Does Ozempic make you itch? Whilst itching is not amongst the most common side effects of Ozempic (semaglutide), some patients do experience pruritus during treatment. Ozempic is a GLP-1 receptor agonist licensed in the UK for type 2 diabetes mellitus. Injection site reactions, including localised itching, are recognised as common adverse effects, affecting between 1 in 10 and 1 in 100 people. Generalised itching is less frequently reported but may occur as part of a hypersensitivity reaction. Understanding when itching warrants medical attention and how to manage symptoms is essential for safe and effective diabetes care.
Quick Answer: Ozempic can cause itching, most commonly as localised injection site reactions affecting 1 in 10 to 1 in 100 people, though generalised itching may occur as part of hypersensitivity reactions.
Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for the treatment of type 2 diabetes mellitus. Whilst itching (pruritus) is not listed amongst the most common adverse effects of Ozempic in the Summary of Product Characteristics (SmPC) approved by the Medicines and Healthcare products Regulatory Agency (MHRA), some patients do report experiencing itching during treatment.
The mechanism by which Ozempic might cause itching is not fully established. Injection site reactions are recognised adverse effects and can include redness, swelling, and localised itching at the site where the subcutaneous injection is administered. According to the Ozempic SmPC, injection site reactions are classified as 'common' adverse effects (affecting between 1 in 10 and 1 in 100 people). These reactions are typically mild and self-limiting, resolving within a few days without specific intervention.
Generalised itching (affecting areas beyond the injection site) is less commonly reported but may occur as part of a hypersensitivity reaction. Allergic responses to semaglutide or excipients in the formulation can manifest with pruritus, urticaria (hives), or more serious symptoms. While generalised pruritus is not specifically listed as a common adverse reaction in the Ozempic SmPC, hypersensitivity reactions are recognised class effects of GLP-1 receptor agonists.
It's important to note that itching with jaundice (yellowing of the skin/eyes), dark urine, or pale stools could indicate cholestasis or gallbladder disease, which are known risks with GLP-1 receptor agonists. These symptoms require urgent medical assessment.
Patients experiencing itching should consider the timing of symptom onset relative to injection, the location and severity of itching, and any accompanying symptoms such as rash, swelling, or difficulty breathing. Documenting these details can assist healthcare professionals in determining whether the itching is related to Ozempic and whether further investigation or treatment modification is warranted.
Whilst mild, localised itching at the injection site may not require immediate medical attention, certain features warrant prompt evaluation by a healthcare professional. Patients should contact their GP or diabetes specialist nurse urgently if they experience:
Widespread or severe itching that affects multiple areas of the body or significantly impacts quality of life and sleep
Accompanying rash, hives (urticaria), or skin changes such as blistering, peeling, or discolouration
Swelling of the face, lips, tongue, or throat, which may indicate angioedema
Difficulty breathing, wheezing, or chest tightness, suggesting a potential anaphylactic reaction
Persistent itching at injection sites that does not resolve within a few days or worsens over time
Signs of infection at injection sites, including increased warmth, pus, or spreading redness
Itching with yellowing of the skin or eyes (jaundice), dark urine, pale stools, or right upper abdominal pain, which could indicate gallbladder or liver problems
Anaphylaxis is a rare but serious hypersensitivity reaction that requires immediate emergency care. Patients experiencing symptoms such as rapid onset of widespread itching, facial swelling, breathing difficulties, dizziness, or collapse should call 999 or attend the nearest Accident & Emergency department without delay. Anaphylaxis is a medical emergency and requires prompt administration of intramuscular adrenaline.
For urgent but non-emergency concerns, patients can contact NHS 111 for advice. For less urgent concerns, patients should arrange a routine appointment with their GP or diabetes care team. A thorough clinical assessment can help determine whether the itching is related to Ozempic, another medication, an underlying skin condition, or an unrelated cause.
Patients should not abruptly stop Ozempic without medical guidance, as this may affect glycaemic control. If anaphylaxis or serious hypersensitivity is suspected, patients should not re-inject Ozempic until they have been clinically reviewed.
Patients are encouraged to report any suspected adverse reactions to Ozempic via the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk or the Yellow Card app).
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Start HereFor patients experiencing mild, localised itching at injection sites, several practical measures may provide relief and reduce the likelihood of recurrence. Proper injection technique is fundamental: patients should ensure they rotate injection sites regularly (abdomen, thigh, or upper arm) to avoid repeated trauma to the same area. The skin should be clean and dry before injection, and the needle should be inserted at the correct angle as demonstrated by a diabetes specialist nurse. Patients should use single-use needles and dispose of them safely in an approved sharps container, following local NHS guidance.
