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The notable exception to this is saxagliptin
~16% on placebo in STEP trials Typical onset / first 1 to 4 weeks after starting or increasing dose Usual duration / self-limiting within 2 to 4 weeks at each dose tier Severity in trials / mostly mild to moderate (grade 1 or 2) Discontinuation rate / ~1.5% of STEP-1 participants stopped due to GI events Mechanism / GLP-1 receptor activation slows gastric emptying and alters intestinal motility Red-flag signs / blood in stool, dehydration, fever, or persistent symptoms beyond 72 hours First-line management / oral rehydration, smaller meals, temporary low-fat diet Dose adjustment / physician may pause dose escalation or reduce to prior tolerated dose Why Wegovy Causes Diarrhea Semaglutide 2.4 mg activates GLP-1 receptors throughout the gastrointestinal tract, not just in the pancreas
Strength begins returning for movements that were previously problematic
& Anderson, R
