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Side effects that some people using semaglutide experience include: Gastrointestinal issues, such as nausea, vomiting, diarrhea, constipation, heartburn, burping and stomach pains Less often, the following more serious side effects can also occur: Fatigue Rash and itching Swelling of the legs and hands Vision changes Fainting or dizziness Allergic reactions Higher risk for pancreatitis (inflammation of the pancreas) Hypoglycemia (especially when combined with other diabetes medications) Possible risk of increased heart rate and thyroid tumors, including cancer (a warning required by the FDA) If you experience any of these symptoms, call your doctor right away and get emergency medical treatment if the symptoms become severe