constipation as common.
Is Zepbound different from Wegovy?
Zepbound (tirzepatide) acts on two hormone receptors, GIP and GLP-1. Wegovy (semaglutide) acts on GLP-1 only. Both list the same main side effects. Their label rates differ, but they come from separate trials.
Are compounded semaglutide or tirzepatide the same?
No. Compounded versions are not FDA-approved, so the FDA has not reviewed them for safety, quality or effectiveness. Dosing can also differ from the branded products. Talk to your prescriber about where your medication comes from.
When should I call my prescriber?
Call if you can’t keep fluids down, have severe stomach pain that may spread to your back, signs of dehydration, yellowing skin or eyes, or any symptom that feels severe or unusual.
Sources
- Wegovy prescribing information (DailyMed)
- Zepbound GI adverse events, SURMOUNT-1 (Lilly Medical)
- Zepbound prescribing information (FDA)
- Foundayo prescribing information (Lilly)
- Saxenda prescribing information, Table 2
- OASIS 4 trial summary, oral semaglutide 25 mg (ACC)
- FDA approves Wegovy pill (Healio)
- FDA approves higher-dose Wegovy (Boston Globe)
- Ozempic prescribing information (DrugCentral)
- Mounjaro common adverse events (Lilly Medical)
- Drugs@FDA database
Rates are from FDA prescribing information or the pivotal trial for each product, at the doses listed. Labels change; check Drugs@FDA for the latest version. This page is information, not medical advice.
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