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Patients should contact their GP or diabetes care team if they experience: Persistent or worsening reflux symptoms despite implementing dietary and lifestyle changes Difficulty swallowing (dysphagia) or pain when swallowing (odynophagia), which may indicate oesophageal complications Unintentional weight loss beyond that expected from Ozempic's appetite-suppressing effects Persistent nausea or vomiting , particularly if unable to tolerate adequate fluid or food intake Symptoms of gastrointestinal bleeding , including black, tarry stools or vomiting blood or coffee-ground material Iron-deficiency anaemia , which may indicate chronic blood loss Red flag symptoms requiring urgent or emergency assessment include: Severe, persistent abdominal pain, especially if radiating to the back (may indicate pancreatitis stop Ozempic immediately and seek urgent medical attention) Signs of dehydration due to inability to keep fluids down Chest pain that could potentially be cardiac in origin (always err on the side of caution) Your healthcare provider may need to review your Ozempic dose or consider temporarily reducing it to assess whether symptoms improve

Journal of Asthma and Allergy

Hair shedding several months into rapid loss is usually telogen effluvium, the temporary response seen after many large weight changes rather than direct drug toxicity

Hepatology 51 , 329335