Common Side Effects (STEP 1 Trial)
The following side effects were reported in the STEP 1 clinical trial. Most are gastrointestinal and typically improve during the first 4–8 weeks of treatment.
The most common side effect. Usually mild and improves with time.
Typically transient during dose escalation.
More common during dose increases.
Increasing fibre and fluid intake can help.
Usually mild. Severe pain needs urgent assessment.
May relate to dietary changes and hydration.
Can occur during dietary adjustment.
Indigestion. Eating smaller meals helps.
Serious Side Effects
Acute pancreatitis
Severe persistent abdominal pain. Stop medication and seek immediate medical help.
Gallbladder disease
Gallstones and cholecystitis reported at higher rates. Watch for upper right abdominal pain.
Kidney injury
Can occur due to dehydration from severe GI symptoms. Stay hydrated.
Thyroid C-cell tumours
Observed in animal studies. Contraindicated in patients with personal/family history of MTC or MEN2.
Mental health changes
MHRA monitoring reports of mood changes. Report any concerns to your prescriber.
When to Seek Help
Call 999 for severe abdominal pain, allergic reactions, severe dehydration, or thoughts of self-harm. Contact your prescriber or NHS 111 for persistent vomiting, mood changes, or jaundice.
Managing Side Effects
- Eat smaller, more frequent meals
- Avoid greasy, fried, or heavy foods during dose escalation
- Drink at least 2 litres of water daily
- Eat slowly and stop when satisfied
- Ginger tea may help with nausea
- Ask your prescriber about slowing the titration if side effects are severe