Can You Overdose on Ozempic or Wegovy? What to Know About the Symptoms

A close up of Ozempic injector.
Poison control centers are seeing an uptick in calls related to Ozempic and Wegovy. myskin/Shutterstock
  • Poison control centers are reporting a surge in calls about the drug semaglutide (Ozempic, Wegovy).
  • Accidental overdoses of the drug are likely due to compounded versions of the drug, which are not FDA-approved.
  • Signs and symptoms of a semaglutide overdose include unremitting nausea, headache, and vomiting.

Accidental overdoses of the popular diabetes and obesity drug semaglutide, sold under the trade names Ozempic and Wegovy, are on the rise, according to reports. Experts say compounded or adulterated versions of the drug are likely the culprit. 

The surge has come to light through national poison control data, with call centers reporting a dramatic uptick in the number of calls made about the drug semaglutide. According to a report from CNN, the American Association of Poison Control Centers, which aggregates data from state poison control centers, found from January to November, there were “nearly 3,000 calls involving semaglutide, an increase of more than 15-fold since 2019. In 94% of calls, this medication was the only substance reported.”

Individuals report symptoms associated with known side effects of semaglutide, such as nausea, vomiting, and diarrhea. However, in some cases, their symptoms are more extreme, with some requiring hospitalization.

Poison control centers have taken notice and reported their findings.

This year, Dr. Joseph Lambson, PharmD, Director of the New Mexico Poison and Drug Information Center, and an Assistant Professor at the University of New Mexico College of Pharmacy, authored a case report published in the Journal of the American Pharmacists Association describing his experiences with semaglutide overdose while working at the Utah poison control center.

“What really sparked our interest in doing this research is that our specialists in the call center were getting calls about exposures to semaglutide that didn’t quite fit up with what we would expect with the FDA-approved formulations,” Lambson told Healthline.

How people took 10 times the recommended amount of semaglutide

The report documents two individuals who had taken 10 times their intended dosage. In one instance, a 50-year-old man with type 2 diabetes who had obtained semaglutide from a compounding pharmacy accidentally injected himself with 0.5 milliliter of semaglutide instead of 0.05 milliliter. He reported 2 days of vomiting and 1 week of ongoing nausea but didn’t require hospital care. 

In another case, a 37-year-old woman with obesity administered herself with 1 milliliter of semaglutide when the intended dose was 0.1 milliliter. She reported a persistent headache, weakness, and fatigue, but did not require hospitalization. She too, got the drug through a compounding pharmacy.

A third individual, a 33-year-old woman, reported going to the emergency room with nausea, vomiting, and abdominal after receiving what she believed to be semaglutide at an aesthetic spa. It is unclear where the spa got the drug.

Curiously, Lambson found that callers would report their dosage in milliliters, not milligrams. FDA-approved formulations for semaglutide as Ozempic and Wegovy use milligrams and are sold as self-administered injectable pens with a set dosage.

“So, most of these pens will administer only one dose, and you click the pen into action. You inject it like an EpiPen, and you have your dose. But these compounded formulations, what makes them more likely to cause an overdose is that they’re being dispensed commonly in a vial and accompanied with that a needle and syringe,” said Lambson.

What are compounded drugs?

A compounded drug is a mixed or altered version of ingredients to make a medication that is “tailored to the needs of an individual patient,” according to the FDA. People may need a compounded drug if, for example, they are supposed to take a drug in pill form but are unable to take a pill or if they are allergic to a compound in an FDA-approved drug and need a formulation without that compound.

While they are legal, these drugs are not approved by the FDA.

Therefore, they do not come with the same assurances of testing, efficacy, and testing as approved pharmaceuticals. 

“We have no idea what’s in compounded semaglutide,” Dr. Caroline Apovian, a Professor of Medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, told Healthline. According to Apovian, the drugs can be made in different countries without the same safety and manufacturing requirements that are required for FDA-approved drugs.

She also questions whether individuals accessing compounded semaglutide are even seeing doctors to receive a prescription.

“I’m worried that this is stuff that they got illicitly through a compounding pharmacy where they really didn’t meet the physician or nurse practitioner. It’s usually not even a doctor who’s doing this,” she said.

Lambson adds that you should always go through appropriate channels, like seeing your healthcare provider, to obtain only FDA-approved versions of semaglutide for its prescribed uses, which are type 2 diabetes and obesity.

Warnings about unregulated semaglutide

In October 2023, the FDA issued a letter to the National Association of Boards of Pharmacy on the subject of compounded semaglutide, especially semaglutide salts (semaglutide sodium or semaglutide acetate), writing, “There are currently no FDA-approved products containing a semaglutide salt…as an active ingredient…FDA is not aware of information regarding the chemical and pharmacologic properties of the semaglutide salts (e.g., semaglutide sodium or semaglutide acetate) or whether the semaglutide salts have the same safety or efficacy profile as semaglutide.”

Novo Nordisk, the Danish pharmaceutical company that manufactures Ozempic and Wegovy, is also cracking down on compounded semaglutide. In a press release from November 2023, the company announced that they were bringing lawsuits against two compounding pharmacies for “selling adulterated and misbranded compounded drugs claiming to contain semaglutide.”

In a statement to Healthline, a Novo Nordisk representative said: 

“To date, Novo Nordisk has filed a total of 12 legal actions against medical spas, weight loss or medical clinics, and compounding pharmacies to cease and desist from false advertising, trademark infringement and unlawful sales of non-FDA approved compounded products claiming to contain semaglutide.  Consistent with our commitment to patient safety, Novo Nordisk will continue to pursue legal action against other entities engaged in similar conduct.”

Signs and symptoms of semaglutide overdose

Semaglutide is associated with serious gastrointestinal side effects in some individuals. The most common side effects include nausea, vomiting, and diarrhea. More serious side effects, some potentially requiring hospitalization, can also occur, such as:

  • Pancreatitis a painful inflammation of the pancreas.
  • Intestinal obstruction (ileus), a serious complication that can be fatal.
  • Gastroparesis slow or delayed emptying of the stomach.

Signs and symptoms of a semaglutide overdose may include these side effects but may be more severe.

“The symptoms that have been most reported to us are pretty consistent with what you would anticipate at a normal dose, but just a little more exaggerated. And so we’re seeing complaints of nausea, vomiting, abdominal pain, cramping, headache, and dizziness,” said Lambson.

If you’re experiencing symptoms that are more severe than what you’ve discussed with your doctor, you should speak with your healthcare provider, call a poison control center, or go to a hospital.

The poison control hotline is available nationwide at 800-222-1222.

The bottom line

Accidental overdoses of the diabetes and obesity drug semaglutide (Ozempic, Wegovy) are on the rise.

Compounded forms of the drug are not FDA-approved and do not carry the same safety and efficacy guarantees.

Signs of a semaglutide overdose include unremitting nausea, headache, vomiting, and diarrhea.

Always obtain semaglutide through a prescription from a licensed healthcare practitioner.

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