Side effects, dosing and using the pen.

What the approved New Zealand product information says. Your prescriber decides what applies to you.

This is a summary of the approved New Zealand product information, not a substitute for the leaflet in your pack or for what your prescriber tells you. glp.nz is not a substitute for a clinician and gives no medical advice.

When to get help

Signs that need a doctor

Contact a doctor straight away, or call 111 if severe

  • Severe or persistent abdominal pain, especially pain radiating to the back. This can indicate pancreatitis
  • Pain in the upper right abdomen with nausea, fever or yellowing of the skin or eyes, which can indicate gallbladder problems
  • Signs of an allergic reaction: swelling of the face, lips or throat, difficulty breathing, a sudden rash
  • Vomiting or diarrhoea severe enough that you cannot keep fluids down, or you become lightheaded and stop passing urine, which is dehydration
  • Sudden changes to your vision
  • A racing heartbeat with no clear cause

For anything milder, contact whoever prescribed for you before changing or stopping the medicine yourself. Healthline is free on 0800 611 116, and your pharmacist can advise without an appointment.

What to expect

Common side effects

Most are gastrointestinal, most appear while the dose is increasing, and most settle. They are the reason the dose is stepped up slowly rather than started at full strength.

Very common

More than 1 in 10 people
  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Abdominal pain
  • Headache
  • Fatigue

Less common, but reported

Fewer than 1 in 10
  • Dizziness, mainly while the dose is increasing
  • Reactions at the injection site
  • Gallstones and gallbladder inflammation
  • Hair thinning
  • Changes in taste
  • Worsening of existing diabetic eye disease

In the SELECT trial of semaglutide, 16.6% of participants stopped treatment because of side effects, against 8.2% on placebo. Roughly one person in six found them intolerable over four years. Dizziness during dose escalation is the reason the data sheet advises caution with driving in that period.

Practical

Managing the common ones

1

Nausea

Eating smaller portions, stopping when full, and avoiding rich or greasy food are what the product information suggests. Nausea usually eases after the first few weeks at a given dose.

2

Vomiting or diarrhoea

The main risk is dehydration. Keep fluids up. If you cannot keep fluids down, that is a reason to call someone rather than wait it out.

3

Constipation

Fluid, fibre and movement are the usual first steps. Your pharmacist can suggest something over the counter if it persists.

4

If side effects are stopping you

Talk to your prescriber before changing anything. They may hold you at the same dose for longer, or step up more slowly, rather than moving to the next strength on schedule.

Approved schedules

How the dose is stepped up

The schedules in the approved New Zealand product information. Your prescriber may vary them, commonly by holding a dose longer if side effects are difficult.

Wegovy · semaglutide, once weeklyDuration
Weeks 1–40.25mg4 weeks
Weeks 5–80.5mg4 weeks
Weeks 9–121.0mg4 weeks
Weeks 13–161.7mg4 weeks
Week 17 onward2.4mgMaintenance
Mounjaro · tirzepatide, once weeklyDuration
Weeks 1–42.5mg4 weeks
Week 5 onward5mgMaintenance dose, or step up further
If increasing7.5mg, 10mg, 12.5mg, 15mgAt least 4 weeks at each step

Each strength is a separate pen, which is why the price changes as you move up. Current prices for every strength.

Using the pen

Storage, injecting, missed doses

1

Storage

In the fridge between 2°C and 8°C. Do not freeze, and do not use a pen that has been frozen. Keep the cap on and out of reach of children. Check the expiry date on the pen.

2

When to inject

Once a week, the same day each week, at any time of day, with or without food. If you need to change which day, the product information sets a minimum gap between doses. Check the leaflet or ask your pharmacist.

3

Where to inject

Under the skin of the abdomen, thigh or upper arm. Rotate the site each week. Not into a vein or muscle.

4

A missed dose

The CMI says to take it as soon as you remember if it has been only a few days, then continue on your usual day. If your next scheduled dose is close, skip the missed one rather than doubling up. The exact window differs between products, so check your leaflet.

5

Needles and sharing

Never share a pen, even with a new needle. Used needles go in a sharps container. Your pharmacy can supply one and dispose of it.

6

Travelling

Tell your doctor or pharmacist before you travel so you can plan cold storage. Some pharmacies charge a cold-chain handling fee on delivery for the same reason.

Not for everyone

When these medicines are avoided

The product information advises against use in pregnancy and breastfeeding: semaglutide passed into milk in animal studies and a risk to a breastfed child cannot be excluded. It should not be used by anyone who has had an allergic reaction to the active ingredient, and should not be combined with another GLP-1 medicine. Tell your prescriber about any other conditions or medicines, there are specific cautions around pancreatitis, gallbladder disease, diabetic eye disease and thyroid history that need a clinician's judgement.