Topical measures can help alleviate localised itching. Applying a cool compress or ice pack wrapped in a clean cloth to the affected area for 10–15 minutes may reduce inflammation and provide symptomatic relief. Over-the-counter emollients or moisturisers can be applied to dry or irritated skin, though patients should avoid applying creams immediately before injection to prevent contamination. If itching is accompanied by mild redness or swelling, a mild topical corticosteroid cream (such as hydrocortisone 1%) may be considered for short-term use (up to 7 days) on intact skin, but patients should consult a pharmacist or GP before use, particularly if symptoms persist beyond a few days.
For generalised itching, identifying and addressing potential triggers is important. Patients should review any new medications, skincare products, or dietary changes that coincide with symptom onset. Non-sedating oral antihistamines (such as cetirizine or loratadine) may provide relief if itching is thought to be allergic in nature. Patients should check for potential interactions with other medications and be aware that even non-sedating antihistamines can cause drowsiness in some people. Patients should seek advice from a healthcare professional before starting any new medication, particularly if they have other medical conditions or take multiple medications.
Avoiding known irritants is advisable. Patients should wear loose, breathable clothing, avoid hot baths or showers that may exacerbate itching, and use fragrance-free, hypoallergenic skincare products. Keeping the skin well-hydrated with regular use of emollients can help maintain the skin barrier and reduce susceptibility to irritation.
If itching persists despite these measures, or if it significantly affects daily activities or sleep, patients should contact their healthcare team for further assessment. Any changes to Ozempic dosing or switching to alternative treatments must be clinician-led with appropriate monitoring of glycaemic control.
If itching attributed to Ozempic persists despite conservative management, or if a hypersensitivity reaction is confirmed, healthcare professionals may consider alternative therapeutic options to maintain effective diabetes management whilst minimising adverse effects. The choice of alternative treatment depends on the patient's overall clinical profile, including glycaemic control, cardiovascular risk, renal function, and treatment goals, in line with NICE guideline NG28 (Type 2 diabetes in adults: management).
Other GLP-1 receptor agonists may be considered, as individual patients can exhibit different tolerability profiles to structurally similar medications. Alternatives include dulaglutide (Trulicity), liraglutide (Victoza), or exenatide (Byetta, Bydureon). Whilst these agents share a similar mechanism of action, differences in formulation, excipients, or pharmacokinetic properties may result in improved tolerability for some patients. However, cross-reactivity is possible, and any switch should be undertaken under specialist supervision with careful monitoring for recurrence of symptoms.
For patients in whom GLP-1 receptor agonists are not suitable, NICE NG28 recommends several alternative classes of glucose-lowering therapy. SGLT2 inhibitors (such as empagliflozin, dapagliflozin, or canagliflozin) are particularly recommended for patients with established cardiovascular disease, heart failure, or chronic kidney disease. DPP-4 inhibitors (such as sitagliptin or linagliptin) provide a well-tolerated oral option with a low risk of hypoglycaemia, though their glucose-lowering efficacy is generally more modest than GLP-1 receptor agonists.
Insulin therapy remains a cornerstone of diabetes management and may be initiated or intensified if oral agents and non-insulin injectables are insufficient or poorly tolerated. Basal insulin analogues (such as insulin glargine or insulin degludec) provide once-daily dosing with a lower risk of hypoglycaemia compared to older insulin formulations. For patients requiring more intensive glycaemic control, basal-bolus regimens or premixed insulins may be appropriate.
Metformin remains the first-line oral agent for most patients with type 2 diabetes, unless contraindicated, and should be continued alongside any alternative therapy unless there are specific reasons for discontinuation, as recommended by NICE. Sulfonylureas (such as gliclazide) may be considered in some patients, though they carry a higher risk of hypoglycaemia and weight gain compared to newer agents.
Any change in diabetes medication should be individualised, taking into account the patient's preferences, comorbidities, and treatment objectives. Regular follow-up with the diabetes care team, including monitoring of HbA1c, renal function, and cardiovascular risk factors, is essential to ensure that glycaemic targets are achieved and that any new treatment is well tolerated. Patients should be encouraged to report any new or persistent symptoms promptly to facilitate timely adjustment of their treatment plan.
Localised itching at injection sites is a recognised common adverse effect of Ozempic, affecting between 1 in 10 and 1 in 100 people. Generalised itching is less commonly reported but may occur as part of hypersensitivity reactions.
Seek urgent medical advice if you experience widespread itching, accompanying rash or hives, facial swelling, breathing difficulties, or itching with jaundice (yellowing of skin or eyes). Call 999 if you develop symptoms of anaphylaxis including rapid onset itching, facial swelling, and breathing problems.
Rotate injection sites regularly, apply cool compresses for 10–15 minutes, use emollients on dry skin, and ensure proper injection technique. If symptoms persist beyond a few days or worsen, consult your GP or diabetes specialist nurse for further assessment.
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